CHANGING TO TAKING MEDS AT NIGHT

[goldey]

Hi -- I've been reading all over the web all week now that we should be taking our blood pressure meds at night for remarkably better results. I am pretty much convinced. I now take my Bisoprolol, Candesartin and Lipitor at 9 AM, and my Rivaroxiban at 9 PM. How can I safely move the timing of my morning meds to 12 hours later, so I take all my meds at 9 PM? I asked Dr Gupta about this, but haven't heard anything yet. Should we move the pills like a hour a day later each day, thus taking 12 days to change the pills from morning to evening? Or two hours a day to make the change in 6 days? Or can it safely be done faster or slower or better? What have your doctors advised?

[Tyson4ever]

Hi goldey

Others will I am sure offer sound advice re swapping Meds and timing.

I'm just curious about the time you take your Rivaroxaban ( 9pm) do you have a meal that late? as I am sure you are aware the anticoagulant should be taken with food.

[Izzle in reply to Tyson4ever]

As I understand it, rivaroxaban needs to be taken with a meal taking fat. I'm sure others can confirm this requirement.

[wilsond]

I was told this by my GP a few years ago. He said perfectly safe to miss one day then begin evening dose . But....I am not able to advise of course . Blood pressure tablets have a cumulative effect he said,so unlikely to have much effect to miss a dose,unlike some medications like the NOACS.

Best wishes xx

[Jalia in reply to wilsond]

I've heard the same

[BobD Volunteer]

Do you eat your eveing meal at 9PM?. If not please take your rivaroxaban with your evening meal other wise you are not fully protected from stroke. There was a report a couple of months ago about a number of people who stroked because they were not following the instructions and taking the drug with a full meal containing fat. A bulletin went out about this.

The other drugs I don't think it matters much when you take them or if you miss a dose. Plenty of people do especially when going on holiday.

[Hidden]

How do you know what your Bisoprolol is prescribed for - heart rate control or blood pressure ?

My point is I take my blood pressure meds in morning ( Ramipril and Felodopine).

Although I was prescribed Bisoprolol for the morning I had an adverse reaction to it and it was changed to night time dose. No further issues.

My Bisoprolol was prescribed for heart rate control, not blood pressure.

Just curious.

[F-M-C-MM in reply to Hidden]

As one's heart rate can be much lower when asleep, particularly in the early hours of the morning, I would be reluctant to take a rate lowering drug like Bisoprolol particularly in higher doses.

A sudden drop in heart rate could pethaps trigger AFib? Surely the daytime would be safer?

[Hidden in reply to F-M-C-MM]

Bisoprolol holds my resting HR, day and night at 63 to 67 bpm - mostly at 65. Its been doing this for nearly 10 years. Just occasionally the Bisop slips up and my resting HR hits the 80 mark and at other times it drops down to the mid 50's, and on one or two occasions hits 46 bpm. However, these have always been during the day. It still permits my "working/active" HR to rise and hitting 110 to 120 bpm depending what activity I am doing. however, equally the recovery from these high figures is back to 65 within a minute or so. Again my understanding is that its not the high figure that is the issue, it is how well the heart recovers from it and returns to normal - 65 bpm in my case. I have never had issues with low HR while asleep. That said, I've had the reverse - I have gone into AF while sleeping on my left side, with a max. HR of 149 bpm.

I guess Bisop must have some special properties which enable it to be prescribed for blood pressure. Wouldn't know and am not interested in finding out as all my medication is doing what it should and enables me to lead a very active life and maintain a very good QOL, helped by a sensible diet.

At the time I went on Bisoprolol ( taken at day time) I was working full time, shift work, driving buses. In those days my shifts were daytime only, and day time, driving buses was exactly when the adverse features would hit me ------- random and violent nosebleeds. Many naysayers blamed Warfarin, intuitively I knew it was NOT ( poor old Warfarin because of its properties and the fact that people call it a blood thinner - it isn't its an anticoagulant - it seems to often mistakenly get blamed for every bleed under the sun). Proof was changing Bisop to night time. Job done. No nose bleed or any other problems since - nearly 10 years.

Nose bleeds while driving a bus and facing passengers all the time - it was a no brainer to try and stop this, and changing to night time just did it. Magic.

Basically, its an individual call, in cahoots with an individuals GP, of course.

[Alessa69]

Have been taking BP & statins at night for years( read that info somewhere) started on Rivaroxaban a year ago, I take with breakfast , as I usually have fat in a yoghurt or boiled egg. Seems to work well for me, so far so good

[Barb1]

I split my Beta blocker, taking half with my evening meal and half in the morning. If I take it all at night or even half just before lying down, I have dreadful nightmares

[Bluz]

I've never heard that about taking Rivaroxaban with a meal with fat. I was told to take it at suppertime, but I told her I was afraid I would forget to take it (and I never forget my before sleep meds or I can't get to sleep without the melatonin), so my doc said it was OK to take it without a meal. I'm wondering if the rest of you are in the UK, since the information you have seems to vary from what I got here in the US (I've noticed in posts from the UK that y'all seem to have more or different information than we do here - or at least that is my perception).

[Tapanac in reply to Bluz]

Yes I’m in UK and I was told to take my rivaroxaban with my main meal of the day as this one normally contains the most fat. So I took it with my evening meal about 7pm. I have since then changed to apixaban with doesn’t need to be taken with food, but I take it about 8.30 pm.

[Bluz]

I am going to ask to change back to Eliquis (apixaban) because my blood is way too thin on rivaroxaban (xarelto). Any tiny scratch just pours blood. I had a cat scan and knowing I was on blood thinner, they carefully wrapped the needle puncture wound afterwards, especially tightly, yet when leaving, halfway across the lobby, I felt some tickles on my arm, looked down and it was going in several rivulets. I've also had a bladder bleed on it and all my blood work shows a small amount of blood in my urine now. I didn't have quite the problems on Eliquis.