Has anybody noticed an increase in Nocturia since taking CCB's?
I am taking Amlodipine in the evening and noticed an increase in Nocturia. Every morning at about 03:30 I am awakened by a familiar and unwelcome urge....ok, it's very common in over 70's, but it's fairly new to me. Problem is I rarely get back to full sleep after and spend the next few hours tossing and turning until I get up....about 05:30, it's been going on for the last few months....
I know CCB's are implicated in an increase in bladder problems but was wondering if changing the timing would give me a full night's sleep? Anyone have any experience here? I'm thinking of taking them in the morning instead.
I have taken all the normally prescribed actions, nothing to drink after 9pm, limit alcohol etc, but I'm worried this is the future and hoping it's just the CCB's, are there alternatives without the bladder issues?
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tunybgur
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I am on Diltiaziem and Amlodipine both are calcium channel blockers.
I take slow release Diltiaziem at 8 am and 8pm
Amlodipine at 11pm which is also slow release.
I have no problems about needing to go for a pee in the night. My problem is that as I live with Vasospastic angina I am woken with chest pain in the night. Once awake I will sometimes then decide to get up and go to the loo.
I take Amlodipine for hypertension, I used to take Ramipril as well but stopped them as I was concerned about the link between Ace inhibitors and covid 19.
Found out that Rami made little or no difference to my BP, currently averaging 125/70, seems Rami is less effective in over 55's.
Is there any particular reason you can’t take the amlodipine in the morning? As far as I’m aware, it’s not one that has to be taken at night, although I know there is some research to suggest antihypertensives are more effective if taken in the evening. I take a CCB primarily to manage my arrhythmia and find it probably does make me pee a bit more often, but I take it in the morning: doing it that way, I’m alright as long as I go last thing, then wake up most days around 6 with a full bladder.
Edited to add that I’m only a young chap, relatively speaking (36), and used to go longer overnight pre CCB than I do now, but then I’ve also had a bunch of other stuff diagnosed in the last few months, so it’s hard to keep track of what’s causing what sometimes 🤷♂️
I always check to find out the best time to take meds and Amlodipine is supposed to be most efficacious if taken at night, but it didn't mention any bladder issues.
I'm going to change to the morning and see if that makes any difference.
Even if the drug is more effective at night, the disrupted sleep must be far worse for my overall health!
I have the same problem with amlodipine and seems worse since being prescribed bisoprolol for a fib in Dec but I also take atorvastatin and wonder if it's a combination of all 3 may try taking mine am see if that changes anything I have been drinking more water but have cut down of evening so fingers crossed
You could be on to something there....my problem really got worse when I started taking Amlodipine in the evening together with Atorvastatin. I'm also on Bisoprolol but take it in the morning....I also take Flecainide for Afib am and pm.
Taking Amlodipine in the morning now to see if that works....keep you posted.
I have been in Amlodipine and Diltiaziem at different times. Never noticed anything unlike Furosemide when I felt like a peeing gold medallist! I took them in the morning.
Never been prescribed Furosemide, but I hate diuretics. They may be effective at treating hypertension but the effect on your life can be quite severe....have to plan each trip out to make sure you know where all the loos and emergency bushes are! Ok for us blokes, but for the ladies it can very distressing.
I’ve tried taking amlodipine in the morning and the evening, either way I’ve had to have a nocturnal “wandering” about twice a night. Now on finasteride to shrink a greatly enlarged prostate, but after eight months it’s still twice nightly!
That's what I'm worried about, the half life of Amlodipine is quite long so the timing may not make a huge amount of difference, but there must be level changes associated with the timing of the doses?
I'll give it a try but might just end up dehydrating myself.....what's worse, dehydration or disrupted sleep?
The number of side effects from Amlodipine is not far short of 200. Mayo clinic lists most of these. I've had the same sleep problems after my dose of amlodipine was increased.
Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking amlodipine, hydrochlorothiazide, and valsartan. This can lead to very low blood pressure, a serious electrolyte imbalance, or kidney failure.
Drink plenty of water each day while you are taking this medicine.
It does not matter what time of day you take amlodipine (morning or evening) but it is best to take it at the same time every day, when you are most likely to remember, for more even blood levels and therefore effectiveness. Amlodipine is a calcium channel blocker that dilates blood vessels and improves blood flow.5
Yes, there's a connection between calcium channel blockers, nocturia and polyuria - only GPs appear to have been slow to familiarise with the latest research and recognise it. I'm 52 and have almost identical symptoms to the ones you described. My nocturia - and nocturnal polyuria - getting up to pee sometimes up to 8 times in the night (no exaggeration) only started when I started taking Amlodipine - back in February of this year. Incidentally, Amlodipine has also resulted in fluid retention and ankle swelling for me - I can't help wondering if this too is connected to nocturia and polyuria. (The swelling is worse at night and not evident in the morning - so where does that fluid relocate to?)
Like you, my quality of life has deteriorated significantly. I don't know how much longer I can go on like this, with such little sleep, night after night.
I suggested to my GP that Amlodipine was causing nocturia. It was simply too much of a coincidence that the symptoms started occurring literally only a day or two after starting the medication. My GP told me that nocturia was not one of the symptoms associated with Amlodipine. Well, with due respect, I believe he is mistaken. Many medical papers conclude that there is a connection between CCBs and nocturia - notably in men over 40.
Instead of altering my medication, my GP suggested that I needed a prostate examination, which I duly had - carried out by a different GP who admitted that she had little experience in prostate examination, and wasn't 100% certain, but felt sure that I had a slightly enlarged prostrate. As a result of that - and despite having not been for an ultrasound scan of my prostate - a different GP again (a third GP) has prescribed me Tamsulosin to treat what she understands to be a mild case of benign prostatic hyperplasia - which she believes is the root cause of the nocturia.
I'm not convinced. For me, the concurrence of nocturia symptoms with the start of Amlodipine treatment is too much of a coincidence - in fact, I do not believe it is a coincidence. The two are undoubtedly linked.
Just to complicate matters, I am also taking Atorvastatin for high cholesterol and Clopidogrel - a blood-thinning medicine - but I didn't start taking either of those until May, so I don't think they are the cause, although, taken in combination with Amlodipine, perhaps they may be exacerbating the situation.
Like you, I am taking all of these medications at night, just before sleep. I've read that this is the best time to take Amlodipine - although there are at least two medical articles online that absolutely refute this and suggest that not only can taking Amlodipine at night result in nocturia but also affect nocturnal heart rate - which might increase morbidity and mortality.
Can I ask if you have had any success with taking Amlodipine in the morning? Are you still suffering with nocturia?
I'm going to ask my GP if I can swap to Felodipine, also a calcium channel blocker, but not as closely associated as Amlodipine with causing lower urinary tract symptoms like nocturia, polyuria etc.
extremely interesting. I’ve been on Amlodipine 2 days in evening now and have nocturia which I never have had before and hence looking for advice having already considered morning dose instead and I’m a medic! Plus previous sleep was poor but since BP normalised I feel great bar the nocturia.
This post is 3 years old, so things have settled down now.
I have moved my Amlodipine to the morning, and the nocturia has diminished slightly with no real change in BP.
I often get 5-6 hours now without having to get up, but it's still a bit of a problem. This morning I managed 4 hours sleep and had to get up, but I had an early train to get and I never sleep soundly if my mental alarm is on, but I have also got into the habit of taking and hours nap after lunch.
I'm 75 and have increasing problems with reduced flow rate and increased frequency which I have put down to a possible enlarged prostate....isn't growing old fun? I keep meaning to see the doc but the last few years have been difficult for everyone so I don't like to bother them too much.
I am convinced that some meds are critical re timing, I take flecainide for AF and by trial and error have found the correct timing to virtually eliminate AF......
Psychosomatic? possibly, the mind works in mysterious ways, but if it works.....
Slackbladder, I just wanted to say thank you for your comment regarding amlodipine and nocturia. Your experience and mine are so identical that I could have written your comment. Thanks for the added links as well. Like you, my primary care MD was not aware of the connection. Actually, I had been sent to a urologist and, while he had my medication list, he too missed it. From my perspective, I had been on amlodipine 5mg for probably 5 or more years for hypertension. Then had the dosage increased to 10mg daily a couple years ago. The side effects are insidious, and I did not connect the amlodipine. Getting up a couple times a night just seemed like symptoms of normal aging. Then the nocturia escalated to 5 or 6 times a night. I suspected my use of non-sugar sweeteners so I removed them from my diet but this did not help. Then, kind of on a hunch, I reduced the amlodipine back to 5mg daily. Within a few days I was back down to twice a night trips to the bathroom. A week later I cut it back to 2.5mg daily and was down to a single trip nightly at around 5am. After another week I stopped the amlodipine completely and am now sleeping through the night. The amazing thing is I had gotten so use to getting up, my body/mind didn't know how beneficial a good night's sleep is. I've had a few weeks now with good sleep and I feel so much better it's like a new lease on life. BTW: Yes, I'm monitoring my BP daily which has been stable and have set up an appointment with my primary care doctor.
This post is quite old now, but I thought I would update it.
My slow pee turned out to be advanced prostate cancer, I really should have insisted on seeing the doc and having a PSA test earlier but was put off by the difficulty getting past the GP's reception and gave up in the end.
Fortunately there was a men's health charity (CHAPS) that was in my area and offering PSA tests so I went along. It turned out my PSA was sky high, but I had absolutely no other symptoms.
I feel very let down by the NHS, a proper health service would do a lot more screening and testing to prevent or discover health issues in their early stages, I feel we have more of a disease treatment service.....well I'm on a new journey now, one I'm not really looking forward to.
My message to you all is, don't be fobbed off by the health service if you think something's wrong, you must insist on being properly checked out.
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