Medication Induced Hypotension

[RonaldoResuelto]

I have primary open angle glaucoma. I'm presently using three medications that lower blood pressure -- an alpha blocker (Alfusosin) for prostate, an ace inhibitor (Lisinopril) for my blood pressure, and a beta blocker (Tymolol) in my eyes. My blood pressure tends to be erratic, and I am concerned about the resulting optic perfusion pressure when the BP dips -- particularly at night. Does anyone else have this problem? My optic pressure is under control, but perhaps another eyedrop without the Timilol would lower my optic pressure without contributing to the periodic hypotension.

[Trish_GlaucomaUK Partner]

Hello RonaldoResuelto.

Does your consultant know you hare already taking the other medication for blood pressure? The combination of having to take three must be making you feel very tired and lethargic!

If you haven't advised your consultant of the other medications it is important that you do so. He can then look at an alterative drop to treat your glaucoma that doesn't include a betablocker. Any concerns should always be discussed with your consultant as they want to be kept up to date with any problems you may be experiencing with the medication they have prescribed you.

[RonaldoResuelto in reply to Trish_GlaucomaUK]

Thanks for your reply. I have discussed it on the portal with the technician who then consulted with my glaucoma opthamologist, who doesn't think it's anything to be concerned about. However, other opthamologists (in professional journal published studies and articles) disagree with him. I have an opthamology appointment on the 14th and intend to bring the subject up again. I could vary the time of administration. . I presently take the ace inhibitor (Lisinopril) for my blood pressure at night as recommended. I take the alpha blocker in the morning, and the eyedrops with the beta blocker morning and evening. From my research, the evening dosing of lisinopril seems to be preferred in order to prevent cardiac and kidney problems. and I have CKD. However, I'm not sure night time dosage it is best for my optic nerve. I would like to get 24 hour ambulatory blood pressure monitoring (APBM), but the technician says they don't do that. My GP dpoesn't seem particularly concerned, and she doesn't have an APBM device. I am considering consulting a different opthamologist. I have my first appointment with with a nephrologist on the 24th. Perhaps he can help.