need some answers

I have been on 30 mg of adalat gits a day for the past half a month.
In the first week of taking the new medicine, the blood pressure was relatively normal. It was 135-40/80-85 both before bed time and in the morning before taking med. But a flu came and with the flu my bp went as high as 180-200/90-100. I immediately put back my lodoz(diuretics and beta blocker combined) and the bp had a significant reduction. I used to take lodoz before with 2 tablets of nifedipine(10 mg each taken twice a day) but changed the whole regime upon the doctor's advice 'for convenience' into a single tablet of 30 mg of adalat gits. The curious thing is i used to hear quite a bit of buzz in my ear with the new medication of adalat gits but with the lodoz put back, the buzz sound was greatly reduced too.

Question:

(1)do you think it is a good idea for me to go back to the old arrangement?
(2)for the past years my experience with calcium channel blocker is that the body gets tired of it easily and this medication is not very stable or effective without other med to go with it. should i consider changing to other categories of drugs?
(3)could a high blood pressure like 180/100 be tolerated during the cold in order to give the new med a chance?

When I was much younger, I was able to switch from one med to a different kind of hbp med at will. Now, i somehow 'feel' that once i am out of one med, it is very difficult for me to get back to the same kind of med. I was out of Norvase and could never get back until i realized, after a lot of suffering, that this whole category of pills named calcium channel blockers is not that effective in controlling my bp without being co-administered with beta-blockers. Is such a change permanent because of the passage of time or aging?

Thank you for the reply. I moved to another doctor who is WORSE. So
I came back to the old one who is at least willing to 'work with me'.
I will keep the morning combination intact and gradually move onto an
ACE inhibitor. I was on ace inhibitors initally many years ago but due to its effect on my sexual performance, i moved to calcium channel blocker. Now, my priority is safety rather than performance on bed.

Will enrol in an exercise program and see if things will improve.

I believe the pharmacokinetics are a little different. Regarding this, I am not certain.

Would also suggest you ask your doctor about the 2PD approach:
http://www.heartmdphd.com/wtloss.asp

if you are overweight (BMI greater than 20).

Were you taking any over the counter medications for your flu? Many of they have an effect on your B.P.

I seem to have found the answer to my dilemma.

I was talking to a friend of mine who went through the same experience. His suffering was stopped when he applied a beta blocker named CONCORD to his existing Norvase. This beta blocker is believed to cut out signals sent from hidden tension in our inner mind, according to his doctor's explanation. By the way, his doctor is the family doctor of Li Kar Shing or the wealthiest man in HK. I found out that the beta blocker element in Lodoz named BISOPROLOL FUMARATE is called bi-concord and has the same tranquilizing effect as CONCORD.
That perhaps is why I need this pill (Lodoz) to go with almost any kind of hypertensive medicine administered.

Last 5 months i was going through pain and fear, and I went to see many doctors for answers. At this time, I might have found it. It is 'hidden anxiety or tension' that is pumping up my blood pressure.

I took 10 mg of Zestril this morning with a Lodoz, and an additional
25 mg of betalog at 3pm. By 8:30 this evening, my blood pressure was
130/80! This does have something to do with the nerve calming herb pills i took this morning with the synthetic medication. That is why i am thinking of replacing that 25 mg of betalog with a CONCORD 5.
That latter, i was told, is more sustained releasing.

Ace inhibitors have more data supporting their use for prevention of cardiovascular and renal disease than calcium channel blockers.

If you are having symptoms from the elevated pressures, this should be addressed instead of "tolerated.

Thank you very much for the reply.

I am trying to move out of nifedipine altogether but will do it gradually for fear that my blood pressure may get out of control. The reason is because i suspect it to have a bearing with my tinnitus that took place about 2 months ago at the same time when I moved up my daily intake of nifedipine from 10 to 20 mg, and went worse when I moved into adalat gits which comes with the min 30 mg tablets.

Questions:
(1)Do you have anything to suggest to help alter my above-mentioned combination gradually? How about replacing one tablet of nifedipine with one tablet of plendil 2.5 mg or others?

I know what my doctor will say. He will urge me to stay on and dismiss beta-blocker content in Lodoz(5 mg of bisoprolol fumarate
+6.25 mg of hydrochlorothiazide) as being a possible cause for my poor erection and will ask me to put up with my tinnitus. So I would forget about him first.

(2)I am using a kind of generic fidedipine drugs which are made like adalat retard. It needs to be taken twice a day. But when i moved to adalat gits (30 mg) about half a month ago, i found the new drug (adalat gits) to be totally ineffective without its drug interaction with beta-blocker. The day before I discontinued adalat gits, I took one tablet with a diazide(25 mg hydrochloridethiazide) at 8am in the morning. But 10am, my bp went to 170/100 and this was not the first time! So that was the clear signal i should discontinue adalat gits.
Now I am back to the old combination as mentioned above. Whenever my bp is out of control, i have found a Lodoz to be my life saver! IS
THERE ANY DIFFERENCE BETWEEN ADALAT RETARD AND ADALAT GITS?

(3)I used to be on Norvase for many years until sometime this year I discovered the tablet was getting weaker and weaker. I moved out of it upon a doctor's advice and moved into nifedipine. I tried to get back also upon two doctors' advice but have been unsuccessful. It took me A LOT OF suffering to have finally realized that most calcium channel blockers are not effective to me at all AT THIS TIME without a drug interaction with beta-blockers. And i do find beta-blockers to hiner my erection. But now i place controlling my bp as the first priority and ask my girl friend to 'work harder' when she is with me.
So Dr. Chung, what do you think is the reason that my body no longer responds to calcium channel blockers adminstered either alone or with diurectics(with the exception of indapamide, which caused me headache and constipation)? Is there anything wrong or changed with my body metabolism?

Thank you in advance for your answers, in particular to how you would advise me to alter my current medication intake. By the way, I just had to try by trials and errors to have come up with my current combination, sometimes with doctorS' advises during crisis about 2-3 months ago. Most of the doctorS' advices did not work at all. Most new med combinations prescribed worked for the initial few days and all of a sudden my bp got out of hand. Without that Lodoz, I would have been in serious trouble by now.

I so miss the old days in which I took just one pill a day for my hbp.
Now i have to take med twice and sometimes 3 times daily. Taking bp med is now an issue in my daily life and is getting very unpleasant.

In my experience, hypertension worsens with aging *and* weight gain. Sometimes the latter is more important than the former.