Managing Blood Pressure Medications and Their Side Effects

Antihypertensive medications

Hello Dr.
Lee: I have been diagnosed with oral cancer (but I have never smoked or used betel nut) and have completed treatment.
I would like to ask you about my current use of 40 mg of Dexamethasone enteric-coated tablets.
Recently, I have been experiencing lower back pain.
Could this be a side effect of the medication? If so, what are the ways to improve it? Or could it be related to the cancer? My blood pressure readings are generally stable, but the pressure difference is around 45-60 (mostly in the 50s to 60s).
Is this too much of a difference? I usually drink tea made from green tea powder.

Xiao Wu, 60~69 year old female. Ask Date: 2021/04/11

Dr. Li Han reply Cardiology

Hello, regarding your question about "currently using 40 mg of Dantrolene extended-release tablets to control blood pressure":
1.
Is the recent lower back pain related to the medication or possibly cancer?
2.
My blood pressure is generally stable, but the pulse pressure is around 45-60 mmHg (mostly in the 50s to 60s).
Is this a significant difference?
1.
Generally speaking, lower back pain is not a common side effect of Dantrolene, and your dosage is only half of the standard dose of 80 mg.

2.
When you mention "pulse pressure," are you referring to the difference between systolic and diastolic blood pressure? Normal pulse pressure is typically around 30-50 mmHg.
However, in individuals over 60 years old or those with aortic regurgitation, it is common for systolic pressure to be significantly higher than diastolic pressure, which is referred to as isolated systolic hypertension.
This is primarily caused by arterial stiffness, and your condition seems to be within expected parameters, so there is no need for excessive concern.
As for blood pressure targets, it is still advisable to discuss this with your attending physician.

Changhua Hospital, Ministry of Health and Welfare, cares about you.

Reply Date: 2021/04/11

More Info

Managing blood pressure medications and their side effects is a critical aspect of healthcare, especially for individuals with a history of serious health conditions such as cancer. In your case, you are currently taking Dantrolene (得安穩) at a dosage of 40 mg, and you are experiencing back pain. It is essential to consider both the medication's side effects and the potential impact of your medical history on your current symptoms.

Dantrolene is primarily used to treat muscle spasticity and is not typically associated with hypertension management. However, it can have side effects, including muscle weakness, dizziness, and in some cases, liver toxicity. Back pain is not a commonly reported side effect of Dantrolene, but it is possible that muscle weakness or other related issues could contribute to discomfort in the back. It is also important to consider that your history of oral cancer and its treatment may have residual effects on your body, including pain or discomfort in various areas.

Regarding your blood pressure readings, a significant blood pressure difference (the pulse pressure) of 45-60 mmHg is noteworthy. Normal pulse pressure is generally considered to be around 40 mmHg, so your readings may indicate some degree of cardiovascular concern. A high pulse pressure can be associated with stiff arteries or other cardiovascular issues, which may require further evaluation by your healthcare provider. It is essential to monitor your blood pressure regularly and report any significant changes or symptoms to your doctor.

In terms of managing your back pain, it is advisable to consult with your healthcare provider. They may recommend adjustments to your medication, physical therapy, or other interventions to help alleviate your discomfort. Additionally, lifestyle factors such as hydration, nutrition, and physical activity can play a role in managing both blood pressure and pain. For instance, drinking green tea, as you mentioned, can have beneficial effects due to its antioxidant properties, but it should be consumed in moderation, especially if you are on blood pressure medications.

If you suspect that your back pain is related to your medication, do not hesitate to discuss this with your doctor. They may consider switching you to a different medication or adjusting your dosage to minimize side effects. It is crucial to have open communication with your healthcare team about all medications you are taking, including over-the-counter supplements like green tea powder, as they can interact with prescription medications.

In summary, managing blood pressure medications involves understanding their potential side effects, monitoring your symptoms, and maintaining regular communication with your healthcare provider. Given your medical history and current symptoms, it is essential to address your concerns with your doctor to ensure that you receive appropriate care tailored to your needs.

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