Can Hypertension Patients Switch Medications Before Vaccination?

Can I change my hypertension medication before getting vaccinated?

Hello Dr.
Lee, I am a patient with hypertension and have been taking antihypertensive medication since I was about 20 years old, for approximately 5.6 years.
Initially, I was diagnosed with hypertension at a general clinic, and my blood pressure has been controlled below 120/80 mmHg.
Occasionally, it drops to hypotensive levels.
I have also been actively losing weight and have currently lost about 20 kg, but my BMI is still around 24.5, which is not yet in the normal range.
I have been gradually reducing my medication as follows: Epanutin 5/160 mg (one tablet daily) ↓ Epanutin 5/160 mg (one tablet every two days) ↓ Epanutin 5/80 mg (one tablet daily) ↓ Epanutin 5/80 mg (one tablet every two days) (currently).
The clinic doctor suggested that I could try stopping the medication, but I noticed that around the sixth day of stopping, my blood pressure rises to about 130/80 mmHg, so I am hesitant to stop and continue with the Epanutin 5/80 mg regimen of one tablet every two days.
Recently, due to mild mitral valve prolapse, I had a follow-up appointment at a major hospital and asked the doctor if I could stop taking antihypertensive medication.
The doctor advised against it and inquired about the specific medication I was taking.
I replied that I was taking Epanutin 5/80 mg, and the doctor mentioned that it might be a bit too strong for someone my age to be on a combination antihypertensive.
They prescribed another medication (Hengmaixun).
Since I need to schedule a time for a cardiac ultrasound and follow-up, I told the doctor that I would continue taking Epanutin for a while before switching to Hengmaixun, hoping to have my hypertension follow-up and the cardiac ultrasound report on the same day.
The doctor agreed.
Subsequently, I noticed that the government announced the 12th round of vaccine administration (vaccination dates from 10/28 to 10/31), and I am eligible for the first dose of the BNT vaccine.
However, this coincides with my need to start the new medication (Hengmaixun).
Therefore, I would like to ask: 1.
Can I switch medications before receiving the BNT vaccine? What are the risks? Or would you recommend that I return to the clinic to have the doctor prescribe Epanutin again? 2.
Are the side effects of vaccination more pronounced in hypertensive patients? (Considering I am a younger hypertensive patient) 3.
If I continue to lose weight to reach the normal range, is there a chance I could stop the medication, or will I have to take medication for life? Thank you for your response, Doctor!

DONA, 20~29 year old female. Ask Date: 2021/10/23

Dr. Li Han reply Cardiology

Hello, regarding your inquiry about concerns related to antihypertensive medications and the COVID-19 vaccine, you can rest assured that there is no impact.
As for blood pressure management, it is still important to emphasize non-pharmacological approaches and not neglect them.
If you have any doubts about your blood pressure targets or medications, it is advisable to discuss them with your family physician.
The Changhua Hospital of the Ministry of Health and Welfare cares about you.

Reply Date: 2021/10/23

More Info

When it comes to managing hypertension and considering vaccination, there are several important factors to keep in mind. As a patient with a history of hypertension, you have raised several pertinent questions regarding medication adjustments before receiving the COVID-19 vaccine, specifically the BNT vaccine. Let's address your concerns one by one.

1. Switching Medications Before Vaccination: It is generally advisable to avoid making significant changes to your medication regimen right before receiving a vaccine. This is because any new medication can take time to show its full effects, and switching medications could lead to fluctuations in your blood pressure that might complicate your response to the vaccine. If you are currently stable on your medication (in this case, Amlodipine 5/80 mg), it would be prudent to maintain this regimen until after your vaccination. After you receive the vaccine, you can then consider transitioning to the new medication (恒脈循) as advised by your doctor. Always consult with your healthcare provider before making any changes to your medication, especially in the context of an upcoming vaccination.

2. Side Effects of Vaccination in Hypertensive Patients: Generally, individuals with hypertension do not experience more severe side effects from vaccines compared to those without hypertension. However, it is essential to consider that stress and anxiety about vaccination can temporarily elevate blood pressure. As a younger patient with hypertension, you may be more attuned to your body's responses, which can sometimes amplify perceived side effects. It is crucial to manage anxiety and stress, as these can contribute to fluctuations in blood pressure. If you have concerns about side effects, discussing them with your healthcare provider can help alleviate anxiety and provide reassurance.

3. Possibility of Discontinuing Medication with Weight Loss: Weight loss can significantly impact blood pressure management. If you continue to lose weight and reach a healthier BMI, there is a possibility that you may be able to reduce or even discontinue your antihypertensive medication. However, this should be done under the guidance of your healthcare provider. Regular monitoring of your blood pressure is essential during this process. Your doctor may suggest a gradual tapering of medication, allowing for close observation of your blood pressure response. It is important to note that some individuals may need to remain on medication long-term, depending on various factors, including genetics, lifestyle, and the underlying causes of hypertension.

In summary, it is advisable to maintain your current medication until after your vaccination to avoid any potential complications. Discuss any concerns about side effects with your healthcare provider, and continue to focus on your weight loss journey, as it may positively influence your blood pressure management. Always prioritize open communication with your healthcare team to ensure that your treatment plan is tailored to your individual needs and circumstances.

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