Fourth Blood Pressure Medication (updated)

Ok, it’s more like three and a half. My blood pressure was still high during dialysis so my nephrologist told me to take 10 mg of NIFEdipine before dialysis. This is in addition to the 30 mg extended release version I take at night. I used to have a prescription for this medication so I still have lots of it at home. And it seems to work:

Time	Systolic	Diastolic	Pulse	Notes
9:13 am	162	92	67	Standing
9:27 am	163	91	64	Sitting/legs up
9:57 am	160	90	65	Sitting/legs up
10:27 am	138	82	66	Sitting/legs down
10:57 am	135	83	65	Sitting/legs down

I took the 10 mg of NIFEdipine at around 9:45 am so the 9:57 am reading could be just random noise. However, the next two readings are definitely lower even though my legs are down. That’s my experience in the past too. NIFEdipine is very effective for me and it usually kicks in 30-45 minutes after I take it. I’m not sure what the long term plan is for managing my blood pressure will be with this new data point. I want to try and reduce the number and dosage of all my medication. I just make an appointment with the cardiology nurse practitioner for tomorrow; maybe she will have some ideas.

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Well, that didn’t last very long. The last reading at 11:27 am was 160/94/66, which is similar to the reading at 9:57 am. It seems like the lower blood pressure only lasted a hour. Is that the effective life of the medication, or is it getting dialyzed out? I read that NIFEdipine does not usually get dialyzed out so maybe it’s still working but being offset by something else. During the past week, after I started taking Olmesartan in the morning before dialysis, my blood pressure would start in the 160’s but climb to the 190’s about halfway through the session. Perhaps this second effect is causing the increase. Next reading is in five minutes.

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The 11:57 am reading was 153/87/66 with legs down while sitting up. This is consistent with the previous reading with legs up of 160/94/66. My nephrologist also told me to take the morning Metoprolol before dialysis. My dialysis nurse suggested I take it after dialysis since Metoprolol seems to be highly dialysable. This is turning out to be quitevthe science experiment.