Cyclosporine and blood pressure

[Lisa V]

I'm wondering if anyone here has taken any additional medication to lower blood pressure while on Cyclosporine. We all know that high BP is one of the more common side effects, but is there anything you can do about it besides lowering the dosage?

Just to recap, Ken's been on cyclo since '04. He tried one taper and relapsed, and had to repeat ATG in order to turn things around. He has a trisomy 8 mutation, and there seems to be some evidence that that is associated with long term cyclo dependence, so we haven't wanted to attempt another taper. His creatinine has been an issue, but at 175 mg/day and lots of water, he's been able to maintain his counts and keep his creatinine under control. Now, however, his BP is getting high, averaging about 140/90, or right on the edge of stage 1 hypertension. We see the doc tomorrow, so will talk about perhaps taking his dosage down to 150 mg/day, but if any of you have tried other alternatives I'd like to hear about it and take that info with us when we go.

[triumphe64]

High BP is common. Dr. Maciejewski put me on Norvasc.

[squirrellypoo]

I agree. I've had textbook perfect blood pressure my entire life (pre- and post-illness) except when I was on Ciclosporin, which gave me blood pressure so high it was causing crippling headaches. my doctors put me on BP medication to lower it until we started the Ciclosporin taper a few months later, but I can't recall the name of it off the top of my head. If you look through my thread in the Transplants forum, I would've gone on it near the beginning of Sept 2009 in case I may have mentioned it at the time.

[Marlene]

Hi Lisa,

Doesn't cyclo effect magnesium levels? Sub-optimal magnesium can effect blood pressure. You can do a topical magnesium oil, soak in epsom salts, or take a magnesium citrate.

John was able to get his down with CoQ10.


Marlene

[Lisa V]

Thanks for the replies!

Melissa, I checked your BMT thread. You were given Amlodipine, which is the same as the Norvasc that triumphe64 mentions. That sounds like the drug of choice. Good to know.

Marlene, I'll ask his doctor about the magnesium connection. It was normal a few years ago when they checked it, but I don't know if he's been tested since then. Probably not. Something else to consider.

Of course I'd be very happy if he could lower his cyclo intake without relapsing, but it's good to know there may be other options.

[susansr]

In response to Lisa V, I have been on tacrolimus but have also developed high bp. My primary put me on: metoprolol but I know 2 others using clonidine with success. Hope this helps.

[Gloria J]

Hi Lisa,

At NIH, post-ATG, I was put on Amlopodine along with the Cyclo, and I had no problems with my blood pressure. Hope this helps,

Gloria

[Lisa V]

Thanks Gloria and Susan for that info. I knew high BP was an issue but I'd never seen a discussion of what to do about it. Good to have some options.

After meeting with the doctor yesterday, we all came to the conclusion that it's not critical yet, and in this case less meds are probably better than more. His counts have been good and stable for a while, and we had talked earlier about the possibility of seeing if he could get by with a lower dose of cyclo anyway. This seems like as good a time as any to try it, so he'll take it down to 150 mg/day and see what happens. If that doesn't help, or if his counts start to slip, then it's on to plan B. Meanwhile we'll get his magnesium checked with the next CBC, and see if there's anything hinky going on there.

[Hopeful]

Hi Lisa,

I've noticed that my cyclosporine trough has creeped up along with my creatinine the longer that I am on the drug. I'm guessing it is because my kidneys aren't filtering the drug as well as in the past. Have you noticed this with Ken? Perhaps a lower dose today is the same as a higher dose taken previously because of the increased concentration in his system?? I've noticed that even a small decrease in dosage (25mg) can make a HUGE difference in side effects.

Also, has Ken had his cholesterol checked recently? I was shocked to see the increase in my LDL but have since read that it can happen as a side effect of cyclosporine. There also may be a link between high blood pressure and high cholesterol.

[SNichols]

To Lisa V.
My bp was stroke level (I was told) in Dec. I was given a new bp med. clonidine. I was already taking lisinopril. Bp just fine now. I am still on
cyclosprine.





Suzie5.6 dx June 2010 SAA, ATG July 2010

[Lisa V]

Originally Posted by Hopeful

Hi Lisa,

I've noticed that my cyclosporine trough has creeped up along with my creatinine the longer that I am on the drug. I'm guessing it is because my kidneys aren't filtering the drug as well as in the past. Have you noticed this with Ken? Perhaps a lower dose today is the same as a higher dose taken previously because of the increased concentration in his system?? I've noticed that even a small decrease in dosage (25mg) can make a HUGE difference in side effects.

Also, has Ken had his cholesterol checked recently? I was shocked to see the increase in my LDL but have since read that it can happen as a side effect of cyclosporine. There also may be a link between high blood pressure and high cholesterol.

If anything, it's been just the opposite, Hopeful. His CSA has actually gotten lower over the last 4 years that he's been on this dosage. He doesn't get it tested that often, but his trough was in the 80s a year after he dropped it to 175 mg, and it's been going down from there. The last reading in November just said <40. I guess they can't even measure it below 40? Of course that poses the question of whether or not it has any therapeutic value at all at that level, but based on his previous experience, we don't want to mess with it too much.

He hasn't had his cholesterol tested in ages either, along with a lot of other things that just got put on the back burner for a long time. We talked about that too, and decided it's time to see his GP for a regular check-up.

[Snuuze]

Hi! I'm so thankful for the forum and the contributors. I checked the "archives" for threads dealing with high BP before starting my own thread. And here you all are answering my questions! My BP had been on the low end of normal until my second day of ATG which is also the day I began cyclosporine. It shot up dramatically and has stayed there. In fact, last week after a platelet transfusion, it skyrocketed. Lucky I was still at the hospital, as they had to load me up with drugs to get me out the door. I bought a BP cuff so I can monitor it at home. Will visit the dr. this week armed with information and hope for some relief. As if dealing with MDS isn't enough, must we add high blood pressure to the mix?