Types of Blood Pressure Medications
Prescription blood pressure drugs
come in many classes
Many blood pressure medications,
known as antihypertensives, are available by prescription to lower high blood pressure (HBP
or hypertension). There are a variety of classes of high blood pressure
medications and they include a number of different drugs.
Overviews of the classes of blood
pressure medications
Summaries of some of the major
types of commonly prescribed cardiovascular medications are provided here.
- For your information and reference, we have included generic
names as well as major trade names (noted with a *) to help you identify
what you may be taking. However, this information does not signify a
recommendation or endorsement from the American Heart Association.
- If your prescription medication isn’t on this list, remember
that your healthcare provider and pharmacist are your best sources of
information.
- It's important to discuss all of the drugs you take with your
doctor and understand their desired effects and possible side effects.
- Never stop taking a medication and never change your dose or
frequency without first consulting your doctor.
The classes of
blood pressure medications include:
- Diuretics
- Beta-blockers
- ACE
inhibitors
- Angiotensin
II receptor blockers
- Calcium
channel blockers
- Alpha
blockers
- Alpha-2
Receptor Agonists
- Combined
alpha and beta-blockers
- Central
agonists
- Peripheral
adrenergic inhibitors
- Vasodilators
Diuretics
Diuretics help the
body get rid of excess sodium (salt) and water and help control blood pressure.
They are often used in combination with additional prescription therapies.
Generic name |
Common brand names |
Thiazide diuretics |
|
chlorthalidone |
Hygroton* |
chlorothiazide |
Diuril* |
hydrochlorothiazide |
Esidrix*,
Hydrodiuril*, Microzide* |
indapamide |
Lozol* |
metolazone |
Mykrox*,
Zaroxolyn* |
Potassium-sparing
diuretics |
|
amiloride
hydrochloride |
Midamar* |
spironolactone |
Aldactone* |
triamterene |
Dyrenium* |
Loop diuretic |
|
furosemide |
Lasix* |
bumetanide |
Bumex* |
Combination diuretics |
|
amiloride
hydrochloride + hydrochlorothiazide |
Moduretic* |
spironolactone
+ hydrochlorothiazide |
Aldactazide* |
triamterene
+ hydrochlorothiazide |
Dyazide*,
Maxzide* |
Some noted possible side effects from diuretics:
- Some of these drugs may decrease your
body's supply of the mineral potassium. Symptoms such as weakness, leg
cramps or being tired may result. Eating foods containing potassium may
help prevent significant potassium loss. If your doctor recommends it, you
could prevent potassium loss by taking a liquid or tablet that has
potassium along with the diuretic. Diuretics such as amiloride (Midamar)*,
spironolactone (Aldactone)* or triamterene (Dyrenium)* are called
"potassium sparing" agents. They don't cause the body to lose
potassium. They might be prescribed alone, but are usually used with
another diuretic. Some of these combinations are Aldactazide*, Dyazide*,
Maxzide* or Moduretic*.
- Some people suffer from attacks of gout
after prolonged treatment with diuretics. This side effect isn't common
and can be managed by other treatment.
- People with diabetes may find that
diuretic drugs increase their blood sugar level. A change in medication,
diet, insulin or oral anti-diabetic dosage corrects this in most cases.
- Impotence may occur.
Beta-blockers
Beta-blockers reduce
the heart rate, the heart's workload and the heart's output of blood, which
lowers blood pressure.
Generic name |
Common brand names |
acebutolol |
Sectral* |
atenolol |
Tenormin* |
betaxolol |
Kerlone* |
bisoprolol fumarate |
Zebeta* |
carteolol hydrochloride |
Cartrol* |
metoprolol tartrate |
Lopressor* |
metoprolol succinate |
Toprol-XL* |
nadolol |
Corgard* |
penbutolol sulfate |
Levatol* |
pindolol* |
Visken* |
propranolol hydrochloride* |
Inderal* |
solotol hydrochloride |
Betapace* |
timolol maleate* |
Blocadren* |
Combination beta-blocker/diuretic |
|
hydrochlorothiazide and bisoprolol |
Ziac* |
Some noted possible side effects of beta-blockers:
- Insomnia
- Cold hands and feet
- Tiredness or depression
- Slow heartbeat
- Symptoms of asthma
- Impotence may also occur
- If you have diabetes and you're taking
insulin, have your responses to therapy monitored closely.
- If you have been prescribed
beta-blockers, consult your healthcare provider prior to conception if you
are considering pregnancy or if there is a chance you could become
pregnant. If you discover that you are pregnant consult your healthcare
provider as soon as possible to determine the safest medication for you at
this time.
ACE inhibitors
Angiotensin is a
chemical that causes the arteries to become narrow, especially in the kidneys
but also throughout the body. ACE stands for Angiotensin-converting enzyme. ACE
inhibitors help the body produce less angiotensin, which helps the blood
vessels relax and open up, which, in turn, lowers blood pressure.
Generic name |
Common brand names |
benazepril hydrochloride |
Lotensin* |
captopril |
Capoten* |
enalapril maleate |
Vasotec* |
fosinopril sodium |
Monopril* |
lisinopril |
Prinivel*, Zestril* |
moexipril |
Univasc* |
perindopril |
Aceon* |
quinapril hydrochloride |
Accupril* |
ramipril |
Altace* |
trandolapril |
Mavik* |
Some noted possible side effects of ACE inhibitors:
- Skin rash
- Loss of taste
- Chronic dry, hacking cough
- In rare instances, kidney damage
- Women who
are taking ACE inhibitors or ARBs for high blood pressure should not
become pregnant while on this class of drugs. If you're taking an ACE
inhibitor or an ARB and think you might be pregnant, see your doctor
immediately. These drugs have been shown to be dangerous to both mother
and baby during pregnancy. They can cause low blood pressure, severe kidney
failure, excess
potassium (hyperkalemia) and even death of the newborn.
Angiotensin II
receptor blockers
These drugs block
the effects of angiotensin, a chemical that causes the arteries to become
narrow. Angiotensin needs a receptor- like a chemical "slot" to fit
into or bind with- in order to constrict the blood vessel. ARBs block the
receptors so the angiotensin fails to constrict the blood vessel. This means
blood vessels stay open and blood pressure is reduced.
Generic name |
Common brand names |
candesartan |
Atacand* |
eprosartan mesylate |
Teveten* |
irbesarten |
Avapro* |
losartan potassium |
Cozaar* |
telmisartan |
Micardis* |
valsartan |
Diovan* |
Some noted possible side effects of Angiotensin II receptor
blockers:
- May cause occasional dizziness.
- ARBs should not be used during pregnancy.Medications
that act directly on the renin-angiotensin system can cause injury or even
death to a developing fetus. When pregnancy is detected, consult your
healthcare professional as soon as possible.
Calcium channel blockers
This drug prevents
calcium from entering the smooth muscle cells of the heart and arteries. When
calcium enters these cells, it causes a stronger and harder contraction, so by
decreasing the calcium, the hearts' contraction is not as forceful. Calcium
channel blockers relax and open up narrowed blood vessels, reduce heart rate
and lower blood pressure.
Generic name |
Common brand names |
amlodipine besylate |
Norvasc*,
Lotrel* |
bepridil |
Vasocor* |
diltiazem hydrochloride |
Cardizem
CD*, Cardizem SR*, Dilacor XR*, Tiazac* |
felodipine |
Plendil* |
isradipine |
DynaCirc*,
DynaCirc CR* |
nicardipine |
Cardene
SR* |
nifedipine |
Adalat
CC*, Procardia XL* |
nisoldipine |
Sular* |
verapamil hydrochloride |
Calan
SR*, Covera HS*, Isoptin SR*, Verelan* |
Some noted possible side effects of calcium channel blockers:
- Palpitations
- Swollen ankles
- Constipation
- Headache
- Dizziness
Alpha blockers
These drugs reduce
the arteries' resistance, relaxing the muscle tone of the vascular walls.
Generic name |
Common brand names |
doxazosin mesylate |
Cardura* |
prazosin hydrochloride |
Minipress* |
terazosin hydrochloride |
Hytrin* |
Some noted possible
side effects of alpha blockers:
- Fast heart rate
- Dizziness
- A drop in blood pressure when you stand
up
Alpha-2 Receptor Agonists
These drugs reduce
blood pressure by decreasing the activity of the sympathetic
(adrenaline-producing) portion of the involuntary nervous system. Methyldopa is
considered a first line antihypertensive during pregnancy because adverse
effects are infrequent for the pregnant woman or the developing fetus.
Generic name |
Common brand names |
methyldopa |
|
Some noted possible
side effects of Alpha-2 Receptor Agonists:
- Methyldopa can cause drowsiness or
dizziness
Combined alpha and beta-blockers
Combined alpha and
beta-blockers are used as an IV drip for those patients experiencing a hypertensive crisis.
They may be prescribed for outpatient high blood pressure use if the patient is
at risk for heart failure.
Generic name |
Common brand names |
carvedilol |
Coreg* |
labetalol hydrochloride |
Normodyne*,
Trandate* |
A noted possible
side effect of combined alpha and beta-blockers:
- May cause a drop in blood pressure when
you stand up
Central agonists
Central agonists
also help decrease the blood vessels' ability to tense up or contract. The
central agonists follow a different nerve pathway than the alpha and
beta-blockers, but accomplish the same goal of blood pressure reduction.
Generic name |
Common brand names |
alpha methyldopa |
Aldomet* |
clonidine hydrochloride |
Catapres* |
guanabenz acetate |
Wytensin* |
guanfacine hydrochloride |
Tenex* |
Some noted possible
side effects of central agonists:
- Alpha methyldopa (Aldomet)* may produce a
greater drop in blood pressure when you're in an upright position
(standing or walking), and it may make you feel weak or faint if the
pressure has been lowered too far. This drug may also cause drowsiness or
sluggishness, dryness of the mouth, fever or anemia. Male patients may
experience impotence. If this side effect persists, your doctor may have
to change the drug dosage or use another medication.
- Clonidine (Catapres)*, guanabenz
(Wytensin)* or guanfacine (Tenex)* may produce severe dryness of the
mouth, constipation or drowsiness. If you're taking any of these drugs,
don't stop suddenly because your blood pressure may rise quickly to
dangerously high levels.
Peripheral adrenergic
inhibitors
These medications
reduce blood pressure by blocking neurotransmitters in the brain. This blocks
the smooth muscles from getting the "message" to constrict. These
drugs are rarely used unless other medications don't help.
Generic name |
Common brand names |
guanadrel |
Hylorel* |
guanethidine monosulfate |
Ismelin* |
reserpine |
Serpasil* |
Some noted possible
side effects of peripheral adrenergic inhibitors:
- Reserpine may cause a stuffy nose,
diarrhea or heartburn. These effects aren't severe, and no treatment is
required other than to change the dosage. If you have nightmares or
insomnia or get depressed, tell your doctor immediately.
- Guanadrel (Hylorel)* or guanethidine
(Ismelin)* may cause some diarrhea, which may persist in some people. This
side effect usually becomes less of a problem if you continue treatment.
These drugs reduce blood pressure more when you stand. Consequently, you
may get dizzy and lightheaded and feel weak when you get out of bed in the
morning or stand up suddenly. If you notice any of these reactions and if
they persist for more than a minute or two, contact your doctor. He/she
may instruct you to reduce or omit the next dose of the medication.
- When taking guanethidine, don't stand in
the hot sun or at a social gathering if you begin to feel faint or weak.
These activities cause low blood pressure and fainting. Male patients may
experience impotence. Contact your doctor if either of these side effects
occurs.
Blood vessel dilators (vasodilators)
Blood vessel
dilators, or vasodilators, can cause the muscle in the walls of the blood
vessels (especially the arterioles) to relax, allowing the vessel to dilate
(widen). This allows blood to flow through better.
Generic name |
Common brand names |
hydralazine hydrochloride |
Apresoline* |
minoxidil |
Loniten*† |
Some noted possible
side effects of vasodilators:
- Hydralazine (Apresoline)* may cause
headaches, swelling around the eyes, heart palpitations or aches and pains
in the joints. Usually none of these symptoms are severe, and most will go
away after a few weeks of treatment. This drug isn't usually used by itself.
- Minoxidil (Loniten)* is a potent drug
that's usually used only in resistant cases of severe high blood pressure.
It may cause fluid retention (marked weight gain) or excessive hair
growth.
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