Blood pressure medication

[Price Wooldridge]

@karyn1972 keeping blood pressure in line is very important as you know. Chronic high BP is a concern for increased risk of stroke, heart attack, kidney damage, and many others problems.
Blood pressure medications are complicated because drugs not specifically prescribed for BP can have an affect on it.
My primary meds for BP are Lisinopril, Carvedilol, and furosemide (lasix).
All my specialties watch my blood pressure, but I only like one doctor regulating my BP meds. That person is my nephrologist. I hope you can find that one doctor on your team who can help you sort this.

[Karyn]

Thank you for responding.   Have you had any increased muscle weakness with any of those medications?   I would imagine that I am having issues with BP meds because my LEMS is not stabilized .  Also it seems like the weakness is increased just on one side.  Strange .

[Price Wooldridge]

@karyn1972 I have not experienced any LEMS muscle weakness I can attribute to any of by BP meds. I expect this to be watched by my neurologist for any contraindications. She has access to all my medications list. I hope you will consult with your neurologist on this. We are all so different with a unique set of problems, it’s impossible to make generalizations on meds.

[Ashley]

Hi @karyn1972

I currently take a beta blocker twice a day for my POTS and haven’t had any issues personally, but of course everyone is different.

However, many blood pressure medications could potentially worsen myasthenia.

Here’s a full list of medications to avoid in general. You may have to do some experimenting to figure out if it’s the medication itself, or if its because your LEMS is unstable.

Hope this helps!

[Ginny Boynton]

Here is a specific case regarding blood pressure medication being problematic.

https://pubmed.ncbi.nlm.nih.gov/12622445/

[Wanda Grischkowsky]

I take Losartan. Prior to that I took Lisinopril, but it was stopped. I was told to avoid beta blockers.

It can become complicated because some days I have to miss or decrease the dosage because my blood pressure drops too low, causing grey-outs or blackouts.

[Price Wooldridge]

@wanda-king-grischkowsky we are all so different. One reason I’m on Lisinopril is for my kidneys. With beta blockers and other meds, suggestions aren’t hard and fast rules. I’m on a minimum dose, but my heart gets very angry if I’m not on it. We do what we must.
I’ve had low blood pressure events too. In one case I reported and we adjusted medications. Please talk with your doctor if this is ongoing.

[Anngail Norris]

I have been taking Metoprolol 25mg for the past two years, since my LEMS diagnosis. My doctor started me on it because with LEMS one of my symptoms was that my heart would race when I walked or did any physical activity, like getting out of bed or standing up to brush my teeth. It was meant to slow my heart rate, since I didn’t normally have high blood pressure. I have not noticed any worsening of symptoms because of this.

[Bernie]

I was recently diagnosed with AFIB, three trips to the ER so far this year. At first they gave me Diltiazem, which is supposed to also regulate the wayward heartbeat that I now occasionally get. However, it also nullified my Ruzurgi and Mestinon. That was no fun.  They replaced that  with the Metoprolol, which seems to be a little less intrusive to my LEMS drugs, but allowed another episode on Monday. I was told previously that my next options would be either ablation surgery or to start taking Tikosyn, which I would be admitted for observation for 72 hours for initiation. Right now we are pretty wary of this drug that would have that level of hazard, much less spending so much time under care during the pandemic.

I cannot take lisinopril, as I was on it for almost ten years before having a lung reaction to it. The good (?) news is that my bp has been acceptable since I became symptomatic with LEMS.

[Price Wooldridge]

@bernie Bernie, I’m sorry to hear you are having the heart issues. I’ve had them as so many others have. Those ER trips are not fun. I’m always very reluctant to go.
My cousin has had ablation surgery, one way to correct certain electrical problems. There were issues, but I believe the end results for him have been good.
I am actually on the drug you are considering, dofetilide. You mentioned it by brand name. It has worked very well for me and, yes, you have to go into the hospital for 3 days to monitor as they put you on it due to the possibility of unwanted arrhythmias. I had no problems and the medication has cut down significantly on my rhythm problems (Second Degree Block). To use it or not is a decision between you and your cardiac team, but I found the problems from afib, the block, palpations and all, to be worth it.
I am glad you BP has been good. That’s a big piece of the puzzle!

[Price Wooldridge]

@anngailn Anngail, I was on Metoprolol for some time in the past. At some point that was switched to Carvedilol due to other medical conditions. Slowing the heart rate is often good for blood pressure, rate issues, and other problems. I’m glad it hasn’t affected your LEMS. I’ve never noticed that it has been an issue either.