The common side effects of some anti-hypertension drugs
Anti-hypertensive Drugs

Anti-hypertensive (or blood pressure-lowering) drugs can help control blood pressure
when diet and physical activity alone have not succeeded. However, they always come
with lots of side effects. Blood pressure-lowering drugs are divided into seven groups
and they are diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotension-2
receptor antagonists, beta blockers, calcium channel blockers, alpha blockers and
central alpha agonists.


Diuretics lower blood pressure by causing the body to rid itself of excess fluids and
sodium through urination. If the prescribed diuretics can not achieve the desired effects,
combination with other anti-hypertensive agent is also used to enhance the effects. Some
commonly prescribed diuretics are Amiloride (Midamor), Bumetanide (Bumex),
Chlorothiazide (Diuril), Chlorthalidone (Hygroton), Furosemide (Lasix),
Hydrochlorothiazide (Esidrix, Hydrodiuril), Indapamide (Lozol) and Spironolactone
(Aldactone).  Common side effects of diuretics include low sodium in the blood
(hyponatremia), increased blood sugar, increased cholesterol, rash, joint disorders
(gout), impotence in men, menstrual irregularities, and breast enlargement in men
(gynecomastia). [2]

Angiotensin-Converting Enzyme (ACE) Inhibitors

ACE inhibitors expand blood vessels and thus decrease resistance. This allows blood to
flow more easily and makes the heart's work easier or more efficient. ACE inhibitors are
used to treat symptoms of heart failure and to lower blood pressure. You should not take
ACE inhibitors if you are pregnant. Commonly prescribed ACE inhibitors include:
Benazepril (Lotensin), Captopril (Capoten), Enalapril (Vasotec), Fosinopril (Monopril),
Lisinopril (Prinivil, Zestril), Moexipril (Univasc), Perindopril (Aceon), Quinapril (Accupril),
Ramipril (Altace) and Trandolapril (Mavik) The major potential risks and side effects of
ACE inhibitor therapy are birth defects (or death of an unborn baby), kidney problems
(symptoms are sudden weight gain, swelling of arms, hands, and feet). The most
common side effects with ACE inhibitors are dizziness, dry cough and sore throat. [1]

Angiotensin-2 Receptor Antagonists

Angiotensin-2 (AT-2) receptor antagonists also expand blood vessels. But, user can
tolerate them better because these drugs produce less cough as ACE inhibitors do. AT-2
receptor antagonists do not lower levels of angiotensin II (as ACE inhbitor do), they
prevent angiotensin II from having any effects on the heart and blood vessels. This is how
it keeps blood pressure from rising. You should not take ACE inhibitors if you are
pregnant. Commonly prescribed angiotensin-2 receptor antagonists include:
Candesartan (Atacand), Eprosartan (Teveten), Irbesartan (Avapro), Losartan (Cozaar),
Telmisartan (Micardis) and Valsartan (Diovan). The common side effects among
angiotensin-2 receptor antagonists are back pain, cold-like symptoms, sore throat, stuffy
nose, sinus inflammation, diarrhea and dizziness.

Beta Blockers

Beta-blockers work differently. They decrease the heart rate and cardiac output to lower
blood pressure. They're also used to treat cardiac arrhythmias and angina pectoris.
Commonly prescribed beta-blockers include: Acebutolol (Sectral), Atenolol (Tenormin),
Betaxolol (Kerlone), Bisoprolol/hydrochlorothiazide (Ziac), Bisoprolol (Zebeta), Carteolol
(Cartrol), Metoprolol (Lopressor, Toprol XL), Nadolol (Corgard), Propranolol (Inderal),
Sotalol (Betapace) and Timolol (Blocadren). Their common side effects, in general, are
bradycardia, congestive heart failure, hypotension, joint/back pain, liver abnormalities,
fatigue, dizziness, nausea, colitis, constipation, diarrhea, allergy, systemic lupus
erythematosus, urticaria etc. Please, note that the manifestation of the types of side
effects vary from product to product and from patient to patient.

Calcium Channel Blockers

Calcium channel blockers (or calcium antagonists) interrupt the movement of calcium into
heart and vessel cells. They're used to treat hypertension, angina and/or some
arrhythmias. Commonly prescribed calcium channel blockers include: Amlodipine
(Norvasc, Lotrel), Bepridil (Vascor), Diltiazem (Cardizem, Tiazac), Felodipine (Plendil),
Nifedipine (Adalat), Nimodipine (Nimotop), Nisoldipine (Sular) and Verapamil (Calan,
Isoptin, Verelan)

The most common-frequent adverse effect experienced by users are headache, flushing
and peripheral (or lower-limb) edema. Other common adverse side effects are dizziness,
nausea, constipation, vertigo, rash, leg cramps, allergy, bradycardia, cardiac arrest,
hypotension, palpitations, tachycardia, anxiety, dry mouth, dyspepsia, abdominal pain,
cough, arthritis, joint disorder, abnormal vision, dysuria, kidney calculus, nocturia,
polyuria, impotence, urinary frequency or even first-degree atrioventricular block.

Alpha Blockers

Alpha blockers include Doxazosin mesylate (Cardura), Prazosin hydrochloride
(Minipress) and Terazosin hydrochloride (Hytrin). The common side effects of Cardura
include dizziness, fatigue, hypotension, edema and dyspnea. The most frequent reactions
associated with Minipress therapy are dizziness, headache, drowsiness, lack of energy,
weakness, palpitations and nausea. The common side effects for Hytrin are asthenia,
postural hypotension, dizziness, somnolence, nasal congestion/rhinitis, and impotence.

Central Alpha Agonists

Examples of central alpha agonists are Clonidine hydrochloride (Catapres), Clonidine
hydrochloride and chlorthalidone (Clorpres, Combipres), Guanfacine hydrochloride
(Tenex), Methyldopa (Aldomet), Methyldopa and chlorothiazide (Aldochlor) and
Methyldopa and hydrochlorothiazide (Aldoril). Common side effects of this group of drugs
include sedation, headache, asthenia (or weakness), aggravation of angina pectoris,
congestive heart failure, prolonged carotid sinus, pancreatitis, colitis, vomiting, diarrhea,
bone marrow depression, leucopenia, liver disorders, hypersensitivities, Parkinsonism
and Bell's palsy etc. Some may experience dry mouth, drowsiness, dizziness,
constipation, depression, vomiting,
anorexia and loss of libido.

To decrease the side effect or to improve the therapeutic effect of drugs,
manufacturers combine two different drugs:

(1) Angiiotensin II receptor antagonist/diuretic

* Irbesartan and hydrochlorothiazide (Avalide)
* Losartan and hydrochlorothiazide (Hyzaar)
* Valsartan and hydrochlorothiazide (Diovan HCT)

(2) ACE Inhibitor/Calcium Channel Blocker

* Amlodipine and benazepril (Lotrel)
* Enalapril and felodipine (Lexxel)
* Trandolapril and verapamil (Tarka)

(3)  Combined Alpha and Beta Blockers

* Carvedilol (Coreg)
* Labetalol hydrochloride (Normodyne)

(4) Combination Therapies

* Atenolol and chlorthalidone (Tenoretic)
* Bisoprolol and hydrochlorothiazide (Ziac)
* Nadolol and bendroflumethiazide (Corzide)
* Propranolol and hydrochlorothiazide (Inderide)
* Timolol and hydrochlorothiazide (Timolide)

(5) Combination Therapy – ACE Inhibitor/Diuretic

* Benazepril and hydrochlorothiazide (Lotensin)
* Enalapril and hydrochlorothiazide (Vaseretic)
* Lisinopril and hydrochlorothiazide (Prinzide, Zestoretic)
* Moexipril and hydrochlorothiazide (Uniretic)
* Quinapril and hydrochlorothiazide (Accuretic)