Understanding the Side Effects of Common Hypertension Drugs in Singapore

November 7, 2024

Hypertension, or high blood pressure, is a growing concern not just in Singapore, but worldwide. Left unmanaged, it can lead to serious complications like heart attacks, strokes, and even kidney disease. But the good news is, there are many medications available to help keep it under control. However, as with any medication, high blood pressure drugs may come with side effects.

Side Effects of Hypertension Drugs

In this article, we’ll break down the common side effects of some frequently prescribed high blood pressure medications in Singapore—Exforge, Concor, Twynsta, Micardis, and Norvasc. By understanding these potential side effects, you can make informed decisions with your doctor about what’s best for you.

Exforge	Concor	Twynsta	Micardis	Norvasc
Dizziness Feet/Ankle Swelling Palpitations Fatigue Headaches	Fatigue Cold Hands Slow Heart Rate Sleep Issues Dizziness	Leg Swelling Dizziness Muscle Pain Flushing Nausea	Back Pain Sore Throat Dizziness Diarrhoea	Lower Limb Swelling Dizziness Flushing Gingival Overgrowth Tiredness

1. Exforge (Amlodipine/Valsartan)

Exforge combines two powerful components: amlodipine (a calcium channel blocker) and valsartan (an angiotensin II receptor blocker). Together, they help lower your high blood pressure by relaxing your blood vessels, making it easier for blood to flow¹².
Common Side Effects:

• Dizziness and Light-headedness: Feeling dizzy, especially when standing up quickly, is quite common. This happens as your high blood pressure reading drops³.
• Swelling in the Feet or Ankles: You might notice some swelling, especially in your feet or ankles, due to fluid retention from the amlodipine¹.
• Palpitations: Your heartbeat may feel irregular at times, but don’t worry—it usually gets better with time³.
• Cough or Fatigue: Some people experience a lingering cough or just feel extra tired, although this is less common⁴.
• Headaches: You might get a headache as your body adjusts to the medication, but it should pass soon⁵.

When to Talk to Your Doctor: If these side effects stick around or get worse, it’s a good idea to check in with your doctor. Sudden swelling, chest pain, or difficulty breathing? Those are signs to seek help immediately.

2. Concor (Bisoprolol)

Concor, which contains bisoprolol, is a beta-blocker. It works by reducing the workload on your heart and relaxing your blood vessels. This makes it easier for your heart to pump blood, lowering your high blood pressure⁶⁷.
Common Side Effects:

• Fatigue: Feeling a little more tired than usual is common when starting beta-blockers⁶.
• Cold Hands and Feet: Your extremities might feel chilly due to reduced blood flow¹.
• Slow Heart Rate (Bradycardia): While Concor is designed to slow your heart rate, if it slows down too much, it could be an issue⁴.
• Sleep Issues: Some people report trouble sleeping or even nightmares, although this isn’t very common⁷.
• Dizziness or Low Blood Pressure: Feeling light-headed, especially when standing up quickly, is a possible side effect⁵.

When to Talk to Your Doctor: If you notice your heart rate slowing down too much, or if you’re feeling overly tired or breathless, it’s important to check in with your doctor.

3. Twynsta (Telmisartan/Amlodipine)

Twynsta is a combination of telmisartan (an angiotensin II receptor blocker) and amlodipine (a calcium channel blocker). Together, they work to prevent your blood vessels from narrowing, keeping your high blood pressure in check²³.
Common Side Effects:

• Leg or Ankle Swelling: Amlodipine can cause swelling in your legs or ankles—this is one of the most common side effects¹.
• Dizziness or Fainting: Both components may cause dizziness, especially when you stand up too quickly³.
• Muscle Pain or Cramps: Some people experience mild muscle pain or cramps⁶.
• Flushing: You might notice your face feels warm or looks red⁷.
• Nausea and Indigestion: Your stomach might feel a bit upset when you start the medication⁶.

When to Talk to Your Doctor: If the swelling in your legs gets worse or muscle pain becomes intense, speak to your doctor right away to adjust your dosage.

4. Micardis (Telmisartan)

Micardis is often prescribed to those who can’t tolerate other medications, such as ACE inhibitors. It’s an angiotensin II receptor blocker (ARB) that helps relax blood vessels, lowering high blood pressure⁷⁸.
Common Side Effects:

• Back Pain: Some people report occasional back pain after starting Micardis⁷.
• Sinus Congestion or Sore Throat: Mild respiratory symptoms, such as a stuffy nose or sore throat, may occur⁵.
• Dizziness or Light-headedness: You might feel a little dizzy, especially when you stand up quickly, as your high blood pressure reading drops⁸.
• Diarrhoea: While rare, some people experience gastrointestinal issues like diarrhea⁴.

When to Talk to Your Doctor: If the dizziness or light-headedness persists, or if you experience fainting or trouble breathing, call your doctor for advice.

5. Norvasc (Amlodipine)

Norvasc is another calcium channel blocker that helps to relax your blood vessels, making it easier for your heart to pump blood¹⁷.
Common Side Effects:

• Swelling of the Lower Limbs: As with other amlodipine-based drugs, swelling in the legs or feet is common¹.
• Dizziness or Light-headedness: Dizziness can occur, especially when changing positions too quickly³.
• Flushing: Some people feel warm or flushed after taking Norvasc⁷.
• Gingival Overgrowth: Although rare, some patients may experience an overgrowth of gum tissue⁶.
• Tiredness: Fatigue can set in as your body adjusts to the medication².

When to Talk to Your Doctor: Severe swelling, chest pain, or changes in vision are all good reasons to contact your doctor right away.

Conclusion

Managing high blood pressure is essential for long-term health, and medications like Exforge, Concor, Twynsta, Micardis, and Norvasc can play a critical role in keeping your blood pressure under control. While these medications are highly effective, it’s important to remember that side effects may occur.

A healthy lifestyle, including food for high blood pressure and supplements for high blood pressure, can also support your overall treatment. The key is open communication with your healthcare provider—don’t hesitate to bring up any discomfort or side effects you experience. Minor issues often resolve as your body adjusts, but persistent or worsening symptoms should never be ignored.

Every person responds to medication differently, so finding the right treatment for you may take some time and monitoring. With the right plan, you can successfully manage high blood pressure and live a healthy, fulfilling life.

References

1. Mayo Clinic. General information on high blood pressure (hypertension) and the effects of medications such as beta-blockers, calcium channel blockers, and ARBs. Available from: [https://tinyurl.com/2d3m6hby]. Accessed on October 25, 2024.
2. WebMD. A comprehensive guide to hypertension medications, including detailed side effects of common drugs like Exforge, Concor, Twynsta, Micardis, and Norvasc. Available from: [https://tinyurl.com/3ns2nkkk]. Accessed on October 25, 2024.
3. Singapore Ministry of Health (MOH). Local information on hypertension management and common medications prescribed in Singapore. Available from: [https://www.moh.gov.sg/]. Accessed on October 25, 2024.
4. Drugs.com. Detailed drug information, including side effects of medications such as Exforge, Concor, Twynsta, Micardis, and Norvasc. Available from:

• Exforge: [https://tinyurl.com/ypxcc5v3]
• Concor: [https://tinyurl.com/dxu9cjpt]. Accessed on October 25, 2024.

5. National Heart Centre Singapore (NHCS). Information on heart-related treatments, hypertension, and medications used to control blood pressure in Singapore. Available from: [https://tinyurl.com/4rum35af]. Accessed on October 25, 2024.
6. American Heart Association (AHA). Global perspectives on high blood pressure and its treatment, including common side effects of antihypertensive drugs. Available from: [https://tinyurl.com/2pn8bcsx]. Accessed on October 25, 2024.
7. National Institutes of Health (NIH). General information on antihypertensive drugs, their mechanisms, and potential side effects. Available from: [https://tinyurl.com/4xhbsmmf]. Accessed on October 25, 2024.
8. Medscape. Comprehensive drug references, including side effects of antihypertensive medications like beta-blockers and calcium channel blockers. Available from: [https://tinyurl.com/5h2vksbp]. Accessed on October 25, 2024.