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Weaning off BP meds: When do they know when?

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Weaning off BP meds: When do they know when?

Postby dbronson » Sat Jul 11, 2009 01:25 pm

by dbronson (113 Posts), Sat Jul 11, 2009 01:25 pm

Hey ladies! So I am six weeks pp and at my appointment my BP was 130/80 on labatalol 100mil 3X a day. They mentioned taking it 2x a day to start to wean off and I am all for that (since i can't lose any of this weight on the labatalol Ug!) Anyway my question....

What is a safe number to start weaning off? Is there a threshold or a crieteria? I go back in two weeks then I guess i head to a cardiologist if it has not resolved. Is that correct?

Thanks in advance.
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Re : Weaning off BP meds: When do they know when?

Postby alexa5 » Mon Jul 13, 2009 09:12 am

by alexa5 (710 Posts), Mon Jul 13, 2009 09:12 am

I think a lot of us wonder that, and it is hard to say. Sometimes docs will let you try to start weaning if your bp is doing well on meds to see how it does as you wean. But I think it all depends on your baseline, where your bp is now, how stable it is, etc.

In my case I am 6 months pp, and still on the meds I was put on a few weeks pp as I had really elevated bp. It has been down for a while, but I don't know how much without meds so I am trying to reduce the dose at this time and see how that goes based on a cardiologist's recommendation.

Good luck!
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Re : Weaning off BP meds: When do they know when?

Postby countrymom2e » Tue Jul 14, 2009 00:33 am

by countrymom2e (134 Posts), Tue Jul 14, 2009 00:33 am

After my first, my doc had to put me on nifidipine because my BP shot up past 170/110 5 d post partum. I went back weekly for BP checks, it started to come down after a few days but was still hgih. At 6 weeks, he cut me back to half dose and since my BP was fair (not great), then we weaned off completely. A few weeks later I was back to normal (which for me is about 90/60).
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Re : Weaning off BP meds: When do they know when?

Postby alexa5 » Tue Jul 14, 2009 01:37 pm

by alexa5 (710 Posts), Tue Jul 14, 2009 01:37 pm

Danielle, question for you--specifically re: your comment on weight/labetalol. Does labetalol cause you to hold onto or gain weight? I thought I may have read the possibility somewhere but can't find much on it.

I am curious because I have been on it, and though I only had a fairly small amount to lose postpartum after I lost the fluid weight it has taken a while to come off. I just attributed it to postpartum weight being stubborn. But I have recently lowered my dose of labetalol and within a few days lost a couple more pounds....so was curious.
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Re : Weaning off BP meds: When do they know when?

Postby caryn » Wed Jul 15, 2009 01:15 pm

by caryn (10111 Posts), Wed Jul 15, 2009 01:15 pm

I don't know if there's a threshold, really. My internist just started lowering the dose when she saw my pressures trending lower on the labetalol. I was at 160/100 on it, then 140/90, then 120/80, and somewhere around there they lowered the dose...

I like internists for postpartum workups, because cardiologists are heart specialists, and internists are generalists, and this syndrome is so general. If you've got an underlying autoimmune disease, that's probably more likely to get picked up by an internist. On the other hand, if you've got postpartum cardiomyopathy, a cardiologist is what you want.
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Re : Weaning off BP meds: When do they know when?

Postby mbshu » Wed Jul 15, 2009 03:45 pm

by mbshu (62 Posts), Wed Jul 15, 2009 03:45 pm

If you have seen a cardiologist and they run all of the heart tests on you, echocardiogram, ekg, halter, etc. and all comes back normal, should you continue seeing the cardiologist for blood pressure medication/checks or go back to your internist? I have been seeing the cardiologist who wants to start weaning my medication, but the internist I saw told me I should stay on the dose I am on for while more. (My BP at the appt was 118/68).
Who would you say is better at prescribing blood pressure medication for that?
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Re : Weaning off BP meds: When do they know when?

Postby alexa5 » Wed Jul 15, 2009 04:12 pm

by alexa5 (710 Posts), Wed Jul 15, 2009 04:12 pm

Tough call, Kellye. I say that because I know exactly what you mean, though in my case my doctor is willing to go with the cardiologist recommendation. My family doctor originally told me to stay with what I was on, and in the meantime I decided to go to a cardiologist for an echo for some concerns I was having. Everything was fine, and the cardiologist felt that I could start weaning off labetalol, and eventually just be on hctz. So, that is what we are doing...

But I will be seeing my family doctor for the most part, while working with the cardiologist during the time we get our meds straight....all updates will be given to my family doctor to keep him posted on how things are going, as well as I will be doing some follow ups with him.

I guess if I was in your situation I would tell the internist I would like to at least try to start weaning, and will keep a close eye on pressures at home/report any concerns. If you have a qualified professional like a cardiologist who suggests weaning I don't think your internist can outright tell you not to.
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Re : Weaning off BP meds: When do they know when?

Postby mbshu » Wed Jul 15, 2009 04:32 pm

by mbshu (62 Posts), Wed Jul 15, 2009 04:32 pm

Thanks Alexa. I know it gets confusing because I have been told by both the cardiologist and the internist (my family doctor) that I am healthy, I just have high blood pressure ...but then I think if I am healthy why do I have high blood pressure still after 8 months post partum when I work out 5 days a week, eat pretty healthy, and have no risk factors for HBP...
I am also still trying to find out is high blood pressure a heart problem or just a general health condition?
Also good luck with weaning off the Labetalol, I felt so much better once I was off of it. I felt like my pressure was more stable also.
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