What happens if I take my blood pressure medicine twice?
By
Dr Milena Locci de Oliveira (PhD)
Author bio
Dr Milena Locci de Oliveira is a Pharmacist and Doctor of Philosophy in Sciences from the University of São Paulo (USP). She has experience in microbiology, analytical toxicology, and clinical pharmacokinetics. She writes and reviews content on these topics.
Dr Milena’s Highlights:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration in the areas of Pharmacometrics and Population Pharmacokinetics, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
“Science can be translated, and it is essential that everyone has access to quality information to make informed decisions” – Dr Milena Oliveira, PhD.
Professional Experience:
With a decade-long career as a researcher, Dr Milena has amassed extensive experience in conducting research projects in microbiology, analytical toxicology, and clinical pharmacokinetics.
Her expertise also extends to the preparation of technical and scientific reports, literature reviews, data analysis, and scientific communication, both oral and written.
Dr Milena has served as a Clinical Pharmacist, providing expert supervision and guidance to teams during the challenging times of the COVID-19 pandemic, particularly in the ICUs of two reference hospitals for patient hospitalization.
In her most recent role, Dr Milena worked on the implementation of the deliberatives of the São Paulo State Government Pharmaceutical Assistance Coordination. These decisions were aimed at ensuring medication access within the Unified Health System.
A widely multidisciplinary background enabled Dr Milena to become a professional capable of integrating scientific knowledge into private initiatives, education, and healthcare, delivering consistent services in patient safety and population health.
Professional Memberships & Affiliations:
Dr Milena Oliveira is a member of the Regional Council of Pharmacy of the State of São Paulo, Brazil.
Education:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
Relevant Published Work & Citations:
Oliveira ML de, Rocha A, Nardotto GHB, Pippa LF, Simões BP, Lanchote VL. Analysis of daunorubicin and its metabolite daunorubicinol in plasma and urine with application in the evaluation of total, renal and metabolic formation clearances in patients with acute myeloid leukemia. Journal of Pharmaceutical and Biomedical Analysis. Nov 2020. 191:113-124.
Abstracts. CPT: Pharmacometrics & Systems Pharmacology. 2020 Nov; 9 (S1).
Pippa LF, Oliveira ML de, Rocha A, de Andrade JM, Lanchote VL. Total, renal and hepatic clearances of doxorubicin and formation clearance of doxorubicinol in patients with breast cancer: Estimation of doxorubicin hepatic extraction ratio. Journal of Pharmaceutical and Biomedical Analysis. 2020 Jun 5; 185:113-231.
Godoy ALPC, De Jesus C, De Oliveira ML, Rocha A, Pereira MPM, Larangeira DF, Lanchote VL, Barrouin-Melo SM. Determination of Allopurinol and Oxypurinol in Dogs Plasma by High-Performance Liquid Chromatography with an Ultraviolet Detector: Application for Pharmacokinetic Studies. J Chromatogr Sep Tech. 2017; 8 (4).
Clímaco EC, Oliveira ML de, Pitondo-Silva A, Oliveira MG, Medeiros M, Lincopan N, et al. Clonal complexes 104, 109 and 113 playing a major role in the dissemination of OXA-carbapenemase-producing Acinetobacter baumannii in Southeast Brazil. Infection, Genetics and Evolution. 2013 Oct;19:127–33.
Conference Papers:
Oliveira, M. L.; NARDOTTO, G. H. B.; PIPPA, L. F.; ROCHA, A.; SIMOES, B. P.; LANCHOTE, V. L. . Daunorubicin metabolism and urinary excretion in patients with acute myeloid leukemia. In: 84th Annual Meeting of the German Society for Experimental and Clinical Pharmacology and Toxicology (DGPT) and the 20th Annual Meeting of the Association of the Clinical Pharmacology Germany (VKliPha), 2018, Göttingen. Naunyn-Schmiedeberg’s Arch Pharmacol, 2018. v. 391. p. S76-S76.
Oliveira, M. L.; NARDOTTO, G. H. B. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . The low contribution of urinary excretion in the elimination of daunorubicin and its metabolite daunorubicinol in patients with acute myeloid leukemia. In: 49th Brazilian Congress of Pharmacology and Experimental Therapeutics., 2017, Ribeirão Preto. Livro de Resumos, 2017. p. 64-64.
Oliveira, M. L.; PIPPA, L. F. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . Quantification of daunorubicin and its metabolite daunorubicinol in human plasma by LC-MS/MS. In: I International Meeting of Environmental Health and Toxicology (IMEHTOX), 2016, Ribeirão Preto. Livro de Resumos, 2016.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. . PFGE typing of Carbapenem-Resistant Acinetobacter baumannii isolated from different University Hospitals. In: V International Postgraduate and Research Symposium, 2012.
Clímaco, E.C. ; SILVA, A. P. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. Relação clonal entre linhagens de Acinetobacter baumannii produtoras de carbapenemases da família OXA em quatro hospitais no Brasil. In: XXI Latin American Congress of Microbiology, 2012, Santos. XXI Latin American Congress of Microbiology, 2012.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Darini A.L.C. . Dissemintion of OXA carbapenemases genes in carbapenem-resistant Acinetobacter baumannii in University Hospital of Juiz de Fora, MG. In: 8th CIFARP – International Congress of Pharmaceutical Sciences, 2011, Ribeirão Preto.
Clímaco, E.C. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Darini A.L.C. . Avaliação do sequenciamento parcial do gene rpoB e de seus flanqueadores para identificação de espécies de Acinetobacter na rotina laroratorial. In: 2° International Symposium on Clinical Microbiology, 2010, Florianópolis.
You can view some of Dr Milena’s work below and links to her professional profile.
Linkedin: https://www.linkedin.com/in/dra-milena-locci-de-oliveira-28986042/?locale=en_US
ResearchGate: https://www.researchgate.net/profile/Milena-Oliveira-6
Escavador: https://www.escavador.com/sobre/5394254/milena-locci-de-oliveira
Lattes: https://buscatextual.cnpq.br/buscatextual/busca.do
Scopus: https://www.scopus.com/authid/detail.uri?authorId=57199779361
Scholar: https://scholar.google.com/citations?view_op=list_works&hl=pt-BR&user=1YUBDIQAAAAJ
What happens if I take my blood pressure medicine twice?
If you take your blood pressure medication twice, you may suffer from decreased heart rate, which is often defined as a ‘heart-sinking feeling’, and hypotension. However, these effects may depend on a lot of different factors.
If you’re on a low-dose antihypertensive, you may not feel any difference in your condition and may get away with undetected low blood pressure. It also depends on how your body reacts to such a double dose.
The side effects after taking an overdose of your antihypertensive agent also depend on the type of drug that you’re using. There are a number of classes of antihypertensive agents and all classes have distinct mechanisms of action.
They all have different active sites to bind within your body and have different receptor affinities. Medications which can act on more receptors can cause more significant side effects when taken more than the standard dose. Following are some common classes of antihypertensive (1):
- Beta-blockers
- Calcium channel blockers
- Acetylcholinesterase (ACE) Inhibitors
- Angiotensin receptor blockers (ARBs)
- Alpha-blockers
- Diuretics
If we specifically talk about some of these above-mentioned antihypertensives, an overdose of beta-blockers, Alpha-blockers, and diuretics can be quite dangerous. They can dangerously slow down your heart rate and they are also capable of binding to other receptors.
For example, Beta-blockers can also block beta-receptors present in your lungs and can cause bronchoconstriction, which may make it difficult for you to breathe at higher doses (2). This is why you should always stick to your doctor’s recommended dose.
Some of the common side effects associated with overdosing on your antihypertensive include (3):
- Nausea
- Vomiting
- Diarrhoea
- Upset stomach
- Bradycardia or low heartbeat
- Low blood pressure
- Dizziness or lightheadedness
- Shortness of breath
- Tightness of chest
- Weakness
- Cold or pale skin
- Unsteadiness
- Blackouts
These side effects can vary from person to person. Some people may get away with low blood pressure that you can easily reverse. However, people who are more sensitive to the effects of such blood pressure medications may suffer from severe dizziness or they may lose consciousness.
This is why you should always remember to take your medication just as much as recommended by your healthcare provider.
What should you do if you overdosed on your blood pressure medication?
If you’re taking more of your antihypertensive than you’re supposed to, you should consult your healthcare provider. You may not feel a thing if you’re on lower doses or may get away with mild ‘sick’ feelings, but overdosing on your antihypertensive can become dangerous.
If you feel unwell or lightheaded, immediately call your local medical emergency helpline and seek professional help. Overdosing on your blood pressure medication can become life-threatening if you’re a heart patient or you’re taking multiple blood pressure-lowering agents. They all together can slow down your heart to a dangerous level.
How can you avoid overdosing on your blood pressure medication?
There are a few ways through which you can avoid taking your blood pressure medications on time and properly. These include:
- Try to take your antihypertensive at the same time every day. This can help you incorporate your medicine into your routine and you will continue to remember to take the medication.
- Use technology to help you remember to take your blood pressure medication. You can set an alarm or a reminder on your phone to help you remember to take your med.
- You can make a kind of checklist and mark it down after taking your medicine. This way you’ll know whether you have taken it or not and it will eliminate the chances of overdosing on your antihypertensive.
- Use a maintained pill box. In case you forget if you have taken your antihypertensive or not, you can simply go check your pill box and see if the compartment labelled with the present day is empty or not.
- Turn the medicine bottle upside down after taking your dose. This way, you’ll know for sure whether you have taken the medication or not just after looking at the position of the bottle.
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References
1.-
Khalil H, Zeltser R. Antihypertensive Medications. 2022 May 15. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32119466. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554579/
2.-
Lauterbach M. Clinical toxicology of beta-blocker overdose in adults. Basic Clin Pharmacol Toxicol. 2019 Aug;125(2):178-186. doi: 10.1111/bcpt.13231. Epub 2019 Apr 15. PMID: 30916882. Available from: https://pubmed.ncbi.nlm.nih.gov/30916882/
3.-
Olowofela AO, Isah AO. A profile of adverse effects of antihypertensive medicines in a tertiary care clinic in Nigeria. Ann Afr Med. 2017 Jul-Sep;16(3):114-119. doi: 10.4103/aam.aam_6_17. PMID: 28671151; PMCID: PMC5579894. Available from: https://pubmed.ncbi.nlm.nih.gov/28671151/
