Blood Pressure Medication and Hot Flashes

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Blood Pressure Medication and Hot Flashes

Question:

I've been taking Premarin for two years for hot flashes. I recently also started high blood pressure medicine. Now I have hot flashes again. Could the high blood pressure medicine be making the Premarin less effective at controlling hot flashes?

Answer:

Most women with hot flashes related to menopause will notice that the number and intensity of the hot flashes decrease over time. So it is a bit unusual that you are having more hot flashes now.

I could not find any important interactions between the most commonly prescribed blood pressure medications and Premarin. However, some blood pressure medications do cause flushing in the face with a warm feeling that could feel similar to hot flashes. The blood pressure medications most likely to cause that reaction are:

• Nifedipine (Procardia, Adalat)

• Amlodipine (Norvasc)

• Nicardipine (Cardene)

• Felodipine (Plendil)

• Nisoldipine (Sular)

You might also consider reasons other than blood pressure medication for redness and warmth in your face. Perhaps it is a different medication. For example, niacin often causes facial flushing. Or perhaps you have developed rosacea, a common skin condition that causes the face to get red and warm.

I would doubt that your hot flashes are related to spikes in your blood pressure. Estrogen in higher doses can sometimes raise blood pressure. However, the lower doses used in Premarin and other preparations to help reduce menopausal symptoms are less likely to do that.

Howard LeWine, M.D., is chief editor of Internet Publishing at Harvard Health Publications. He is recognized as an outstanding clinician and teacher and is a recipient of the Internal Medicine Teacher of the Year award at Brigham and Women's Hospital. Dr. LeWine continues to practice Internal Medicine; most recently he became a hospitalist after practicing primary care for over 20 years.

Last updated:	July 20, 2009