List of blood pressure medications that can cause peripheral neuropathy

Diabetes is the most common cause of peripheral neuropathy in the UK.

Neuropathy can also be caused by other health conditions and certain medicines.

In some cases, no cause can be identified and this is termed idiopathic neuropathy.

Diabetes

Peripheral neuropathy caused by either type 1 diabetes or type 2 diabetes is called diabetic polyneuropathy. 

It's probably caused by high levels of sugar in your blood damaging the tiny blood vessels that supply your nerves.

Peripheral neuropathy becomes more likely the longer you have had diabetes.

Up to 1 in 4 people with the condition experience some pain caused by nerve damage.

If you have diabetes, your risk of polyneuropathy is higher if your blood sugar is poorly controlled or you:

• smoke
• regularly drink large amounts of alcohol
• are over 40 years old

If you have diabetes, examine your feet regularly to check for open wounds or sores (ulcers) or chilblains.

Other causes

As well as diabetes, there are many other possible causes of peripheral neuropathy.

Health conditions

Some of the health conditions that can cause peripheral neuropathy include:

• excessive alcohol drinking for years
• low levels of vitamin B12 or other vitamins
• physical damage to the nerves, such as from an injury or during surgery
• an underactive thyroid gland
• certain infections, such as shingles, Lyme disease, diphtheria, botulism and HIV
• inflammation of the blood vessels
• chronic liver disease or chronic kidney disease
• the presence of an abnormal protein in the blood (monoclonal gammopathy of undetermined significance, or MGUS) 
• certain types of cancer, such as lymphoma, a cancer of the lymphatic system, and multiple myeloma, a type of bone marrow cancer
• Charcot-Marie-Tooth (CMT) disease and other types of hereditary motor sensory neuropathy, genetic conditions that cause nerve damage, particularly in the feet
• having high levels of toxins in your body, such as arsenic, lead or mercury
• Guillain-Barré syndrome, a rare condition that causes rapid onset of paralysis within days
• amyloidosis, a group of rare but serious health conditions caused by deposits of abnormal protein called amyloid in tissues and organs throughout the body
• health conditions caused by overactivity of the immune system, such as rheumatoid arthritis, lupus, Sjögren's syndrome or coeliac disease

Medicines

A few medicines may sometimes cause peripheral neuropathy as a side effect in some people.

These include:

• some types of chemotherapy for cancer, especially for bowel cancer, lymphoma or myeloma
• some antibiotics, if taken for months, such as metronidazole or nitrofurantoin
• phenytoin, used to treat epilepsy, if taken for a long time
• amiodarone and thalidomide

Any medication can cause side effects, and high blood pressure (HBP) medications are no exception. However, many people do not have side effects from taking hypertension drugs, and often the side effects are mild. Still, it's important to stay informed and work closely with your doctor to manage any side effects you may have. There's no reason to "suffer in silence." Today there are more medication options than ever for managing high blood pressure (hypertension).

This article lists the side effects that may be caused by each type of high blood pressure drug. First, here are four general warnings.

1. Never stop taking medication without first talking to your doctor. In some cases, this can be very dangerous, causing a big spike in blood pressure.
2. If you are pregnant or planning to get pregnant, talk to your doctor about the safest medication to use.ACE inhibitors or angiotensin II receptor blockers (ARBs) can cause harmful side effects for pregnant women and their developing babies.
3. If you take insulin for diabetes, talk to your doctor. Changes in blood sugar can occur in people with diabetes taking diuretics or beta-blockers for high blood pressure.
4. If you have problems with erections during sex, talk with your doctor. Some high blood pressure medications can cause this problem. Reducing the dose or changing to another type of medication may help. But high blood pressure itself can also cause erectile dysfunction.

As an informed patient, read about the type of medication you are taking and its possible side effects. You can find a full list on your medication insert. To get you started, here is an overview of the most common side effects of high blood pressure medications.

Medications Used to Treat High Blood Pressure

Diuretics

These high blood pressure medications flush extra water and sodium (salt) from your body. Diuretics may cause these side effects:

• Extra urination. Extra water out means more time in the bathroom. Take these medications earlier in the day and when you're not far away from a bathroom.
• Erection problems in some men
• Weakness, leg cramps, or fatigue. Diuretics may decrease the body's levels of the mineral potassium, which can lead to these side effects. Certain potassium-sparing diuretics do not have this effect, however.
• Intense and sudden foot pain, which is a symptom of gout; this is rare.

Beta-Blockers

Beta-blockers make your heart beat less forcefully and more slowly. These medications may cause side effects such as:

• Asthma symptoms
• Cold hands and feet
• Depression
• Erection problems
• Insomnia and sleep problems

Angiotensin Converting Enzyme (ACE) Inhibitors

These high blood pressure medications block formation of a hormone that causes blood vessels to narrow, so vessels relax. ACE inhibitors may cause these side effects:

• A dry, hacking cough that doesn't go away. If you have this side effect, the doctor may prescribe another type of medication.
• Skin rash and a loss of taste are two other possible side effects of ACE inhibitors.

Angiotensin II Receptor Blockers (ARBs)

These high blood pressure medications shield blood vessels from a hormone that causes blood vessels to narrow. This allows blood vessels to stay open. One of the more common side effects of ARBs is dizziness.

Calcium Channel Blockers (CCBs)

These high blood pressure medications keep calcium from entering heart muscle and blood vessel cells. Blood vessels can then relax. CCBs may cause these side effects:

• Constipation
• Dizziness
• Headache
• Irregular or very rapid heartbeat (palpitations)
• Swollen ankles

Alpha-Blockers

Alpha-blockers reduce nerve impulses to blood vessels, allowing blood to flow more easily. These medications may cause:

• Dizziness, lightheadedness, or weakness when standing up suddenly or getting up in the morning (from reduced blood pressure)
• Fast heart rate

Alpha-2 Receptor Agonist

This high blood pressure medication decreases activity in the adrenaline-producing part of the nervous system. It may cause drowsiness or dizziness.

Alpha-Beta-Blockers

These high blood pressure medications reduce nerve impulses and also slow the heartbeat. Patients with severe high blood pressure often receive them by intravenous (IV) injection. But the doctor may also prescribe these medications for people who have congestive heart failure. Alpha-beta blockers may cause a drop in blood pressure when you stand up suddenly or first get up in the morning. This can cause dizziness, lightheadedness, or weakness.

Central Agonists

These high blood pressure medications control nerve impulses, relaxing blood vessels.

Central agonists may cause:

• Anemia
• Constipation
• Dizziness, lightheadedness, or weakness when standing up suddenly or getting up in the morning (from a drop in blood pressure)
• Drowsiness
• Dry mouth
• Erection problems
• Fever

Peripheral Adrenergic Inhibitors

This type of medication blocks neurotransmitters in the brain, so the message to constrict doesn't reach smooth muscles. Used less often than other high blood pressure medications, these drugs can cause:

• Diarrhea
• Dizziness, lightheadedness, or weakness when standing up suddenly or getting up in the morning (from reduced blood pressure)
• Erection problems
• Heartburn
• Stuffy nose

If nightmares or insomnia persist, talk with your doctor about another HBP medication option.

Vasodilators

Vasodilators relax muscles in vessel walls, opening blood vessels and allowing blood to flow better. These medications may cause:

• Excessive hair growth
• Fluid retention
• Headaches
• Irregular or very rapid heartbeat (palpitations)
• Joint aches and pains
• Swelling around the eyes

Renin Inhibitor

This newer class of high blood pressure medication works by decreasing chemicals that tighten blood vessels. This medication may be used alone or in combination with another medication. Side effects may include:

• Cough
• Diarrhea or stomach pain
• Heartburn
• Rash

If High Blood Pressure Drug Side Effects Bother You

Partner with your doctor. Ask if there are any steps you can take to lessen medication side effects. For example, to lessen the effects of low blood pressure, it may help to avoid standing for a long time in the sun. In some cases, side effects such as fatigue or diarrhea may subside with time. In other cases, your doctor may change the dosage or prescribe another high blood pressure medication. A combination of medications sometimes works better than one medication alone by not only improving high blood pressure control but also by reducing side effects.

Also, when you first start a new high blood pressure medicine, be aware of rare allergic reactions. Call 911 right away if you develop hives, wheezing, vomiting, light-headedness, or swelling in your throat or face.