From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
The best blood pressure medication to use with TCHP is an angiotensin receptor blocker (ARB) such as telmisartan, in combination with a calcium antagonist like amlodipine, due to their effective blood pressure control and favorable effects on central hemodynamics, as shown in the most recent study 1.
Key Considerations
- The choice of blood pressure medication is crucial in patients undergoing TCHP chemotherapy, as it can help mitigate cardiotoxicity and reduce the risk of cardiovascular events.
- ARBs, such as telmisartan, have been shown to be effective in controlling blood pressure and reducing cardiovascular risk, with a lower risk of adverse events compared to ACE inhibitors 2.
- The combination of an ARB with a calcium antagonist, such as amlodipine, has been shown to be effective in reducing blood pressure and improving central hemodynamic parameters, making it a suitable option for patients with TCHP 1.
Treatment Recommendations
- A typical starting dose for telmisartan could be 40mg daily, with amlodipine 5mg daily, with dose adjustments based on blood pressure response.
- Blood pressure should be monitored regularly during TCHP therapy, and medication adjustments should be made promptly to maintain readings below 130/80 mmHg.
- Beta-blockers, such as metoprolol, may also be considered, especially if there's evidence of reduced heart function during treatment.
Rationale
- The most recent study 1 provides strong evidence for the use of ARBs and calcium antagonists in combination for blood pressure control, making it the preferred choice for patients with TCHP.
- The study's findings on the effectiveness of telmisartan and amlodipine in reducing blood pressure and improving central hemodynamic parameters support the use of this combination in clinical practice.
- The lower risk of adverse events associated with ARBs compared to ACE inhibitors 2 also supports the use of ARBs as a first-line treatment option.