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Fainting (syncope) with the first dose, awareness of rapid heartbeats (palpitations), dizziness, low blood pressure when the person stands (orthostatic hypotension), and fluid retention (edema)
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Spasm of the airways (bronchospasm), an abnormally slow heart rate (bradycardia), heart failure, possible masking of low blood sugar levels after insulin injections, impaired peripheral circulation, insomnia, fatigue, shortness of breath, depression, Raynaud syndrome, vivid dreams, hallucinations, and sexual dysfunction
With some beta-blockers, an increased triglyceride level
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Low blood pressure when the person stands and spasm of the airways
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Angiotensin-converting enzyme (ACE) inhibitors
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Cough (in up to 20% of people), low blood pressure, an increased potassium level, rash, angioedema (allergic swelling that affects the face, lips, and windpipe and may interfere with breathing), and, in pregnant women, serious injury to the fetus
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Angiotensin II receptor blockers (ARBs)
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Dizziness, an increased potassium level, angioedema (rarer than with ACE inhibitors), and, in pregnant women, serious injury to the fetus
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Nifedipine (sustained-release only)
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Dizziness, fluid retention in the ankles, flushing, headache, heartburn, enlarged gums, and an abnormally fast heart rate (tachycardia)
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Diltiazem (sustained-release only)
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Headache, dizziness, flushing, fluid retention, problems in the heart's electrical conduction system (including heart block), an abnormally slow heart rate (bradycardia), heart failure, and enlarged gums
With verapamil, constipation
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Centrally acting alpha-agonists
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Drowsiness, dry mouth, fatigue, an abnormally slow heart rate, rebound high blood pressure when the drug is withdrawn (except with methyldopa), and sexual dysfunction
With methyldopa, depression, low blood pressure when the person stands, and liver and autoimmune disorders
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Headache, an abnormally fast heart rate (tachycardia), and fluid retention
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Decreased levels of potassium and magnesium, temporarily increased levels of blood sugar and cholesterol, an increased level of uric acid, sexual dysfunction in men, and digestive upset
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Potassium-sparing diuretics
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With all, a high potassium level and digestive upset
With spironolactone, breast enlargement in men (gynecomastia) and menstrual irregularities in women
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Thiazide and thiazide-type diuretics
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Decreased levels of potassium and magnesium, increased levels of calcium and uric acid, sexual dysfunction in men, and digestive upset
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