Tips for Proper Management of High Blood Pressure Medications

High blood pressure medications are, like medicines in general, relatively sensitive products. To prevent a loss of quality, there are several things to consider. In this article, you will find many helpful tips that will make your daily management of your blood pressure-lowering medications easier.

Proper Storage of High Blood Pressure Medications

Medications are sensitive products that can lose quality if stored incorrectly. To ensure your own safety and that of others, the Federal Ministry of Health recommends the following (as of 14.02.2023):¹

On the folding box and in the package leaflet of the medication, you will find information on the proper storage of the medicine, e.g., the temperature. Three common temperature ranges are: room temperature, storage in the refrigerator, or frozen.
Every medication has an expiration date. Medications that have exceeded the expiration date should no longer be taken. You will learn how to dispose of expired medications in the next chapters.
Medications should remain in their original packaging, as this additionally protects the medicine from light. The package leaflet contains important application instructions and must be kept for future reference.
Medications should not be exposed to high temperatures or direct sunlight.
It is not recommended to store medications in the bathroom, even though this is very common. High humidity and fluctuating temperatures can be harmful to medicines.
Medications should not be accessible to children or animals.

Disposing of High Blood Pressure Medications

The proper disposal of medications is important for both people and the environment. If a medication has expired or there are other reasons for disposal, the following procedure should be followed:

The package leaflet indicates whether the so-called old medication needs to be disposed of separately. If not otherwise described in the package leaflet, medications can be disposed of in household waste in Germany. To prevent active ingredients from entering groundwater and consequently the environment, medications should never be disposed of via the toilet or sink.

Also, rinsing containers with remnants of medications should be avoided. Municipalities and pharmacies occasionally offer additional services and information for the proper disposal of medications to act in an environmentally friendly manner.¹

Splitting Tablets

There can be various reasons for splitting tablets: on one hand, when the doctor wants to achieve the lowest necessary dose, and on the other hand, to save costs².

However, there are some aspects to consider before splitting tablets:

If a tablet is broken, it must be assumed that the individual pieces are of different sizes or that particles are lost, and consequently, the dose is not the same.³

The package leaflet indicates whether a tablet may be split or not. Since this is not always specified, the doctor or pharmacist should be consulted in case of uncertainty.

The so-called breaking notch is not a guarantee that a tablet may be split, as there are also so-called decorative notches. Soft gelatin capsules and dragees cannot be split at all. If a tablet without a breaking notch is to be split, the opinion of the doctor or pharmacist should be sought in advance.

High blood pressure medications that release their active ingredient over a longer period due to their special formulation are called extended-release tablets. Breaking these tablets may disrupt this mechanism, leading to an overdose of the active ingredient, as it is released too quickly. Extended-release tablets should not be split unless permitted in the package leaflet.

There are medications that are coated with a special layer to protect them from acidic gastric juice and are only absorbed later in the body. If this protective layer is broken by splitting, the medication may be less effective or lead to side effects.³

If there are difficulties swallowing, the package leaflet indicates whether tablets may be crushed. In case of uncertainty, the doctor or pharmacist should be consulted.

Some people find it very difficult to split medications by hand. Tablet cutters can make splitting easier and are available at pharmacies.³

Tip: Before splitting or taking tablets, you should ensure proper hand hygiene. Washing hands or using hand sanitizer can prevent or reduce the transfer of germs to your tablet. However, your hands should be dry when taking the medication, as moisture can prematurely soften the tablet.

Organizing High Blood Pressure Medications

Keeping track of daily medications is not always easy. If three or more medications are prescribed, individuals in Germany are entitled to the so-called nationwide medication plan, also known as the medication plan. This document clearly lists all medications that have been prescribed. The medication plan is available in digital and paper form.⁴

However, there are additional tools that can facilitate the organization of blood pressure-lowering medications. Here we present three options with their advantages and disadvantages:

Medication Dispensers

One way to organize medications is to pre-sort them into box systems for medications, called medication dispensers. Each day and time of day (morning, noon, evening) is assigned a container from the dispenser, and the daily medications are sorted accordingly. The containers can be filled by the individuals themselves, by helpers, or by professionals.

Pharmacies also offer this service. However, after blistering and possibly splitting tablets, they are exposed to temperature and humidity fluctuations, which can negatively affect the quality of the medications.^3,5 To prevent this, tablets can be cut out of the blister with scissors without opening the tablet and stored in box systems with larger containers. Once the tablets have been unblistered, it can be difficult to reassign them to their active ingredients. In any case, the folding box and the package leaflet of the tablets should be kept.⁵

Blistering Service

In a blistering service, the daily necessary medications are professionally sealed in individual blisters. This service is offered by pharmacies and has the advantage that the medications are blistered by trained professionals. They know which tablets can go into a blister, and the assignment is safer than with laypersons.

App

Smartphones accompany daily life almost everywhere. Blood pressure apps are thus a useful way to remind you to take your blood pressure medications daily to keep your blood pressure in the desired range.⁶ If you want to enjoy all the benefits of the BloodPressureDB App, you can find more information here.

Preparations for Vacation

Traveling with medications requires some preparation. Heres what you should consider:

It is advisable to prepare the necessary supply of medications before departure. The pharmacy should be contacted in good time, and the prescriptions should be checked for their validity. The need for medications should not only cover the entire duration of the trip but also for unplanned delays on the way home. A backup supply for a few days is recommended.

Import Prohibition List: Some countries (e.g., Singapore) have very strict import prohibition lists for medications. These can be found through the respective embassies and websites of the customs regulations of individual countries. It is advisable to have a medical prescription and the instructions for use, including the chemical composition of the medication, issued in the appropriate language or in English before departure.

Even on vacation, it is important to store medications properly: during the summer months, high temperatures can be reached in the car. Medications should be stored in a way that they are not exposed to direct sunlight or high heat.¹

Incorrect Intake and Side Effects

It can happen that you forget a dose or take the wrong medication. Mistakes are human, and hiding them can lead to complications. You should consider the following tips:

You have taken the wrong medication: Contact your doctor immediately and explain which medication you mistakenly took and which one you actually intended to take. Do not wait to see if anything happens.

You have forgotten a dose: The package leaflets contain information on what to do if you have forgotten a dose. In most cases, it is not recommended to take a double dose to "catch up" on the missed one. Contact your doctor, who will explain the exact procedure if you have forgotten a dose.

You have side effects: If you feel unwell or suspect that you are experiencing a side effect from your blood pressure medication, you should consult your doctor. It is not recommended to replace or exchange medications on your own. Some medications need to be gradually tapered off before switching; an example of this is beta-blockers. In emergencies or if your condition worsens, please contact emergency services.

Additionally, you or your doctor can report side effects. This is an important part of drug safety that checks the safety of medications that are already approved. Information on reporting can be found through the Paul-Ehrlich-Institut.

Sources

https://www.bundesgesundheitsministerium.de/arzneimittelentsorgung-und-aufbewahrung.html (Cited on 14.02.2023)¹
Stafford, R. S. & Radley, D. C. The potential of pill splitting to achieve cost savings. Am. J. Manag. Care 8, 706–712 (2002)²
Saran, A. K., Holden, N. A. & Garrison, S. R. Concerns regarding tablet splitting: a systematic review. BJGP Open 6, BJGPO.2022.0001³
https://www.bundesaerztekammer.de/themen/aerzte/digitalisierung/digitale-anwendungen/telematikinfrastruktur/medikationsplan (Cited on 15.02.2023)⁴
Borja-Oliveira, C. R. de. Pill organizers and pill cutters: risks and limitations. Rev. Saúde Pública 47, 123–127 (2013)⁵
Xu, H. & Long, H. The Effect of Smartphone App-Based Interventions for Patients With Hypertension: Systematic Review and Meta-Analysis. JMIR MHealth UHealth 8, e21759 (2020)⁶

By Dr. med. univ. Lisa Raberger. This article is medically reviewed. Last updated by Sabine Croci (03/2024).
Information on the website and within the app cannot replace a consultation with a doctor, but can certainly complement it.

We hope you found the article on the topic helpful. For good blood pressure management, it is important to take the medications correctly. Our app BloodPressureDB is happy to remind you of the intake times. It also manages the supply and informs you in good time when it is running low. This feature is also fully available in the free version. Get the free app now.

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