Htn management after failing arb and ccb with a sulfa allergy? other than bb, what are other options? what class/drugs are recommended to trial w/ pt. next! options are limited..?

I heavily rely on a first line of ACE inhibitors or ARB with associated mild dose of a long acting diuretic such as HCTZ(sulfa allergy no concern) I then add, if necessary, a CCB , but if the patient tends to have a resting heart rate over 80, a BB is helpful. If a goal of 130/80 is not achieved, I add an alpha blocker such as cardura or a beta dilator such as labetolol in varying doses. Success

Before adding antihypertensives with many options available from diuretics to hydralazine and nitrates for example for refractory hypertension, work up for secondary hypertension or potential causes for the high blood pressure has to be completed with weight loss critical if overweight for example.