Nancy
Well-known member
Just wanted to mention something for those with CHF who also might have intermittant kidney failure.
Joe has had a couple of serious consequences with some of his medications which were either prescribed incorrectly for his conditions or built up in his system, causing strange symptoms.
The first med was Paxil. Although his dose was long standing, and well tolerated, once his CHF and kidney failure got to a certain level with ascities, it built up in his system and caused palsy-like problems including shaking hands, slow gaited walking, unsteadiness, and slow thinking. It took some sleuthing and many lab tests to rule out everything else. His dose was cut in half and things got a lot better, and he is still OK, depression-wise.
Another just happened recently. He went to a new and young doctor for his voice problems (ENT). She prescribed Zantac in a very large dose, 300mg. He immediately started getting headaches, felt blah and listless and his CHF worsened. We weren't sure what was going on, and had to call his card. and his hematologist and his labs turned out just fine anemia-wise and cardio-wise.
The symptoms started to happen with the beginning of the whopping Zantac dose, so he stopped taking it, however, his CHF has still been a problem, in spite of Lasix, Aldactone and even Zaroxolyn.
A little more sleuthing with the help of the card's NP and the teaching hospital's pharmacist, turned up the fact that 300mg was way too much for anyone with compromised kidneys, and Joe should have been started on a much, much lower dose to see how things went and should have never exceeded 150mg. He probably shouldn't have been given it at all.
It turns out that Zantac can cause renal interference and liver problems, and a blah feeling and headaches.
There are "renal doses" for those who have the potential for kidney problems and Joe should have been on the renal doses.
The other unfortunate thing is that because Zantac is excreted in the kidneys and metabolized in the liver, it will hang around longer in Joe's system than it would in an ordinary person's system because his kidneys aren't working 100 percent, so after about a week off it, he still has symptoms.
So another lesson learned the hard way.
When you are getting a new prescription and you have CHF and/or kidney problems, ask the doctor if it has to be adjusted for your personal problems. Not every doctor thinks about that. There are also dose adjustments for renal and older folks too. And you may need a much lower dose at least to start.
Joe has had a couple of serious consequences with some of his medications which were either prescribed incorrectly for his conditions or built up in his system, causing strange symptoms.
The first med was Paxil. Although his dose was long standing, and well tolerated, once his CHF and kidney failure got to a certain level with ascities, it built up in his system and caused palsy-like problems including shaking hands, slow gaited walking, unsteadiness, and slow thinking. It took some sleuthing and many lab tests to rule out everything else. His dose was cut in half and things got a lot better, and he is still OK, depression-wise.
Another just happened recently. He went to a new and young doctor for his voice problems (ENT). She prescribed Zantac in a very large dose, 300mg. He immediately started getting headaches, felt blah and listless and his CHF worsened. We weren't sure what was going on, and had to call his card. and his hematologist and his labs turned out just fine anemia-wise and cardio-wise.
The symptoms started to happen with the beginning of the whopping Zantac dose, so he stopped taking it, however, his CHF has still been a problem, in spite of Lasix, Aldactone and even Zaroxolyn.
A little more sleuthing with the help of the card's NP and the teaching hospital's pharmacist, turned up the fact that 300mg was way too much for anyone with compromised kidneys, and Joe should have been started on a much, much lower dose to see how things went and should have never exceeded 150mg. He probably shouldn't have been given it at all.
It turns out that Zantac can cause renal interference and liver problems, and a blah feeling and headaches.
There are "renal doses" for those who have the potential for kidney problems and Joe should have been on the renal doses.
The other unfortunate thing is that because Zantac is excreted in the kidneys and metabolized in the liver, it will hang around longer in Joe's system than it would in an ordinary person's system because his kidneys aren't working 100 percent, so after about a week off it, he still has symptoms.
So another lesson learned the hard way.
When you are getting a new prescription and you have CHF and/or kidney problems, ask the doctor if it has to be adjusted for your personal problems. Not every doctor thinks about that. There are also dose adjustments for renal and older folks too. And you may need a much lower dose at least to start.
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