Over medication

[Der Biermeister]

About a month ago, my cardio doubled my dosage of Linsinipril (generic for the ACE inhibitor Prinivil) from 20 mg to 40 mg a day to hopefully lower my bp. (I also take 10 mg of Norvasc for bp along heavy dosage of diuretic).

Anyway, each day since then I've been feeling gradually worse. Of all the listed side effects of this drug, I now have 5 of them: cough, dizziness, excessive tiredness, upset stomach, and weakness. Generally speaking - I feel like crap, like a truck has run over me. I have no energy whatsoever, and I even think this has contributed to some increase in labored respirations resulting in an increase in SOB.

I don't know why it has taken me so long to put this picture together because I remember now about 5 years ago, my family doc had also doubled up on this drug and about 3 weeks later I started getting very dizzy (almost passed out on a business trip). I stopped the extra pill each day and returned to normal.

So here is my dilemma. I see my cardio tomorrow morning. I am going to tell him flat out that I can't live like this. Even if it means my bp goes back up 20 pts., I am going to just take my chances. Hell, it's been this high for 20 years, what else is new. I'm not sure if he has any tricks to pull out of his bag - what do you all think?

If I can get to feeling halfway decent again, I might be able to bring my bp down naturally. After all, I've been losing weight on this restrictive diet, and all I really needed to do to really take the pounds off was to walk 3 miles a day. That has totally ceased in the last 3 weeks because of the way I feel. I have even given up ALL alcohol since I began the diet - just because I know how beer and the hard stuff can add pounds.

Does my doc have any other drugs to substitute with?
DB

 

[tobagotwo]

Agreeing to prescriptions is always your choice. If you do agree to take them, you should, and you should contact the doctor before stopping them.

If a drug has side effects that you feel at a certain level, the most obvious tack is to seek a different drug for the purpose.

If a suitable one is not available, then it may be best to discontinue the higher dosage (with your doctor's knowledge), depending on the risk from not taking it.

However, you should know the risk. The real risk, not just a general "Well, you risk this or that with high blood pressure," which is meaningless, but rather, "there's a 1 in x chance of this happening if your blood pressure is 20 points higher." If he doesn't know the risk level, why should it be appropriate for him to put you on such a high dose of hte drug? Numbers talk, baloney walks.

If the drug interferes with your quality of life to the extent that this appears to, then there would have to be a very significant, immediate risk to make the higher dosage of that drug worth taking.

Best wishes,

 

[Ross]

There are other meds he can give you. I'm trying to remember what they replaced mine with after my first surgery. It's not coming too me at the moment, but there are other things.

 

[Nancy]

For those who have a little more complicated issues than others, and who might be slightly older than 29, and who might have CHF and possibly additional co-morbidities, sometimes medications can build up and cause unusual things.

There are doses that are appropriate for those with compromised kidneys, and anyone with CHF has this possibility. Diuresis can cause it too. These doses are lower than for other people without the complicating problems.

I would discuss this possibility with your doc. I know that in a couple of situations, it's happened to Joe and his meds have had to be reduced in dosage or eliminated. And it was strictly his own unique set of problems that caused it.

You want to keep your BP under good control, of course.

I'm always looking up side effects for medications, and also for medical problems. Not easy to keep ahead of it all.

 

[Granbonny]

Db

Db

My soon to be age 75 year old Hubby..went to local clinic..2 years ago ( I was on jury duty..had no idea he went)..next thing I knew..he was down at local heart hospital having a Cath of Heart....Everything was fine..but came home with that linsinipril (sp?)..he started coughing and felt awful.. Luckly, I had read about the effects from it .and got them to change to..now..he takes..1..Hyzaar.. and 1 coreg.. a day.. and just had his yearly checkup..doing great..so great, he's outside planting Fall flowers in the dark. Cannot get him to slow down. ...His b/p is great.. Today, he bought something to paint his basement floors with.. 10 years older than me..I'm worn out from babysitting my age 4 year old new Grandson from Russia.. Ask your doctor about these 2 b/p meds..Bonnie

 

[Marge]

You asked if there are any other drugs you could substitute for the ones you take. I only know about lisinopril, the ACE blocker. If your cough is due to the lisinopril, you might talk to your doctor about an ARB (angiotensin receptor blocker) instead.

Coughing is a common side effect of ACE blockers. "Lisinopril cough" can be a minor annoyance or a major problem. I was on lisinopril for high blood pressure for a period of some months several years ago. Shortly after I started taking it I began coughing. It was honestly the worst cough I've ever had in my life. i stood it for several months not connecting it with the ACE blocker. Finally I went back to my doctor who took me off the lisinopril. He put me on cozaar, an ARB, which seems to work fine for my blood pressure.

When I was at the hospital, after my valve surgery, they had me for a while on captopril, another ACE blocker. I started coughing almost immediately.

I made sure that at discharge they had me back on the ARB.

 

[Der Biermeister]

thanks to all your replies -- looks like I have some ammo for tomorrow's visit!

 

[Georgia]

If you had some heart failure, they'll want you on an ACE inhibitor. They can have you try various brands.

If you're on it primarily for bp control, I believe they could reduce the ACE inhibitor back to the acceptable levels and try different others meds for bp. My husband has been messing with bp control for over 2 years and his meds are changed occassionally because the bp creeps back up.


I honestly think you're better off having an internist manage bp than a cardiologist; I think cardios get bored with the whole thing. My cardio no longer refills prescriptions; she writes the internist and advises and counts on the internist to manage the symptoms. I think internists are more interested in the whole patient than cardios, who really focus only on the heart/vascular.

 

[Der Biermeister]

If you had some heart failure, they'll want you on an ACE inhibitor. They can have you try various brands.

If you're on it primarily for bp control, I believe they could reduce the ACE inhibitor back to the acceptable levels and try different others meds for bp. My husband has been messing with bp control for over 2 years and his meds are changed occassionally because the bp creeps back up.


I honestly think you're better off having an internist manage bp than a cardiologist; I think cardios get bored with the whole thing. My cardio no longer refills prescriptions; she writes the internist and advises and counts on the internist to manage the symptoms. I think internists are more interested in the whole patient than cardios, who really focus only on the heart/vascular.

My PCP is the one who stays with me while finding the right med.

I had begun having some side effects from Pravachol a few months back and we tried about 4 other kinds of Statins until Finally getting one with no side effects ... AND wow, is it ever a good cholestoral buster. Called Vytorin 20/10, has a statin and another kind of cholestoral drug. Up to now, I've never gotten my total below 180. I am now 127 total and 67 LDL.

 

[Der Biermeister]

Well I had a hell of a day. Dizzier and weaker than ever, I left work at 9:30 to go see my cardio. I could barely walk 10 yards before having to literally hang on to something and rest for a couple of minutes. Didn't help that at the medical center I had to park about 200 yards away from the entrance.

Then, come to find out that my doc wasn't even there ... not sure where he was but he wasn't coming in until this afternoon. THANKS FOR THE CALL! Anyway, his nurse was there I made her take down all my complaints and suspicions about the double-dose of Lisinipril - and had her check my lungs (VERY clear). She said the doc would call me back this afternoon with a new drug.

Well he was too busy with patients but his nurse called back and he is taking me completely off the Lisinipril (ACE inhibitor) -- which I've been on for almost 15 years -- and putting me on something called Cozaar. Here is a brief on it:

It is the first of a new class of blood pressure medications called angiotensin II receptor antagonists. Cozaar works, in part, by preventing the hormone angiotensin II from constricting the blood vessels, which tends to raise blood pressure.

Curious as to whether anyone out here on this forum is using it and what do you think? Main side effects are dizziness, runny nose, and sore throat . No mention of tiredness or weakness (which would be fantastic if true). Although it sometimes causes SOB. Geez -- just what I'm trying to get away from. Also there is some kind of adverse reaction to potassium supplements, of which I am taking because of the bumex I take. So - got to get this straight with the doc tomorrow. I am a little worried in that he is starting me at the max dose of 100 mg. (Also comes in 25 mg, and 50 mg). I guess, in for a penny, in for a pound, eay?

I also take Norvasc (10mg) and bumex (1 mg). I want to strike a deal with my doc, that if this Cozaar really does bring my bp down, that I can cut the Norvasc in half or even eliminate it. It is either partially (or totally) responsible for my ankle edema.

DB

 

[Nancy]

I have high BP and I take Cozaar. I've been on it for several years. It controls the BP well, and I cannot detect any side effects from it.

Granted I don't have the other issues you do, but I think it's a good drug. And I take the 100mg once a day.

Maybe it will work a little differently with your situation, but I hope not. I like it. And I have a friend on it too, and she has no side effects either.

So I'm keeping my fingers crossed for you.

 

[Der Biermeister]

I have high BP and I take Cozaar. I've been on it for several years. It controls the BP well, and I cannot detect any side effects from it.

Granted I don't have the other issues you do, but I think it's a good drug. And I take the 100mg once a day.

Maybe it will work a little differently with your situation, but I hope not. I like it. And I have a friend on it too, and she has no side effects either.

So I'm keeping my fingers crossed for you.

Nancy - it's been 36 hours now since my last Lisinipril dose. I slept good last night (with the help of Tylenol PM), but I find myself this morning still quite weak, some dizziness, some stomach discomfort, still a cough, and of course what I call serious dypsnea.

I am hoping beyond hope that this lisinipril effect on overall weakness has also made my respiratory system weak, and that has contributed in a big way to my steadily worsening dypsnea. Do you think that is plausible?

Also - how long does it take to get that medicine out of my system?
DB

 

[Georgia]

Potassium supplements are not indicated for those taking an ACE inhibitor - wonder if that's part of your problem with the lisinopril? Apparently ACE inhibitors are potassium-sparing. Altho I'm on lasix my cardio won't allow a potassium supplement due to the Mavik. Have to eat bananas, etc., to make sure the potassium doesn't get low.

 

[Der Biermeister]

Potassium supplements are not indicated for those taking an ACE inhibitor - wonder if that's part of your problem with the lisinopril? Apparently ACE inhibitors are potassium-sparing. Altho I'm on lasix my cardio won't allow a potassium supplement due to the Mavik. Have to eat bananas, etc., to make sure the potassium doesn't get low.

Georgia - I am taking Potassium supplements already because of the heavy diuretics (1 mg bumex).

 

[Nancy]

What I have found with Joe is that any nasty aftereffects of medications take much longer to clear from his system than most ordinary folks. It may have a short half-life, but for Joe it might take a week to finally get outta there.

So allow yourself a little more time, and I bet things will start to improve.

Hope you feel better soon.

 

[Der Biermeister]

What I have found with Joe is that any nasty aftereffects of medications take much longer to clear from his system than most ordinary folks. It may have a short half-life, but for Joe it might take a week to finally get outta there.

So allow yourself a little more time, and I bet things will start to improve.

Hope you feel better soon.

Ok - I kind of figured it might take a while and you confirmed it. Thanks

 

[Jamboesque]

My soon to be age 75 year old Hubby..went to local clinic..2 years ago ( I was on jury duty..had no idea he went)..next thing I knew..he was down at local heart hospital having a Cath of Heart....Everything was fine..but came home with that linsinipril (sp?)..he started coughing and felt awful.. Luckly, I had read about the effects from it .and got them to change to..now..he takes..1..Hyzaar.. and 1 coreg.. a day.. and just had his yearly checkup..doing great..so great, he's outside planting Fall flowers in the dark. Cannot get him to slow down. ...His b/p is great.. Today, he bought something to paint his basement floors with.. 10 years older than me..I'm worn out from babysitting my age 4 year old new Grandson from Russia.. Ask your doctor about these 2 b/p meds..Bonnie

Granbonny, What you need to do is get your Hubby to look after your/his grandson and you paint the basement floor & plant stuff. That you should be equally tired, No !

 

[Nancy]

I think your first obvious clue that it's going, going, gone will be when your little cough goes away. If it were Joe, that's what I'd be looking for.

 

[Der Biermeister]

I think your first obvious clue that it's going, going, gone will be when your little cough goes away. If it were Joe, that's what I'd be looking for.

Nancy - been about 2 1/2 days now since I took my last Lisinopril pill. For some reason I am dizzier and weaker today than before - so I am a believer now that it takes maybe a week to start feeling better. I have NOT begun the new med (Cozaar) yet. And I won't until I feel better. No sense in compounding side effects or making things even more confusing.