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Odd combination of BP meds?

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stuart1953
stuart1953

Hi, new to the forum and this is my first post!

I've suffered with high BP for a number of years. I'm now 61 and despite losing weight recently (which has had an amazing impact on my T2 diabetes) my BP has not improved. In fact it's got slightly worse with some odd readings (to my untrained eye).

ranging from: 86 / 69 to 150 / 104 (average 106 / 80). This seems a bit erractic to me (I'm using a "approved" meter).

I'm also concerned about my heart rate which is invariably in the high 80's to low 90's (all readings taken at rest).

Would anyone else be worried? Bizarely, my readings have got more erratic as I've lost weight!

Also, I'm on 3 drugs for BP:

Lercanidipine 10mg

Lisinopril 10mg

Valsartan Hydrochlorothiazide 160/25mg

My new GP (who has helped me sort my diabetes, so I like her!) reckons that it is a slightly unusual mix of drugs (established by the previous GP) but she's happy for me to continue with them as she's happy with my home-monitored readings. She said will review the meds if I have problems with feeling faint / fainting.

Today I've been consulting Dr Google :-) and on the Multi-Drug interaction checker I found a serious red flag on using Valsartan and Lisinopril...which concerns me. I couldn't check Lercanidipine as it doesn't appear to be licensed in the US where the website is based.

Does anyone know of a UK based drug interaction checker?

Cheers

Stuart...

1 like, 10 replies

10 Replies

  • Tazchurch
    Tazchurch stuart1953

    Posted

    Try these, not sure if will have what need, and University of Utah list it as used in America, was patented there in 2004

    http://ukhealthcare.uky.edu/druginteractionchecker.aspx?id=4294967314

    http://drugs.webmd.boots.com/drugs/

    http://www.drugs.com/uk/

    http://www.nhs.uk/medicine-guides/pages/default.aspx

    • stuart1953
      stuart1953 Tazchurch

      Posted

      Hi,

      Looks to me like these sites (apart from the NHS one which doesn't allow multiple drug selection as far as I can see) are possibly getting their data from a US database as they don't like Lercanidipine (or Zanidip, a common brand name). Two of the sites red-flag Lisinopril and Valsartan though, so I'll ask my GP about that.

      I need to have a discussion with my GP about pain management (for arthritis and musculo-skeletal pain) anyway. I've tried plenty of different pain killers but Ibuprofen is the only one that helps. Unfortunately, the interaction checkers show that Ibuprofen has a "significant" interaction with both the Lisinopril and Valsartan I'm taking. I don't envy the GP, that's for sure. It's all a bit of a mine-field!

      I did try some Ibuprofen last week but stopped after a couple of days as I was feeling a bit "spaced-out" and there was something in the back of my mind about not taking it...I was probably told not to by the GP! The specialist at the Pain Management Clinic did give me some ibuprofen gel though and she was fully aware of the meds I'm on. Perhaps oral ibuprofen works differently to the gel version that's absorbed through the skin...who knows.

      Thanks for your efforts re the sites, I'll have to bookmark them.

      Stuart

    • Tazchurch
      Tazchurch stuart1953

      Posted

      One of the contraindications for oral Ibuprofen is High Blood Pressure,
  • sue7777
    sue7777 stuart1953

    Posted

    Hi Stuart, I've only been on BP meds since March this year, started on enalapril with very bad side effects & not getting readings down anywhere near low enough, replaced that with amlodopine, milder but similar effects as previous med but with really swollen feet & legs which aggravated a problem I already had with my feet, however readings still no better so water tablet was added, ironically this seemed to make swelling worse, 1st August exchanged amlodopine for ramipril swelling went but head got wobblier & eyes constantly blurred, I have just been put onto Losartan at my own request & stopped the water tablet as that seemed to revive a dormant tummy problem. All this time I have been on strict NO SALT diet & lots of all the veg & fish that are supposed to help lower BP, low fats/sugar etc etc. Hour's brisk walk most days & 30 klm bike rides when possible & the only time I got decent readings was when we were in Italy for 11 days & I ate normally? but hardly any veg served with meals, & first 6 days back home my readings were 129/74, 132/76, & similar so I really question if we should take it a bit easier & gradually improve our diet until our bodies get used to medication, as if we haven't been particularly eating healthily for a number of years I guess it's another shock to the system??? just a theory anyway, but your mention of the greatly improved diet for your diabetes struck a chord. Sorry I don't know of a recommended site for checking drug interactions, local pharmacist maybe? or earlier this month there was a guy called Derek that posted something about BP drug interactions, candastartan & a couple of others, maybe mentioning BMA?? site. Anyway, good luck, sorry can't be of any help but if the Dr's pleased with your readings I shouldn't be too worried but obviously still look into it, as the doctors can only be guided by what we tell them really.

    Cheers Sue

    • Tazchurch
      Tazchurch sue7777

      Posted

      Replied with a list of sites and that is why the coment is awaiting moderation.
    • stuart1953
      stuart1953 sue7777

      Posted

      Hi Sue, thanks for the reply.

      I've not been on any of the drugs that you've listed, there seem to be so many options out there!

      One cautionary tale I can tell is about Atenolol. My previous GP (different practice to my current GP) put me on the drug and my dose was gradually increased until it got to 100mg a day. Long story short, based on my on readings showing a heart rate of 50 during the day and mid 30s during sleep, I self-diagnosed (assisted by Dr Google) Bradycardia! My GP, to her credit, agreed as did the heart specialist I was sent to see. When I told him I'd been on 100mg he was not best pleased and called it "old school doctoring" and said he would be writing to my GP and telling her to "get her knowledge up-to-date"! The specialist also said that he hoped I came off it gradually. I said that I asked that very question and was told to just stop taking it - at which point he just groaned and put his head in his hands! I've never taken amphetamines (speed), but I can only imagine that it's very similar to stopping Atenolol abrutbtly! It was frightening..but kind of nice..if you get my drift.

      This is the main reason I changed surgeries (there were others but I'll save them for another post). Best move I ever made, I can't praise the Doctors and Nurses at the new surgery enough.

      You're right though, the doctor can only work with what you tell them, especially when it comes to side-effects, BUT this assumes the doctor will listen..I find the younger ones do, the older ones don't - guess time takes its toll when dealing with miserable sick people every day!

      Cheers

      Stuart

    • stuart1953
      stuart1953 Tazchurch

      Posted

      Aaah.. I was pretty sure I put a URL in my original post, assume it must have been removed (it was my first ever post so I knew it was going to be moderated).
    • derek76
      derek76 sue7777

      Posted

      Losartan and Valsartan are both Angiotensin-II receptor antagonists.

      I wonder why they are being prescribed together but that was not the clash reported..

      This was my earlier posting: 

      This warning is issued to doctors in the BNF:

      Concomitant use of drugs affecting the renin-angiotensin system

      The MHRA has issued new guidance that combination therapy with two drugs that affect the renin-angiotensin system (ACE inhibitors, angiotensin-II receptor antagonists, and aliskiren) is not recommended due to an increased risk of hyperkalaemia, hypotension, and renal impairment, compared to use of a single drug. There is some evidence that the benefits of combination use of an ACE inhibitor with candesartan or valsartan may outweigh the risks in selected patients with heart failure for whom other treatments are unsuitable, however, the concomitant use of this combination, together with an aldosterone antagonist or a potassium-sparing diuretic is not recommended. For patients currently taking combination therapy, the need for continued combined therapy should be reviewed.

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