flowergirl2day
07-03-2007, 01:39 AM
Hello everyone,
I discovered a Canadian government website with all things pharmaceutical that also publishes a Canadian Adverse Drug Reaction Newsletter. A motherlode of information! Wow!
In today's issue is an article titled as above. (ACE Inhibitors and Bronchospasm). I thought I was dreaming when I saw it! I decided to share it just in case there's another person out there suffering with severe shortness of breath for no apparent reason.
I've only heard about one common adverse effect of Ramipril, the dry cough. Apparently, ACE inhibitors also cause adverse respiratory reactions in some people. (This is not very common). They induce bronchial hyperresponsiveness - airways respond abnormally; this results in their narrowing, which then causes bronchospasms.
I suspect I am one of the few whose airways are affected in this manner. I am on a maximum dose of this drug. Add to it my high dose of alpha&beta blockers - I have the answer I've been seeking for so long!
Unfortunately, the only way to alleviate this problem is by discontinuing the drug. I don't think that's an option. What's worse, I'll be back on the beta blockers soon. :(
Flowergirl
I discovered a Canadian government website with all things pharmaceutical that also publishes a Canadian Adverse Drug Reaction Newsletter. A motherlode of information! Wow!
In today's issue is an article titled as above. (ACE Inhibitors and Bronchospasm). I thought I was dreaming when I saw it! I decided to share it just in case there's another person out there suffering with severe shortness of breath for no apparent reason.
I've only heard about one common adverse effect of Ramipril, the dry cough. Apparently, ACE inhibitors also cause adverse respiratory reactions in some people. (This is not very common). They induce bronchial hyperresponsiveness - airways respond abnormally; this results in their narrowing, which then causes bronchospasms.
I suspect I am one of the few whose airways are affected in this manner. I am on a maximum dose of this drug. Add to it my high dose of alpha&beta blockers - I have the answer I've been seeking for so long!
Unfortunately, the only way to alleviate this problem is by discontinuing the drug. I don't think that's an option. What's worse, I'll be back on the beta blockers soon. :(
Flowergirl
Sponsor
famnd
07-03-2007, 11:15 AM
Glad you found that newletter. I'll check it out too. Sorry to be so late getting back to you. My b/p has zoomed up again so I am trying to figure out the cause (226/78). Its probably a combination of stress, switching med doses, & of course good old "cuff anxiety." Anyhow re: the pkg inserts. If you can find a PDR (Physician's Desk or drug reference), it will have all the info as the pkg inserts. The PDR is usually in bigger libraries. [removed] Which ARB are you most concerned about? I can probably get a pkg insert & relay the info. I keep forgetting you are in Canada where things may be different. Fam
flowergirl2day
07-03-2007, 12:14 PM
Hello, :)
If you can find a PDR (Physician's Desk or drug reference), it will have all the info as the pkg inserts.
Fam, thanks for your reply. I have ordered several books, which include a PDR diagnostic and PDR drug references from my favorite book discount place. I should have them shortly.
An excellent book I highly recommend: "What your doctor may not tell you about hypertension", written by Mark Houston, MD (and others). The author has conducted many hypertension studies. The information contained within led me (indirectly) to the above mentioned article. I plan to use some of the information in this book to help me reduce the need for BP meds. I have to remain on Ramipril but will see if there's an alternative drug. I don't need any info about the ARBS as I am allergic to them (they caused me severe breathing difficulties & temporary paralysis of limbs). That's too bad! Because of their similarity they work so well together with ACE inhibitors, and are beneficial in more ways than just a BP reduction.
Flowergirl
If you can find a PDR (Physician's Desk or drug reference), it will have all the info as the pkg inserts.
Fam, thanks for your reply. I have ordered several books, which include a PDR diagnostic and PDR drug references from my favorite book discount place. I should have them shortly.
An excellent book I highly recommend: "What your doctor may not tell you about hypertension", written by Mark Houston, MD (and others). The author has conducted many hypertension studies. The information contained within led me (indirectly) to the above mentioned article. I plan to use some of the information in this book to help me reduce the need for BP meds. I have to remain on Ramipril but will see if there's an alternative drug. I don't need any info about the ARBS as I am allergic to them (they caused me severe breathing difficulties & temporary paralysis of limbs). That's too bad! Because of their similarity they work so well together with ACE inhibitors, and are beneficial in more ways than just a BP reduction.
Flowergirl
mod-anon
07-03-2007, 01:13 PM
Please bring your attention to the posting policy. Please do not offer to provide contact, in any form, with commercial providers.
flowergirl2day
07-03-2007, 01:25 PM
My apologies. Thank you for reminding me.
FG
FG
Lenin
07-04-2007, 10:40 AM
I've only heard about one common adverse effect of Ramipril, the dry cough. Apparently, ACE inhibitors also cause adverse respiratory reactions in some people. (This is not very common). They induce bronchial hyperresponsiveness - airways respond abnormally; this results in their narrowing, which then causes bronchospasms.
I think the bronchospasm and the dry unbearably TICKLYcough and even the extreme of angioedema are one and the same thing...the body's cascading response to an onslaught of kinins (which ACE normally inactivates.) Only the degree of discomfort and risk are different.
If the ONLY class of BP drugs were the ACE inhibitors and I had to choose THEM or living with a 175/100 BP...I'd have to choose the BP.
I think the bronchospasm and the dry unbearably TICKLYcough and even the extreme of angioedema are one and the same thing...the body's cascading response to an onslaught of kinins (which ACE normally inactivates.) Only the degree of discomfort and risk are different.
If the ONLY class of BP drugs were the ACE inhibitors and I had to choose THEM or living with a 175/100 BP...I'd have to choose the BP.
flowergirl2day
07-04-2007, 02:52 PM
Lenin,
I think the bronchospasm and the dry unbearably TICKLYcough and even the extreme of angioedema are one and the same thing...
Thanks for your response. My ACE cough returned with a vengeance as the beta blockers were discontinued and we started trying new meds. It gets me up at night with my eyes running and is only a little better during the day.
My SOB is a separate issue. I am aware that it could be caused by factors other than the drugs. I have consulted another doctor who is going through my medical records and will advise me on the course of action to take. She suggested I change my diuretic :) and agreed that Lasix and some hydrochlorothiazide would be a good choice (they can be taken together). I would like these changes made before my doctor returns from holidays. I don't know if she'll be willing to do it or just make the recommendations. In her opinion, I should see the BP specialist again to get my meds straightened out. The doctor gave me a referral to a dietitian for a custom-made diet that will deal with my health issues. My ultimate goal is to be on as few meds as possible.
If the ONLY class of BP drugs were the ACE inhibitors and I had to choose THEM or living with a 175/100 BP...I'd have to choose the BP
I am on these for more than one reason. I'd have to see a specialist before going off these.
Flowergirl
I think the bronchospasm and the dry unbearably TICKLYcough and even the extreme of angioedema are one and the same thing...
Thanks for your response. My ACE cough returned with a vengeance as the beta blockers were discontinued and we started trying new meds. It gets me up at night with my eyes running and is only a little better during the day.
My SOB is a separate issue. I am aware that it could be caused by factors other than the drugs. I have consulted another doctor who is going through my medical records and will advise me on the course of action to take. She suggested I change my diuretic :) and agreed that Lasix and some hydrochlorothiazide would be a good choice (they can be taken together). I would like these changes made before my doctor returns from holidays. I don't know if she'll be willing to do it or just make the recommendations. In her opinion, I should see the BP specialist again to get my meds straightened out. The doctor gave me a referral to a dietitian for a custom-made diet that will deal with my health issues. My ultimate goal is to be on as few meds as possible.
If the ONLY class of BP drugs were the ACE inhibitors and I had to choose THEM or living with a 175/100 BP...I'd have to choose the BP
I am on these for more than one reason. I'd have to see a specialist before going off these.
Flowergirl
famnd
07-05-2007, 12:06 PM
Hi FG,
So sorry to hear about the return of your cough. That must be so annoying. Hope you don't have a hiatal hernia & reflux because the cough will just aggravate those issues. Did your new Dr. think that you may have GI issues (acid reflux?). With all the meds plus supplements you are taking it wouldn't be suprising if you had acid reflux (especially having had 4 kids) Thanks for the name of that book-sounds interesting.
My b/p Dr. wanted me to consider taking two diuretics but there were too many problems with that in my case. McConnel has a note in her book concerning taking diuretics (particularly HCTZ) if one has kidney problems.
I hope you can get all this settle before your regular gets back. You never know he maybe relieved. By the time I told my Dr. that I was getting another opinion, she was more than ready to turn my b/p problems over to another Dr.I went back to her once I had a course of action. Hang in there it looks like you are turning a corner & a solution will be found. Fam
So sorry to hear about the return of your cough. That must be so annoying. Hope you don't have a hiatal hernia & reflux because the cough will just aggravate those issues. Did your new Dr. think that you may have GI issues (acid reflux?). With all the meds plus supplements you are taking it wouldn't be suprising if you had acid reflux (especially having had 4 kids) Thanks for the name of that book-sounds interesting.
My b/p Dr. wanted me to consider taking two diuretics but there were too many problems with that in my case. McConnel has a note in her book concerning taking diuretics (particularly HCTZ) if one has kidney problems.
I hope you can get all this settle before your regular gets back. You never know he maybe relieved. By the time I told my Dr. that I was getting another opinion, she was more than ready to turn my b/p problems over to another Dr.I went back to her once I had a course of action. Hang in there it looks like you are turning a corner & a solution will be found. Fam
flowergirl2day
07-05-2007, 01:32 PM
Some clarification:
An adverse effect - identified in PRE-market testing; this can be managed as an expected or tolerated side effect
An adverse reaction - comes to light AFTER a product is made available on the Canadian market. New, unexpected or undesirable side effects noted when the product is used in ''real world".
[removed]
I am going to look into this further & ask the doctor for her opinion on this. I'll post any new information, if any.
Flowergirl
An adverse effect - identified in PRE-market testing; this can be managed as an expected or tolerated side effect
An adverse reaction - comes to light AFTER a product is made available on the Canadian market. New, unexpected or undesirable side effects noted when the product is used in ''real world".
[removed]
I am going to look into this further & ask the doctor for her opinion on this. I'll post any new information, if any.
Flowergirl
flowergirl2day
07-05-2007, 06:28 PM
Hi Fam,
What do you think of the quotes in my previous post? It SOUNDS as if the ACE inhibitors cause previously undocumented respiratory problems.
I've had to put up with my cough for so long, I don't notice it much. It got better for a while before becoming more persistent again. I had two kids (not 4 :) by C/section-how does the hernia figure into that? I did not have any GI, acid reflux or pulmonology tests done. She'll make recommendations based on her review of my medical records which mostly consist of cardio and renal tests. I will ask her about acid reflux, sleep apnea (on my list of questions). She is also copying all the important files for me. :)
If both diuretics are used, the doses will be low. Depending on how things go, I might ask her to take me on as a patient. Thank you for your post and all the encouragement - things are looking up!
P.S. I hope your get your BP under control!
Flowergirl
What do you think of the quotes in my previous post? It SOUNDS as if the ACE inhibitors cause previously undocumented respiratory problems.
I've had to put up with my cough for so long, I don't notice it much. It got better for a while before becoming more persistent again. I had two kids (not 4 :) by C/section-how does the hernia figure into that? I did not have any GI, acid reflux or pulmonology tests done. She'll make recommendations based on her review of my medical records which mostly consist of cardio and renal tests. I will ask her about acid reflux, sleep apnea (on my list of questions). She is also copying all the important files for me. :)
If both diuretics are used, the doses will be low. Depending on how things go, I might ask her to take me on as a patient. Thank you for your post and all the encouragement - things are looking up!
P.S. I hope your get your BP under control!
Flowergirl
mod-anon
07-06-2007, 03:39 AM
Please call your atention to the Sticky at the top of this page: "Copying and Pasting is not allowed."
Please paraphrase in your own words what you read somewhere else. For copyright reasons, do not copy material directly from another website.
Please paraphrase in your own words what you read somewhere else. For copyright reasons, do not copy material directly from another website.
famnd
07-08-2007, 04:53 AM
Sorry I gave you two extra kids:). Anyhow, if I'm correct one child was over 10 lbs? Have a larger baby could have put more pressure on your upper abdomen. I my 10lb 5oz boy is where I got my hiatal hernia. Not everyone with a h. hernia has acid reflux etc.
I have to look in my drug book to see how the adverse effects versus reactions is labeled. I do know that once a drug has passed the FDA approval & gets into the general population more problems come up because a wider variety of patients are taking it. It is important to report both to the FDA & the manufacturer any significant side effects. The manufacturer is required to report these findings to the FDA but just to be sure I always give my own report to the FDA. A representative from the manufacturer will often call to find out details of the reaction. My fingers are tiring & I'm tired enough to sleep down. Fam
I have to look in my drug book to see how the adverse effects versus reactions is labeled. I do know that once a drug has passed the FDA approval & gets into the general population more problems come up because a wider variety of patients are taking it. It is important to report both to the FDA & the manufacturer any significant side effects. The manufacturer is required to report these findings to the FDA but just to be sure I always give my own report to the FDA. A representative from the manufacturer will often call to find out details of the reaction. My fingers are tiring & I'm tired enough to sleep down. Fam
flowergirl2day
07-08-2007, 08:31 PM
Thank you Fam. The adverse reactions described in the second half of the report are not about an ACE induced cough. The cough was a known adverse EFFECT at the time of clinical trials and when all the studies were carried out, prior to an approval of this drug. That's the reason for the cough being listed in all the drug info sheets as a possible side effect. I'll make sure to report my difficulties to proper authorities if a determination is made that the ACE inhibitor is partly responsible. I will contact the adverse reaction to drugs newsletter myself for more info.
Thanks for checking out the diuretics and beta blockers. I skipped taking my BP meds a few times just to see what my BP would do. To my surprise, it was very reasonable! I guess it would take a few consecutive days without any BP drugs to find out for sure. :) On the existing medications, my BP is consistently high in the mornings when I wake up, and in the evenings at bedtime. The hiatal hernia is known to cause a shortness of breath and is a good possibility. I know it's common and most people just live with it. I wondered about it when looking for possible causes of shortness of breath. Have you managed to find a new supplier of your dye-free pills? Your BP fluctuates to dangerously high levels - do you get headaches when it gets very high? I don't have to measure my BP to know when it's high. I get a very distinct headache. The higher the BP, the more intense the headache. Have you ever managed to get your hypertension under control? I can't help but wonder if it can be achieved in certain patients.
Flowergirl
Thanks for checking out the diuretics and beta blockers. I skipped taking my BP meds a few times just to see what my BP would do. To my surprise, it was very reasonable! I guess it would take a few consecutive days without any BP drugs to find out for sure. :) On the existing medications, my BP is consistently high in the mornings when I wake up, and in the evenings at bedtime. The hiatal hernia is known to cause a shortness of breath and is a good possibility. I know it's common and most people just live with it. I wondered about it when looking for possible causes of shortness of breath. Have you managed to find a new supplier of your dye-free pills? Your BP fluctuates to dangerously high levels - do you get headaches when it gets very high? I don't have to measure my BP to know when it's high. I get a very distinct headache. The higher the BP, the more intense the headache. Have you ever managed to get your hypertension under control? I can't help but wonder if it can be achieved in certain patients.
Flowergirl
katolb90
07-09-2007, 03:24 PM
A quick note on the ace-inhibitor cough. If and only if you are iron deficient or somewhat low on iron you can try taking a little bit of iron supplementation. Only and only if you are kinda low. Get your iron checked first because too much iron is bad for you. [removed] somehow iron helps the cough. I was on iron and an ace-inhibitor at the same time. I stopped the iron for some reason I don't remember and WALLA! I start all this coughing. [removed] I am no longer on the meds however. Since I am only stage 1 and sometimes not even that, I decided to try to solve it through better eating and vitamins/supplements.
mod-anon
07-09-2007, 03:57 PM
Please honor your membership agreement. Please read and follow the posting rules.
http://www.healthboards.com/boards/faq.php?faq=faq_hb
"Posting any kind of information for any reason on how to find websites, products, services, businesses, commercial sites, message boards, or chats is cause to be banned."
http://www.healthboards.com/boards/faq.php?faq=faq_hb
"Posting any kind of information for any reason on how to find websites, products, services, businesses, commercial sites, message boards, or chats is cause to be banned."
famnd
07-10-2007, 12:22 AM
No, I feel great as a matter of fact when my b/p is high. I don't get a headache or other physical symptoms that's why I have to be vigilant about my lifestyle, emotions, etc. The University Doc said that he had some other pts. in my category. So he said he would be happy if I could
keep my b/p @ 160 most of the time. My diastolic is well controlled. "Cuff anxiety" raises my b/p the most.
I have the sliding type of hiatal hernia so I have to be very careful with my lifestle etc. Part of the stomach slides up into the chest. It can cause shortness of breath when it is in the chest. I cope with that by eating almost all my food in the am & take a nap in a Lazyboy so it isn't a problem unless I try to do lifting etc. while having a full stomach.
Just found out I'm getting some unexpected company tomorrow-friends just traveling through. Guess they will have to overlook the "lived in look" cause I'm in the middle of a lot of projects & can't possibly get everything in order. They are old friends so should understand. You'll be in my thoughts hoping you find an answer soon. Fam
keep my b/p @ 160 most of the time. My diastolic is well controlled. "Cuff anxiety" raises my b/p the most.
I have the sliding type of hiatal hernia so I have to be very careful with my lifestle etc. Part of the stomach slides up into the chest. It can cause shortness of breath when it is in the chest. I cope with that by eating almost all my food in the am & take a nap in a Lazyboy so it isn't a problem unless I try to do lifting etc. while having a full stomach.
Just found out I'm getting some unexpected company tomorrow-friends just traveling through. Guess they will have to overlook the "lived in look" cause I'm in the middle of a lot of projects & can't possibly get everything in order. They are old friends so should understand. You'll be in my thoughts hoping you find an answer soon. Fam
flowergirl2day
07-10-2007, 01:51 PM
Hello,
Katol:
Thanks for the information about iron deficiency and cough. I have not heard of a connection between the two. How interesting! I will look into it!
Fam:
We are working on it! I am waiting for a call from the hospital with a date for pulmonary function tests. None of my BP medications will be discontinued and no new ones added until I am seen by my BP specialist again. Also, a dietitian will design a diet tailored to my needs.
I could live with a higher BP (like you), but have to keep trying to lower it - the nephrologist wants it at 120/70-80. That's because uncontrolled or poorly controlled BP effects the kidney function negatively (especially in the presence of kidney disease), often resulting in further loss of renal function. I now have most of the medical reports from the consults and there's some concern, especially by my nephrologist, about my BP meds not being consistently effective in controlling my BP.
The doctor was very interested in the ACE inhibitor adverse reaction report and will be looking into it. She said she'd contact one of the participating doctors listed. If we find that ACE inhibitors are contributing to my SOB, they will be discontinued. :) We had company for almost a week. I can use a bit of R&R. That's what I'll do today. Enjoy your company!
P.S. I took a list of my supplements to the doctor's office and they were approved.
Flowergirl
Katol:
Thanks for the information about iron deficiency and cough. I have not heard of a connection between the two. How interesting! I will look into it!
Fam:
We are working on it! I am waiting for a call from the hospital with a date for pulmonary function tests. None of my BP medications will be discontinued and no new ones added until I am seen by my BP specialist again. Also, a dietitian will design a diet tailored to my needs.
I could live with a higher BP (like you), but have to keep trying to lower it - the nephrologist wants it at 120/70-80. That's because uncontrolled or poorly controlled BP effects the kidney function negatively (especially in the presence of kidney disease), often resulting in further loss of renal function. I now have most of the medical reports from the consults and there's some concern, especially by my nephrologist, about my BP meds not being consistently effective in controlling my BP.
The doctor was very interested in the ACE inhibitor adverse reaction report and will be looking into it. She said she'd contact one of the participating doctors listed. If we find that ACE inhibitors are contributing to my SOB, they will be discontinued. :) We had company for almost a week. I can use a bit of R&R. That's what I'll do today. Enjoy your company!
P.S. I took a list of my supplements to the doctor's office and they were approved.
Flowergirl