Too many meds? - Heart Disorders Message Board

THE DOVEMAN T · 01-24-2009, 08:51 PM

I recently had an arterial stent placement. My doctor has me on clopidogrel (75mg), gemfibrozil (600mg), hctz (15mg), lisinopril (40mg), nifedipine (90mg), omeprazole (20mg), prazosin (2mg), simvastatin (20mg), metoprolol tartarate (50mg) and aspirin (325mg). Could this be too many meds? I keep having different things happen to me every day (ie: Runny nose one day, palpitations the next, back pain the next day, sore throat the next day, etc). They keep telling me not to worry, everything will be okay once my body adjusts. But it's been a month now, and i'm just sick of being sick. I feel worse now than when this all started. Any ideas?

The doveman t

Machaon · 01-25-2009, 07:10 AM

Everyone is different. Many people react very differently to one medication, never mind as many as you are on.

All medications come with side effects, because ALL medications are somewhat imperfect. The meds try to correct a complex medical situation within the body, and we can't expect the meds to do a perfect job.

That said, many meds can, and do, interact badly when combined. Also foods and drinks and your lifestyle can influence how "one" particular medication effects you personally, never mind a whole bunch of meds.

Your doctor can't know for sure how that combination of meds is going to effect you. There has NEVER been a clinical trial to test that exact set of medications that you are on. Not even close!

They'll throw a hodgepodge of medication at you and wait to see what happens, the same as you are waiting to see what happens with all of those medications circulating in your body. The problems is that you already are seemingly having bad reactions to that soup of chemicals from the medications.

The doctor's office is telling you not to worry and just to wait and see what happens, because they don't have the time to do a detailed, in depth evaluation of you. The easy way for the doctors to collect their big fees, and not have to do much, is to throw a bunch of medications at their patients, wait for the side effects to set in, and then tell their patients not to worry.

Doctors don't EVER take the time to study your diet, or your lifestyle, to determine the best mix of meds for each individual patient. They can't. As an example, my heart failure was getting worse each year, over the past 20 years. I've done hundreds of hours of research into my "individual" reactions to medications, the interactions between my meds, and between my foods and drinks and my meds, and the effect of my lifestyle on my health. As a result, I am doing much better now close to 70, than I was 20 years ago. Doctors can't possibly do this for each patient, so they throw a bunch of meds your way, some which fit your unique situation, some of which don't.

The doctor tells you to ignore your misery because, over time, your body will get used to the meds. He is guessing, and you are paying the price for that guesswork.

You said: But it's been a month now, and i'm just sick of being sick. Those that tell you, don't worry, just listen to the doctor and don't question, aren't listening to you, or just don't care.

Doctors should work with their patients, and try to find the perfect fit of medication, for each patient's unique individual circumstance, and not shrug off the bad reactions some patients get to the clump of meds they throw at them.

Have you thought about getting a second opinion?

PeaceandHarmony · 01-25-2009, 11:41 AM

I have had the same problem as well, infact last week after eight weeks of taking the tablets and feeling unwell, I thought I was going mad !!!!!! I did not have a stent but had a very small area of thickening and they said treat with Medication. I have felt dizzy, lack of appretite, not feeling myself at all......the later part of this week I actually have started feeling better and want to do more. My Doctor thought what I was getting was because of anxiety but I dont think it was. Are you worried or anxious about what you have gone through and what to expect in the future ?

I would certainly go back to your Doctor or ask the hospital if there is anything they can do because you do seem to have alot of tablets to take.

harka · 01-25-2009, 11:58 AM

The doveman,

You've obviously had a very rough couple of weeks. Let me break it down for you: after someone has a heart attack and has stents placed, the minimum drugs the patient should be put on are:

aspirin
clopidogrel (plavix)
a beta blocker (like metoprolol)
and ACE inhibitor (like lisinopril)
a statin (like simvastatin).

Each of those things has a VERY important indications post heart attack.

1. The aspirin helps to keep your platelets from clumping together which can prevent future heart attacks.

2. The beta-blocker helps to take stress off the heart so that it doesn't continue to be overworked and lead to further heart muscle damage.

3. The statin prevents futher deposition of plaque in to the coronary arteries but also helps to stabilize existing plaques. The rupture of an existing plaque and then the clot that forms on top of it is the reason people have heart attacks.

4. The ACE inhibitor (or ARB) helps to prevent the damaged heart muscle from scarring too severely. Cardiac scars lead to malignant arrhythmias in the future.

5. Clopidogrel is generally kept on for a period of 3 months (for a bare metal stent) or 9-12 months (for a drug eluting stent) to prevent the new stent from clotting off.

Other medications are often added to this to further reduce your risk of cardiac events. This happens by reducing modifiable risk factors like; high blood pressure, high cholesterol and diabetes.

I am going to have to disagree with Machaon on this one that the doctors "don't have time" to do a full evaluation of you. They don't profit from giving you these heart medications--it's for your own good. But you are absolutely correct, there are a LOT of new medications you're on and it DOES take the body time to adjust to them, and it often takes around 2-3 months. That said, there are some things which can change in the short run to help you feel better. Sometimes one's blood pressure can be too low because certain blood pressure medications were started in the hospital when your body was stressed and your pressure was high, but as soon as you came home and were able to relax a bit, the pressure came down too low. Go to your family practitioner and see if that is the case. Other than the five medications I mentioned above, you are on a few others that could be held or modified.

One thing you have to accept at this point is that you've had a cardiac event, and in order to have a good outcome you HAVE to remain on some type of pharmacotherapy. Machaon has some other good advice about non-pharmacological methods which are very important as well. When people have adverse events, they always want to blame it on the drugs. It absolutely may be from certain medications, and you should go to your doctor to sort that out; however, remember also WHY you're on the drugs. You've just had a myocardial infarction and that is something that may happen again in the future unless you're careful. NOW is the time to start preventative therapy. You may feel a bit off for the first few months, but remember what you are getting in exchange for that few months of discomfort.

tjlhb · 01-25-2009, 05:54 PM

You may want to ask your primary physician to review the list of medications and discuss the side effects that you are experiencing, just to be sure.