Acceptable medication? - High & Low Blood Pressure Message Board

Webchat · 04-19-2005, 08:58 PM

I have finally got down to around 125 over 70 for most BP tests I take - previously I was on probably 140+ over 85+. I was on Cozaar 100mg plus a low dose of Nifedepine - then my Doctor increased it to an extended release higher dose and I started getting palpitations... So I stopped that medication.

Since then, to save on drug costs (that's another story as I don't qualify for medical insurance) I have purchased generic Cozaar from Mexico - but also decided to order Cardace 2.5.

And finally my BP is down where it needs to be. But I understand both Cozaar and Cardace work in similar ways (except for the added diuretic). Is there a potential problem taking them both? My doctor never got my BP down before so probably I should change doctors - except for the cost etc...

I am 44, male and 205 pounds. Any thoughts on whether this is a safe combination to stick with? Or precautions I should take?

Thanks in advance.

- Webchat.

Palamedes · 04-19-2005, 09:29 PM

Quote:

Originally Posted by Webchat

And finally my BP is down where it needs to be. But I understand both Cozaar and Cardace work in similar ways (except for the added diuretic). Is there a potential problem taking them both? My doctor never got my BP down before so probably I should change doctors - except for the cost etc...

I am 44, male and 205 pounds. Any thoughts on whether this is a safe combination to stick with? Or precautions I should take?

Cozaar (losartan) is an ARB and Cardace (ramipril) is an ACE Inhibitor. I'm not sure what you mean by the "added diuretic"??? In any case, an ACE combined with an ARB is an effective combination. Though, they do work similar, they still are somewhat complementary. It's probably as close to a complete blockade of the renin-angiotensin system as you can get. The biggest problem with this combo is that the cough and angioedema problems are magnified. The ACE prevents bradykinin from breaking down. And, the ARB increases bradykinin production. So, you have an increased potential for cough. You also can get additional BP lowering as bradykinin will lower BP.

In some of the studies, it's shown some strange anomolies. From what I recall, an ACE+ARB worked rather well. But, an ACE+ARB+BB had very poor results. So, you might want to be a little careful if adding a third drug.

Pal

Webchat · 04-19-2005, 09:46 PM

Thanks Pal,

I have never 'experimented' with drugs before but felt I needed to take control of my BP myself - so it's reassuring to know that I may be on the right track.

My comment about diuretics was because I forgot to mention the 'H' - I am using Cardace H which has 2.5mg Ramipril and 12.5mg hydrochlorothiazide. I had read that this three-pronged approach had often been shown to be very effective.

- Webchat

Kaco · 04-19-2005, 10:56 PM

My BP was acting up for some time. Headaches that felt as if the top of my head was comming off, nausea, fatigue. I go to the Dr. regularly and always had my BP taken but no one said anything was wrong. Went last week for a sinus infection and the nurse practitoner flew into a rage over my BP. When I go to the Dr. I usually have to take whomever has an appt. open. My insurance demands this. I was scheduled for blood work and told that someone would be in touch in about three days. Never heard from them. I took my BP at the pharmacy as instructed to do by the Nurse Practitioner and it was 192/105. Scared, I called the Dr. office and they did get me right in. The dR. who saw me asked a lot of questions and was mad as heck that my chart revealed high BP as far back as three years ago.He said heads should roll over this. More blood work was done and he gave me samples and I'm to report to his office every other day for BP reading and more meds. I guess he wants to get it under control by trying different meds before prescribing. I am using Benicar Olmesartan Medoxomil. What do you know about it...anyone? Another good thing is I can see the same Dr everytime now.

Lenin · 04-20-2005, 05:59 AM

I don't the the losartan and the ramipril together will HURT, but there are better choices for the second drug. THe problem is that neither is of much use for salt sensitive hypertension and both drugs focus on the renin-angiotensin system.
If you've never had an ACE inhibitor before you might find THE COUGH really annoying.

My suggestion is to try a diurettic first. At less than a dime a day, they are kind to the wallet and sometimes REMARKABLY effective.

If palps are a frequent problem, the beta-blocker family might be worth a consideration.

IF you can take it, I think the Cardace WITH HCTZ is a better combo, but make sure you are getting the generic of BOTH!