How do MD's decide which type to Rx? - High & Low Blood Pressure Message Board

Janni · 09-17-2005, 10:41 AM

When I was first told I needed bp meds, my DR put me on Univasc (generic moexipril), an ACE inhibitor, because I also have diabetes, and it was believed that the ACE inhib are the best type for diabetes (I don't know why....) The Univasc seemed to work adequately with no side effects. Due to having to change ins co's for a few years, other drs tried cozar and hyzar, with gave me very rapid heart rate, and lisinopril which made me so edgy I blew up at people over nothing. Then was able to change ins and get back to the original doc, and back on the moexipril. Then the company that made the generic discontinued making it, and if I wanted to go back to the brand name Univasc, it would cost me about $50 a month, and would be very hard to fit into the budget-things so tight now I don't know what I could cut to accomodate it.

So, to replace the Univasc, DR Rx generic Accupril (quinapril). I've been on it for a month now, which should be long enough to adjust, and I'm having a bad time with it. Lousy sleep, depressed and blah feelings, cough much worse than with Univasc,and I think some mild angioedema: insides of my lips are puffy, I accidently bite them when I eat, and I think I'm biting on them when I sleep because they are very puffy when I wake up. Going to try to go back to DR this coming week.

So now I'm wondering if the Dr should try a different type other than ACE inhib, and if so, how he would decide. I'm really frustrated with this, and maybe I should just bite the bullet and buy the Univasc. I'm frustrated in general with medicines! So tired of miserable side effects.

smc612 · 09-17-2005, 01:19 PM

my dr. keeps all of mly health problems in consideration. i take catapres for HBP and maxide which is a diuretic for adema in my hands. i also have multiple food and repiratory allergies, asthma and diabetes. do not take diabetic meds. this works for me and i have no ugly side effects to either drug.

Janni · 09-17-2005, 06:38 PM

It's good to hear that something is working well for you angel 54. What gets my goat is that the generic Univasc (moexipril) was working and now I can't get it any more. I've found that there are NINE different types of HBP meds, and no literature that I can find on which type should be prescribed when. And that's not counting the tranquilizers sometimes given.

Lenin · 09-18-2005, 06:59 AM

Janni,

I'm surprised that they seem so different for you; I've always thought of the ACE inhibitors as "peas in a pod."

Might as well try captopril, at about $7 a month the price is certainly appealing, maybe it will be as side-effect free as the Univasc.

Unfortunately the way the doctors TOO OFTEN decide which drug to use is to prescribe the one that is eventually in the best overall financial interest of the doctor, and that is ALWAYS a non-generric. Some drug companies can be VERY generous to big prescribers.
Fortunately, some states and ALL insurers demand filling the Rx with generics when possible, hence the push to find yet another teeny variant that will allow it to be peddled under PATENT.

Janni · 09-18-2005, 09:25 AM

What I meant by 9 different types with different actions: In addition to the ACE inhib, there are also: diuretics, beta blockers, angiotensin antagonists, calcium channel blockers, alpha blockers, alpha-beta blockers, nervous system inhibitors and vasodilators. And within the types, several different brand names. And I'd like to know how a DR decides who should get one type as opposed to a different type.

My ins co, a not-for profit HMO requires that a generic be given if available. Before that ins co, I did have a dr who was pushing Merck products aggressively. I decided to drop him just about the time he moved out of state, LOL. I wouldn't even be fussing about all this if the co. that made moexipril, (generic Univasc) was still making it.