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Old 07-12-2009, 08:28 AM   #1
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Lisinopril to calcium channel blocker hell

I have been very content with my BP meds, until recently. I was on Avapro for 9 years, til Express Scripts decided that I would have to go through trials, before they would cover it anymore. Talk about administrative crap, having nothing to do with proper medical care. Anyway last year my doc put me on Lisinopril, which actually worked somewhat better than the Avapro.

Recently I was scheduled for arthroscopic surgery. When my blood work was done, mysteriously my Potassium spiked, but only in three weeks pre-op. So the anesthesiologist refused to allow me to have surgery. My primary and my surgeon decided the best thing to do would be a Potassium flush, and change the Lisinopril to Amlodipine, and rescheduled the surgery after a new blood test. Problem for me, since calcium channel blockers were tried on me first, ten years ago, when the BP mysteriously went from lifetime low to high overnight. Yeah, no one has ever explained that either.

The past week has been hell. Excruciating headaches and uncontrolled BP. That's the Almodipine doing it, I know, that's why calcium channel blockers didn't work for me in the first place. I now have so much swelling in my fingers that I had to get my wedding rings off, before they would have to be cut off, and I also am noticing broken capillaries everywhere (not something I ever have a problem with), and every old scar on my body is now engorged with blood.

The other problem is that when I saw my primary in May, she was pushing me to get off the Lisinopril, fear of kidney damage.

I'm 2 days pre-op now, and now I'm fearing that I'll either bleed out on the table or after I'm home, or else stroke.

Any helpful ideas since neither doc wants to do anything til after surgery and post-op? I'm in so much pain with the headache that I can't even think, which is already affecting my job.

 
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Old 07-12-2009, 11:19 AM   #2
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Re: Lisinopril to calcium channel blocker hell

Hi MC,

I am surprised they didn't cut the lisinopril down a bit and add a diuretic. HCTZ drops both sodium and potassium. I would tell them, in no uncertain terms, of your concerns and let them know that these concerns have been voiced for all to hear! Maybe they will think twice before doing anything too risky.

Regards, Brenden.

 
Old 07-12-2009, 08:04 PM   #3
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Re: Lisinopril to calcium channel blocker hell

Hi Momcat,

does this mean you've passed the pre-surgical screening? What was your potassium level? What is the cutoff for potassium, do you know? The actual blood pressure readings pre-surgery are not that important (if within reason), heart-rate lowering drugs are routinely used anyway. Have you been asked to stop taking any of your medication prior to your surgery? What is a potassium flush???!!!

Amlodipine has the side effects you mention, and more. Sometimes the body develops tolerance to this drug and the side effects decrease or even disappear. The broken capillaries are from very high blood pressure, not Amlodipine. I have many of those. Some of them might disappear through time on their own. Sorry about the questions, I know you need answers! I am curious why you fear bleeding during your surgery. Are you on blood thinners? They must have tested your bleeding time.

FG

 
Old 07-16-2009, 08:56 AM   #4
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Re: Lisinopril to calcium channel blocker hell

Quote:
Originally Posted by Editor View Post
Hi MC,

I am surprised they didn't cut the lisinopril down a bit and add a diuretic. HCTZ drops both sodium and potassium. I would tell them, in no uncertain terms, of your concerns and let them know that these concerns have been voiced for all to hear! Maybe they will think twice before doing anything too risky.

Regards, Brenden.
Brenden,

I intend to have to reopen this issue with my primary, but now I'm in post-op, hoping to be cleared by the surgeon tomorrow. Good thing they didn't prescribe HCTZ, cause it just make the matter worse. That's what my old doc did first, 10 years ago, the first time I was on calcium channel blocker. I don't know if it was because I had no need of a diuretic, or the HCTZ itself.
i
I was quite vocal about it pre-op, alienating both the surgeon and my primary. I went into surgery with the uncontrolled BP, and even anesthesia didn't act concerned about it.

 
Old 07-16-2009, 09:08 AM   #5
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Re: Lisinopril to calcium channel blocker hell

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Hi Momcat,

does this mean you've passed the pre-surgical screening? What was your potassium level? What is the cutoff for potassium, do you know? The actual blood pressure readings pre-surgery are not that important (if within reason), heart-rate lowering drugs are routinely used anyway. Have you been asked to stop taking any of your medication prior to your surgery? What is a potassium flush???!!!

Amlodipine has the side effects you mention, and more. Sometimes the body develops tolerance to this drug and the side effects decrease or even disappear. The broken capillaries are from very high blood pressure, not Amlodipine. I have many of those. Some of them might disappear through time on their own. Sorry about the questions, I know you need answers! I am curious why you fear bleeding during your surgery. Are you on blood thinners? They must have tested your bleeding time.

FG
Flower Girl,
After the potassium flush, they did my BMP over again, and this time the potassium came back at 4.7. Here's what I can tell you about my potassium readings. Normal is 3.5 to 5.0. Mine were either 4.9 or 5.0 every time they were measured in the past 10 years. When the first pre-op set was taken the potassium came back as 5.3. This is what triggered the anesthesioogist to cancel the surgery, and demand a full physical. When I went for the physical they drew blood again and this time it came back at 5.7. My reading tells me MI is probable at any level beginning at 6.0. So my understanding is the cutoff is 5.0.
On Lisinopril, and previously on Avapro, my BP ran 110/70. On Amlodipine it is 140/90, which was the reading 10 years ago that made my old primary insist on BP meds at all. I know they broken capillaries and spontaneous bruising is from very high BP, the Amlodipine does not lower my BP. As far as BP effect it has none.

They did not test bleeding time on me, I normally taken Glucosamine Chondroitin for my arthritis, and Pantothene, for cholesterol and triglycerides. Both of these supplements have an adverse effect on bleeding time. So they have to be stopped at least a week prior to surgery.

Potassium flush is done by Kaxexalate. It can be taken by mouth or rectally. Mine was by mouth. I only had to take 2 doses, which is a good thing, since I don't know if I could have handled more, from the retching.

 
Old 07-17-2009, 09:01 AM   #6
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Re: Lisinopril to calcium channel blocker hell

Momcat,

thank you very much for answering my questions. I will be having surgery next month and have been having potassium issues. So you can see why I was concerned. I would not want it to be canceled, after I've had to change my plans and reschedule my holiday. I wish there was a way to keep the level low but how it can be done, short of discontinuing the medication that keeps the potassium in the body, I don't know. They do the testing only a week prior to surgery, which does not leave much time for correcting any abnormalities that they might not be happy with.

I hope all went well for you and that you'll heal quickly. I forgot to mention previously that I also have the old scar issues you mentioned. It happens very often. I have been attributing this to high blood pressure, but I really don't know what causes it. Maybe it is from our antihypertensive medication, as you suggest?

So, which of the antihypertensive drugs will you be taking? What have your doctors decided on?

FG

 
Old 07-17-2009, 03:04 PM   #7
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Re: Lisinopril to calcium channel blocker hell

FG,

If you have high potassium levels from some of the meds you are taking, I wonder if drinking more fluid would help with that? What I am thinking is that increased fluid intake causes more urination & increased potassium loss. Fam

 
Old 07-17-2009, 07:05 PM   #8
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Re: Lisinopril to calcium channel blocker hell

I was told that the presence of excessive potassium is a sign of impaired kidney function, not too little hydration. So increasing fluid intake will not resolve the problem.

I don't know what they're going to do with my situation, and unfortunately can't open that issue not that I'm in the post-op recovery, at least until I am cleared by the surgeon. Too many variables at one time, you know?

 
Old 07-17-2009, 11:49 PM   #9
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Re: Lisinopril to calcium channel blocker hell

Fam,

Quote:
If you have high potassium levels from some of the meds you are taking, I wonder if drinking more fluid would help with that?
The only thing that's going to help is to STOP taking these drugs! They cause so many problems! I now have to worry about gout, which, according to my doctor, I will most likely get. Not a big deal? Easy for them to say, they are not the ones who have to live with the side effects.

All ACE inhibitors, including Lisinopril, help keep the potassium in the body. So do the potassium sparing diuretics and beta blockers. When the kidneys don't work very well, even more potassium stays in the body. Any fruit and vegetables eaten only compound this problem.

momcat,

perhaps you will be able to drop both of these medications and start a new one from another drug class. I wish you luck with this.

FG

 
Old 07-18-2009, 10:07 AM   #10
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Re: Lisinopril to calcium channel blocker hell

Flowergirl,

One can only hope. Right now I'm stuck in recuperation from the surgery, and getting back on my feet.

Good luck with your surgery, BTW!

 
Old 07-18-2009, 07:23 PM   #11
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Re: Lisinopril to calcium channel blocker hell

FG & others,

I'm on a mega dose of Labetalol (alpha/beta blocker) plus I eat a vegetarian diet so I get lots of potassium. Yet my potassium level is slightly lower than as it was before meds. I do drink about 10 (8oz) glasses of fluid throughout the day so I am excreting a lot of potassium.

Have you looked at the Gout diet? Remember when we talked about that? I try to factor that into my daily diet. I met a fellow who has Gout & he is young-it's a big deal to him!!! He can't get relief even with meds. Fam

 
Old 07-18-2009, 11:30 PM   #12
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Re: Lisinopril to calcium channel blocker hell

Adding more medication to treat side effects of existing medication doesn't make sense! Unfortunately, it has become a common practice. It takes very little time and no effort to prescribe another medication. Little, if any, thought is given to the possible consequences.

The best way to avoid adverse reactions to prescription drugs is by reducing or eliminating the need for them.This can be achieved most of the time through lifestyle changes. With a little bit of effort, one can improve one's health dramatically.

Anyone taking ACE inhibitors, diuretics and beta blockers, or a combination of these drugs, should have the potassium level checked frequently. People on diuretics should only use them in small doses. Effectiveness of diuretics does not increase with the dose. It remains the same once a certain point has been reached. Too high a dose, or too many diuretics, can cause electrolyte an uric acid imbalances and other problems.

Fam, could your thyroid condition result in a decreased potassium level?

FG

 
Old 07-19-2009, 03:37 AM   #13
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Re: Lisinopril to calcium channel blocker hell

Quote:
Originally Posted by famnd View Post
FG & others,

I'm on a mega dose of Labetalol (alpha/beta blocker) plus I eat a vegetarian diet so I get lots of potassium. Yet my potassium level is slightly lower than as it was before meds. I do drink about 10 (8oz) glasses of fluid throughout the day so I am excreting a lot of potassium.

Have you looked at the Gout diet? Remember when we talked about that? I try to factor that into my daily diet. I met a fellow who has Gout & he is young-it's a big deal to him!!! He can't get relief even with meds. Fam
They already ruled out gout for me, and I drink 8-10 glasses of water each day. I have been doing that for 15 years, primarily to assist weight loss. It hasn't helped weight loss, nor did I 'get used to the taste' as so many people seem to believe. And I have been doing that since before potasssium was an issue. I don't believe the water is making any difference. Plus I have been told that I have decreased kidney function, from an unknown cause. My readings about all of this tell me that with decreased kidney function, potassium accumulates in the kidneys and is not discarded, leading to elevated potassium levels in the blood.

 
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