questions for those using or had used ACEIs

[mgraylorn]

I take 180 mg tiazac (calcium channel blocker) once a day, and clonidine, .05 mg three times a day. I've been trying to wean off the clonidine, but it looks like I can't get by with just the tiazac. I had a bad reaction to increasing tiazac to 240 mg once, so am not ready to try that again yet.

I had an old prescription for captopril (ACEI) that I hadn't really used, so thought I'd give it a try. I got a terrible cough from Lotrel. I can't remember the dose for the captopril, but I think it is about the lowest dose. Monday I started taking one captopril in the morning, so I've taken it for 3 days now (no cough yet! ;-> )

So far I can't tell if it has made a definite impact on my blood pressure. I might be seeing minor improvements, but the stuff I've read says it can take a couple weeks for it to kick in, and this is just my 3rd day. I do notice a decrease in some of the tiazac/clonidine side effects I experience. This is unexpected, and I can't think of why it would happen, but I ain't looking a gift horse in the mouth, so to speak. These decreases started after taking captopril for 2 days. I haven't changed anything else in my life, so it must be the new drug.

My questions for ACEI users, and especially if you have experience with captopril:
1. Do you take your full dose at one time, or multiple doses during the day?
2. Do you take your ACEI with your other bp drugs, or take your drugs at different times of the day?
3. If you didn't develop a cough on a low dose, did you develop a cough going to a higher dose?
4. Is a cough less likely to develop if you take small doses twice or more a day rather than one big dose once a day?

I have a doctor's appointment July 11, so thought I'd experiment with the captopril in the mean time. I'm going to take all 3 drugs for at least a week, and then see if I can't wean some more off the clonidine, provided I don't get the cough.

I was thinking of asking my doctor if I could try an ARB like avapro or benicar, but if captopril works and I don't get the cough, maybe I should stick with it. Besides, its dirt cheap. Which is a better combination, a ccb plus ACEI, or ccb plus ARB?

[CASSIEBEL]

Originally Posted by mgraylorn

I take 180 mg tiazac (calcium channel blocker) once a day, and clonidine, .05 mg three times a day. I've been trying to wean off the clonidine, but it looks like I can't get by with just the tiazac. I had a bad reaction to increasing tiazac to 240 mg once, so am not ready to try that again yet.

I had an old prescription for captopril (ACEI) that I hadn't really used, so thought I'd give it a try. I got a terrible cough from Lotrel. I can't remember the dose for the captopril, but I think it is about the lowest dose. Monday I started taking one captopril in the morning, so I've taken it for 3 days now (no cough yet! ;-> )

So far I can't tell if it has made a definite impact on my blood pressure. I might be seeing minor improvements, but the stuff I've read says it can take a couple weeks for it to kick in, and this is just my 3rd day. I do notice a decrease in some of the tiazac/clonidine side effects I experience. This is unexpected, and I can't think of why it would happen, but I ain't looking a gift horse in the mouth, so to speak. These decreases started after taking captopril for 2 days. I haven't changed anything else in my life, so it must be the new drug.

My questions for ACEI users, and especially if you have experience with captopril:
1. Do you take your full dose at one time, or multiple doses during the day?
2. Do you take your ACEI with your other bp drugs, or take your drugs at different times of the day?
3. If you didn't develop a cough on a low dose, did you develop a cough going to a higher dose?
4. Is a cough less likely to develop if you take small doses twice or more a day rather than one big dose once a day?

I take 10 mgs of altace, Full dose in the am. At night I take 25mgs of atenolol and 1/2 of .1 mg of clonidine.

Sorry, can't comment on the cough as I never developed it.

I am curious about how the ACEI lessened your side effects from clonidine. I don't think I am experencing any difference there.

I was thinking of asking my doctor if I could try an ARB like avapro or benicar, but if captopril works and I don't get the cough, maybe I should stick with it. Besides, its dirt cheap. Which is a better combination, a ccb plus ACEI, or ccb plus ARB?

I think they both work very equally well with diltiazem. At least my doc thinks they do.

Personally I like the ACE better cause I got joint pain from Benicar. But then I never got the cough and I understand very few get the joint pain. ( I always get the weird stuff though)

I would really like to drop the clonidine too but so far haven't been able to.

Hope the good luck keeps up for you!

Cass

[Machaon]

Originally Posted by mgraylorn

Which is a better combination, a ccb plus ACEI, or ccb plus ARB?

I take a CCB (Verapamil), an ACEI (Quinapril) and an Arb (Avapro). From experimenting, I have found that each one has a lowering effect on my blood pressure.

I take the ACEI once in the morning, the Arb once a day, an hour away from the ACEI and the CCB at least three hours from all of my other meds.

Good luck with your ACEI experiment! I hope that it works for you.

[Uff-Da!]

I'm off BP meds now, but was on an ACE1 for five years, a few months at 10 mg Lisinopril, then four years at 30 mg, then one year back at 10 mg. I never developed a cough from either dosage. I tried to take it in the morning, but realistically, I ended up taking it just about any time of day, as I have such a bad memory that I'd forget to take it when I was supposed to.

[mgraylorn]

Right now I take the captopril 25 mg upon getting up in the morning, since it says take it on an empty stomach. Waking up, feeding cats, catching a bit of news, showering, etc. takes about an hour or more before I am ready for breakfast. After breakfast I take the tiazac and the first dose of .05 mg clonidine. I was curious if it would be better to take captopril in the AM and tiazac at bedtime, or some staggering of more than one hour. Sometimes I experience a morning jolt of feeling not quite right (not low bp though), which I wonder if maybe is all the drugs zapping me at once.

My side effects from the ccb are some constipation, almost constant ringing in my ears of various loudness, sometimes strong heart beat (not fast), and a nearly constant hearing/feeling of pulse throbbing in my left ear. From the clonidine I get more constipation, more ear ringing, and as my dose starts to wear off I get often get jittery and experince increased heartrate.

Adding in the captopril has seemed to negate the consipation (increasing the effect of eating lots of prunes in the AM and dried apricots in the PM), reduces or eliminates the pulse throbbing in my ear and chest pounding, and reduces or eliminates the ringing in my ears. I'm also having a smoother transition when my clonidine dose is wearing off. I have noticed some increase in heart rate. Resting can range from the 50s to the 90s. Back when I was taking .1 mg clonidine 3 times a day, resting heart rate was in the 50s and 60s. When I take my bp the higher pulse surprises me - before with the pounding heart and ear throb I could always tell when the heartrate was up. Now I can feel relaxed and have a pulse of 86. I think my pre-medicated pulse rate was in the low to mid 80s.

I appreciate everyone's comments.