Discussions that mention spironolactone

High & Low Blood Pressure board


Some info on aspirin:

Apparently, aspirin was discovered a hundred years ago by a German chemist looking for a treatment for his father's arthritis.

Up to 5% of people with asthma have aspirin intolerance, while up to 20% develop aspirin sensitivity following ingestion of aspirin. Aspirin causes the body to produce increased amount of chemicals called leukotrienes. These chemicals cause the muscles around bronchial tubes to contract, which results in wheezing and shortness of breath. There's no known way to test for aspirin sensitivity. Aspirin sensitive asthmatics can safely take Tylenol.

Everyone taking aspirin on a daily basis as a preventative should take the lowest effective dose to minimize its side effects. These are dose dependent. Long term use in healthy individuals is not recommended, because it creates as many problems as it might prevent. There are natural anti-inflammatories most of us can safely take. These include Omega3s, garlic and ginger.

Some CVD patients on a daily aspirin therapy can develop aspirin resistance. (I did not know this.) When that happens, the therapy does not provide an adequate antiplatelet activity. It is defined by platelet function testing and notable unresponsiveness to therapy.

A couple of interesting facts:

Sodium excretion produced by Spironolactone may be DECREASED in the presence of Salicylates.

ACE Inhibitors can cause an airway narrowing. :(

Hmmmm......
Flowergirl
Fam,

I spent a few hours reading about aspirin and took notes, then mentioned a few highlights in the previous post. There's so much more. But it helps to know the basics and now I feel better informed. Ít's hard to believe how much unrelated yet useful information one comes across while searching for answers. I did not know about the rebound effect of aspirin you mentioned, so thanks for that info! :)

[QUOTE]Concerning aspirin & tylenol, I assume you meant that tylenol could replace aspirin for inflammation but not for prevention of clots?

Sorry it did not come out right, but Tylenol can be used for pain in people with asthma who are sensitive to aspirin. (Not as a substitute for aspirin's blood thinning properties). On discovering about the increase in sodium retention when using Spironolactone and aspirin a light went off. :D The aspirin might have contributed to my edema, its effect compounded by the calcium channel blockers, and vice versa. And I have a feeling I had been right all along about the ACE Inhibitor affecting the airways long after the beta blockers were discontinued.

[QUOTE]There just seems to be so many land mines with these meds no wonder Doctors can't keep up with all this.

You said it, Fam! It's consumer beware!

Flowergirl
[QUOTE]Thus diuretics DIRECTLY casue retention of uric acid. In fact, my use of thiazides CAUSED me to develop gout; that's not an uncommon scenario.

I will need some help with this.:) You are not kidding when you say it's a pretty complex issue. On the subject of retention/excretion of uric acid and diuretics:

My normal dose of a diuretic is 25mg of potassium-sparing Spironolactone.
To this 50mg of HCTZ was added several days ago to help with pretty extreme edema issues. On starting this additional diuretic, I immediately and without my GPs'' knowledge discontinued my calcium channel blocker. The doctor I'd seen twice for my edema (not my GP) believed the CCB to be the most likely cause. I was not willing to wait 10 days or longer to get my doctors'' approval to discontinue the drug (on holidays) and endure this very painful condition. I stopped taking it rightaway. I am happy to say it worked!

As an added benefit, my blood pressure readings have been quite spectacular! This is something that my usual drug therapy of five BP meds has not been able to accomplish in the past. Currently I am on 20mg Ramipril and the two diuretics. Alas, I only have ten HCTZ pills left. :(
When the doctor returns, I'll ask to remain ON the HCTZ and OFF the CCB. It seems to work very well for me.

I have an appointment with my BP specialist for September 14th. Would it be safe for me to remain on the existing meds for the next two months?
My kidney issues are not severe. I don't understand the relationship between the two diuretics (a potassium-sparing and a non-sparing), serum uric acid and a kidney disease. I do worry about retention of uric acid. The poster I mentioned yesterday developed a rare kidney disease as a result of having high concentration of uric acid over time. She'd had regular blood tests and the doctors totally missed her uric acid imbalance.

Are there specific blood tests I should have in addition to my regular ones?
Should I start taking in more potassium?
Does using two different diuretics affect the serum uric acid levels?
And is this drug combo at least relatively safe to take? (not factoring in the fact that spironolactone is known to have caused tumors in rats).

Thanks everyone.
Flowergirl
FlowerGirl,

Currently on HCTZ 50 mg., spironolactone, and ramipril? Do I have that right.

Firstly, if your ankles swell with a CCB, then no more CCB's.

Why the spironolactone...did you have low potassium issues in the past? Remeber both spironolactone and ramipril are potassium sparing so the very BEST thing you could have added was HCTZ because it tends to dump potassium along with sodium.

Dig up any old BP test...uric acid is routinely done. What number?

If you have any uric acid issus with HCTZ, then a good co-drug is losartan (Cozaar)...it is the only BP drug that dumps uric acid and thus it tends to prolong life better than other ARB's that have more of an effect on BP. Interesting, no?
If HCTZ causes problems, then give Lasix a try.
My BP regimen is 40 mg Lasix and 50 mg. Cozaar...it's the best combo I;ve found and works SUPERBLY to battle my salt addictio/edema problems.

If you have no issues with hypokalemia, then spironolactone may be a bad idea. HyPERkalemia is FAR more dangerous than hyPOkalemia.


When you have your next blood draw, check the glucose level to make sure the HCTZ isn't raising it.

(p.s. If you are a salt-sensitive hypertensive NOTHING works as well as a diuretic...like a trip to LOURDES :angel: compared to the other meds around.)

When I took HCTZ for 20 years, my dose was 50 mg./day...anyone with edema issues needs at least that much.
Flower,

I don't understand the units of measurement for your uric acid...in most countries it's reported in mg./dL and thus a leve; of around 4.0 is normal and 9.0 likely to trigger a gout attack...do you know the units of leasurement.

Your sodium of 137 is at the bottom of the low normal. HCTZ may well cause your problems becasue it is likely to lower it further. Mine was consistently in the low 120's...not safe. Check your sodium level after taking HCTZ at your next doctor's visit. NEVER restrict salt when taking HCTZ.
If your Na+ falls way low with the HCTZ you may beed a trial with Lasix instead. It won't cause the same situation...but then it;s SUPPOSED to more drastically lower K+ although it doesn;t in my case...GOOD.
(This is quite a balancing act, isn't it?)


Our bodies tend to keep the sodium concentration REMARKABLY constant...it's a matter of life and death. Problem comes with that constancy because when we eat too much salt and dont get rid of it (some of us can save salt VERY easily) fast enough, the body must and does dilute it with extra water to keep that exact concentration...that extra water is what causes hypertension. That's why you don;t see a change in the serum sodium concentration when you restrict or overeat salt, the water adjusts and either dehydrates or overhydrates you and the overhydration is just another way of saying high blood pressure and edema.

I see the drugs raised your K+ level to more respectable levels so that seems all well and good so I guess the spironolactone is aok.