Meds-Ramipril ~TJ54A

413px-Ramipril.svg

Ramipril – ACE inhibitor

From: http://en.wikipedia.org/wiki/Ramipril

Ramipril is an angiotensin-converting enzyme (ACE) inhibitor, used to treat high blood pressure and congestive heart failure.

Medical uses – Indications for its use include:

Contraindications

Renovascular disease (impaired blood flow in the kidneys), severe renal impairment (especially in patients with one kidney or with bilateral renal artery stenosis), volume-depleted patients, history of angioedema while on an ACE inhibitorpregnancyhypotension.

Adverse effects

  • low blood sugar (in patients taking medication for diabetes), causing sweating or shakiness
  • dry cough
  • dizziness and light-headedness due to low blood pressure
  • tiredness and fatigue, especially in the early stages
  • mouth dryness in the early stages
  • nauseavomitingdiarrhea (persistent in rare cases)
  • fainting
  • change in amount of urine
  • signs of infection (e.g., fever, chills, persistent sore throat)
  • yellowing of eyes or skin, dark urine
  • stomach or abdominal pain
  • neutropenia (low white blood cells)
  • impotence (erectile dysfunction)[2]

Serious allergic reactions to this drug are unlikely, but immediate medical attention must be sought if they occur. Symptoms of a serious allergic reaction include, but are not limited to a rash or swelling of the face, mouth, tongue, or throat.

In extreme cases, ramipril may lead to potentially fatal liver problems.

Mechanism of action

800px-Ramipril_1.25_MG_Oral_Capsule

Ramipril 1.25mg oral capsule.
Letter codes & icons may differ.

ACE inhibitors, as the name suggests, inhibit the actions of angiotensin converting enzyme (ACE), thereby lowering the production of angiotensin II and also decreasing the breakdown of bradykinin. The decrease in angiotensin II results in relaxation of arteriole smooth muscle leading to a decrease in total peripheral resistance, reducing blood pressure as the blood is pumped through widened vessels. Its effect on bradykinin is responsible for the dry cough side effect.

ACE inhibitors, as the name suggests, inhibit the actions of angiotensin converting enzyme (ACE), thereby lowering the production of angiotensin II and also decreasing the breakdown of bradykinin. The decrease in angiotensin II results in relaxation of arteriole smooth muscle leading to a decrease in total peripheral resistance, reducing blood pressure as the blood is pumped through widened vessels. Its effect on bradykinin is responsible for the dry cough side effect.

Ramipril, a prodrug or precursor drug, is converted to the active metabolite (metabolic product) ramiprilat by liver esteraseenzymes.[3] Ramiprilat is mostly excreted by the kidneys. The half-life of ramiprilat is variable (3–16 hours), and is prolonged by heart and liver failure, as well as kidney failure.

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Life with less meds ~TJ54

dividing psp300

Reduced dose by cutting tablets

Just taken my three pills for today (statin later) it feels so strange not having the ritual of popping five pills out of packets, and for last month have been cutting some in half as well.

Long may it continue.

Medicines review part two ~TJ52

Well its been a month since I saw the doc last, at that meeting my Bisoprosol, Atorvastatin and Bendroflumethiazide were all halved due to the weight loss and fitness levels.

link to first post (opens in a new window)

( Later I might add in more details of what pills are / do and their effects on me or maybe links to NICE information and why you should be aware of it. Informed and empowered patients. (opens is new window)

So I went with a little trepidation, my blood pressure has remained at the low end of normal for the last month so I wasn’t expecting an increase in medication.

I was weighed and had blood pressure taken – that was the same as when I had taken it after getting out of bed!  Doctor was pleased, ‘amazing you have lost just over 1kg in a month – despite an obvious increase in muscle mass’ WOW was I pleased. So we had a discussion about the remaining pills:

Bisoprosol stopped immediately

Bendroflumethiazide – I can stop or vary at will

Atorvastation stays as is (20mg) pending blood tests in 2 weeks time. If cholesterol levels are acceptable then the statin will be reduced to 10 mg and a further experimental period will start.

Ramipril – no change as yet

Aspirin – taken prophylactically, extra fitness and weight loss greatly reduces my risk of heart attack or strokes – so left to me to decide whether to take it or not.

Lanzoprazole – taken to protect stomach from aspirin, so if that goes so does this one.

So my decision re Bendroflumethiazide, continue cutting pills in half (2.5 mg /2) and take on alternate days instead of every day and monitor swelling in legs

Aspirin/lanzoprazole combo, hold decision for one month to better monitor the effects of the change to bisoprosol and await blood results, also allows time for some research into the use and effectiveness of aspirin.

All in all a brilliant day.

My Meds ~TJ22

Currently I am taking the following:

Ramipril – blood pressure

Atorvastation – Cholesterol

Lanzoprazole – gastritis and stomach protection

Aspirin – prophylactically for blood thinning

Bisoporol – blood pressure

Bendroflumethiazide – diuretic for bi lateral oedema of legs

When I was first sent to chest pain clinic I was put on beta blockers, ace inhibitors, calcium channel blockers, aspirin, statins, lanzoprazole, GTN spray, and pain killers (8 a day) I felt worse after the medication than I ever did with the pains. I couldn’t drive, I had to sit at home for two hours after taking the meds before I could go to work, then I was dopey all day.

When i complained to the doctor he more or less told me to stop whining at least I was alive! But I had no quality of life so I started researching my ‘conditions’. NICE was a brilliant site where all research papers could be found, advice to government and GPs re efficacy of pills. I went back and insisted that the cocktail was changed and it was. I felt better by a factor of about 200%.

Eventually i felt normal again so I dropped the blood pressure pills – BIG MISTAKE! Within a week I had a TIA (mini stroke) a blood clot in my neck which had to be tracked and busted, and was admitted three days after this with severe chest pains.

Really folks – NEVER EVER just stop taking this stuff it can KILL you.

 

Beginning of the End ~TJ04

Yesterday after three years of starting to lose weight I had the greatest bonus anyone could have. I visited the doctor and she said ‘Wow, what an amazing weight loss, let’s reduce your medication!”

Just what I had wanted but not expected, half my pills were halved and I now have monthly reviews to cut or otherwise modify the regime I have been on for years now!  These are the medicines.

You can do it too, it’s not easy but it is simple.


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… to see how the Journey” began click here …
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