Enalapril

[Gigi1958]

Hi all,

I had HA &stent 10/2020, left with some heart damage (15% not working) after 1yr stopped Clopidogrel👍🏻. I have stopped taking Ramipril in Dec 21 re side effects, cardiologist advised I start Enalapril, so reviews on this med would be appreciated. I have also cut down my bisoprolol 2.5 mg by half due to sleepiness and fatigue. I,ve kept on eye my b/p over 4 weeks ,which averages 112/68 and heart rate 46.) Also on daily aspirin and 5mg rosouvastatin as I cant tolerate a higher dose. Thoughts anyone on meds?

[Alison_L]

Hi Gigi. Sorry, I can't help with the Enalapril. I switched to Candesartan because of Ramipril side effects, and that seems to be marginally better.

[Gigi1958 in reply to Alison_L]

Hi Alison. Ok thank you for your reply. Its difficult with all these meds isn't it , especially as I feel much better without them.

[Alison_L in reply to Gigi1958]

Oh we all feel better without them most of the time!

[richard_jw]

your BP is fine, your heart is in the brachycardia area. 46 is OK providing you are not getting any symptoms (nearly fainting, unsteadiness etc,)I'm surprised you need bisoprolol. The objective of it is to reduce the uptake of adrenaline/noradrenaline by the heart and thus slow it down which can reduce BP. I had a HA 18 months ago, which sustained 12% damage to the heart. The cardiologist took me off the 2.5mg of bisoprolol 6 months ago. My resting BP is around 70 now and less at night. I also feel less of a zombie.

The main objective of Ramipril is to reduce blood pressure, could that have been at the bottom of your side effects? I know they prescribe it after a heart attack, they did so for me, but it reduced my BP too much. It also dilates veins/arteries which is of benefit to patients who have had an MI. Enapril is also an ACE inhibitor, and NICE recommends that post MI people should take such meds indefinitely.

I have never taken it but when I next talk to my cardiologist, I will ask about going back on an ACE inhibitor, since my BP is higher post bisoprolol withdrawal.

You are taking aspirin. Long term it can affect your stomach. I was put on Lansoprazole which reduces stomach acid.

Remember I'm not a doctor, and you need to change meds with a doctor's approval

[Gigi1958 in reply to richard_jw]

Hi Richard, Thank you so much for yourinformative reply. Unfortunatly because of c19 I didnt get a follow up with a cardiologist until Dec 2021 (14mnths after HA and he was a registrar). Ihave been in touch with my gp on the phone a few times to chang my meds myself. I do take 15mg lansoprazole for protection. The registrar has asked if I will take Enalapril to help my heart, but I am reluctant because of the side effects I got from Ramipril. Iwould really like to stop the bisoprolol alltogether, but for now I half them to take 1.25 instead of 2.5 and I am much better during the day, no longer having heavy eyes nor regular naps. I wonder sometimes whether I need all this medicating when I feel much better and all myreadings are much better without it. When I was taking Ramipril& bisoprolol my b/p was always around 89/58 and heart rate 39/40, but GP didnt seem concerned. I had no energy and couldnt think straight. But feeling better now.

[richard_jw in reply to Gigi1958]

Interestingly enough Lansoprazole long term use apparently can casue stomach problems. My cardiologist changed it to Famotidine which works apparently in a different way. My symptoms were mostly gastro in nature. He changed the atorvastatin to 40mg not 80mg and stopped the beta blocker.