Ramapril change to Candersarten?

[Bobkins99]

so after OHS 3 months ago to fix my mitral I was also diagnosed with heart failure EF 45% and put on a regime of pills including bisoprilol, ramaprill and Empagliflozin. At a review my pharmasist he recommended I ask the cardio team change the ramapril to Candersarten. Said has less side effects and is better to my condition. I wondering if anyone else has first hand experience the and of these meds?

[Hidden]

Hello

I take Bisoprolol and Candesartan out of the medications you have named and I don't think I have any issues as such with either certainly not Candesartan which I have taken years now

Pharmacists are very clued up on medications and if that was the advice you were given I certainly would ask

Let us know how you get on x

[AJ786786]

Hello

I'm also a heart failure even after Triple Bypass. I was put on Ramapril & Bisoprolol , Asprin, Isosorbide. I had a constant cough due to Ramapril and my Cardiologist changed it to Candesartan. It worked well my cough disappeared. The Cardiologist gives Ramapril as this is the 1st line of Meds. I would stay on Ramapril unless you have a constant problem with cough. It's a better Med especially for HF patients. All the Best 👍

[fishonabike in reply to AJ786786]

from what i have read Ramipril (ACEi) is prescribed in preference to Candesartan etc(ARB) because it is cheaper - the latter have fewer side effects

[Lezzers in reply to fishonabike]

Im not sure that's correct, there used to be a difference in cost but I think they're pretty much the same cost these days. This link explains why the different drugs are used, hope it helps

bhf.org.uk/informationsuppo...

[fishonabike in reply to Lezzers]

Drug tariff price for Ramipril, lowest dose, 28 tablets £1.08 - Candesartan, lowest dose, 28 tabs £3.56 - these prices do not reflect the cost paid over-the counter if available, they are much more expensive normally

[Lezzers in reply to fishonabike]

Thanks for replying, could you post the link for those costs, I've found ramipril 28 tablets £1.63 and candesartan £2.25, though I admit I may well be looking in the wrong place as I don't usually look at medication costs, but the BHF link does say many are the same price. I'm not sure what you mean by cost paid over the counter, I wasn't aware you could buy this sort of medication over the counter?

I think what the BHF link is saying is that the medication is prescribed based on the patients needs and not costs for this type of medication.

[fishonabike in reply to Lezzers]

Ramipril:bnf.nice.org.uk/drugs/ramip...

Candesartan: bnf.nice.org.uk/drugs/cande...

i suspect that what the BHF says and what doctors do are not always the same thing! in the past there have been directives about the use of the cheapest medication where there are alternatives with similar action

[Lezzers in reply to fishonabike]

Thanks for the links. I must admit I'm not familiar with prices or even how it works but the NHS indicative prices shown in the links range from under £1 to over £11 for both meds! Thanks for replying, I'll ask my husband's nurse about it this week.

[vnarayan in reply to AJ786786]

Hi AJ786786, i did not have heart failure. Immediately after my bypass, i got heart failure

[AJ786786 in reply to vnarayan]

That's exactly how is was diagnosed after the Bypass

[Hidden]

I am also on bisprolol and candesartin which was changed from ramipril and have no problems with either of them too

[Fynndog]

hi Bobkins. Post HA and stents. The morning nurse who took blood pressure saw my tablets and told me to get of ramipril soonest. I think I’d coughed. I told the cardiologist a day later and they changed them for candesartan. Had no problems since. I’ve heard many times that ramipril can bring in a cough

[Prada47]

Hello

I was switched from Ramipril to Candesartan due to a persistent cough I had no problem with Candesartan. I also take Entresto 49/51mg, Bisoprolol 7.5mg, Aspirin 75mg, Eplerenone , Lansoprazole 15mg, Clopidogrel 75mg, Dapagliflozin 10mg ( forxiga ) and Pravastatin 20mg for good measure!

I have had a Bypass and Stents and Heart Failure is at 38% EF which isn't to bad.

Regards

[Pingpongu3a]

Hi, i also have heart failure at 45%,please note average is 55% so you are only slightly impared. I was on ramipril and came off it due to a constant cough. Also on Bisoprilol,

Canderstarten was recommended to me by my Consultant who has years of experience and knowledge.

Only side effects suffered to date is runny nose which may be caused by Bisoprilol.

Cheers from 83 year old who had triple bypass in 2004,stents 2009 and still going strong.!

[080311]

Hello,

After my surgery I was put on Ramipril along with Bisoprolol I ended up with the Ramipril cough, so was changed to Candesartan, have been on these for the pads 6 years with no problems.

Best wishes Pauline

[Bebop2023]

I’m pre OHS, and only on ramipril at the mo for BP and preservation until op time. I’m on 2.5mg daily. No real issues at the mo.

[HappyPaws]

I was diagnosed with moderate HF (EF 40) 10 months ago, I’m on Bisoprolol and Losartan. I started with Ramipril but swapped to Losartan because I was constantly feeling sick, light headed, had blurred vision and a mild sore throat.

Over 30% of people prescribed Ramipril suffer from a cough but it’s apparently better to start everyone on the cheapest drug and just change the ones who can’t tolerate an ACE inhibitor and move them on to an ARB. Losartan is a cheaper generic version of Candesartan, pretty much the same effectiveness and side effects just less cost on the nhs budget.

I also swapped from mornings to taking drugs in the evenings as I was feeling so tired during the afternoons. My resting heart rate is better for it but it’s taken a little while to realise how much I really struggle to wake up in the mornings now!

It would be interesting to know if these have improved my EF. My blood pressure has never been high so I’m only on 2.5mg Bisoprolol and 50mg Losartan to prevent it from dropping too low. I still suffer from shortness of breath, especially when I have a cold.

My father’s been taking Candesartan for the last 10+ years now. He’s also allergic to Ramipril but it wasn’t so well known for its side effects back then.

[Median]

Just deciding whether to ask for something to replace my Ramapril as I have a bit of a cough which came on very suddenly the other night. Two weeks until my next GP phone appointment and I'm hoping the cough will clear up by then.

Following an episode about 6 weeks ago I am also taking Bisoprol, Furosemide and Dapagliflozin which I cannot pronounce. I've had Ramapril before without problems, perhaps it's the mix of tablets causing the cough. Or something.

Just one thing is that when I was in hospital six weeks ago I couldn't help noticing how casual the staff tended to be about my HF. You would have thought I had a sprained ankle 😎