My ejection fraction has decreased from 40-45% to 35-40% so my cardiologist is starting me on Dapagliflozin and then either Spironolactone or Eplenerone. I already take Candesartan.
Is either one of those better than the other and are side effects the same? I’ve also read that Spironolactone can cause migraines so I’d rather avoid that if it’s true as I get them regularly anyway.
I’m wondering what all that will do with my blood pressure which is already in the 120/65ish range.
He’s arranging another echocardiogram in six months to see if they’re working.
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I take Spirolactone for fluid retention. It helps in keeping lungs and heart free from fluid.I take a tiny dose. It is not usually prescribed ,from what i have read, in large doses. I did not know it was prescribed for low EFraction. So perhaps ask what dose he is thinking of prescribing.It can also heighten potassium in your blood....in larger doses. i am mot medically trained. I write from my own experience
Many thanks for your reply. It’s a bit scary suddenly having to take a lot more meds.
Hello
I take Spironolactone along side Candesartan I did not know it was not usually prescribed I thought they both were standard meds given
I also suffer with migraines regular and never knew they can give you migraines even though I did suffer before taking the med I am not sure why they would give me something that could make them worse
So even though I cannot really help with your question it has been very interesting to read your post and has given me something to think about x
Many thanks for your reply. I was hoping the migraines would go when I got older but they’re worse than ever so I don’t want to increase them. I guess I’ll just have to find out and stop the meds if they do.
i take lisinopril and spironolactone. Now the reason for the lisinopril. Was for blood pressure control. What else it does I don't know. I google it but I hate googling, sends me over the top with anxiety. The spironolactone was given to me , after I done a stress test and found that my oxygen transfer was not good due to the tricuspid valve regurgitation, when exercising. Basically it was to remove any water from lungs and heart to help with breathing. I think it is being prescribed to get as much efficiency from what I currently have. The potassium in the blood will go up as this diuretic allows the body to hold onto potassium. That's why I have had a few blood tests since taking it. I take 25mg of spironolactone and 25mg of lisinopril. What the spironolactone does to help the heart in other ways I don't know. Migrains I get them but not too bad. Had them since 15 years old so they come go. The trouble with medication they have have to be given time to adjust your body. One tip I take the spironolactone at tea time before 6pm with food and the lisinopril at 9pm before bed. Incase of side effects. Still really want to know the advantages of both medications
Many thanks for replying. These drugs seem to produce pretty horrible side effects. I guess being alive is ultimately more important. But I already get one or two migraines a week and the thought of more fills me with dread. I can cope with the pain - it’s more the flashing lights in my vision that knocks me for six.
Spiro is an Aldosterone antagonist. I take the similar Eplerenone 25mg to reduce the hormone, which was established very high for some time.It seems to work' as other 2 BP meds work at half previous dose! Not had Aldosterone/Renin check since starting this med, but GP seems unconcerned on that.
well the one bit of positivity Is that the cardiac nurse said said iam on the right medication and in a better place than I was before my issue was found. as you say being alive and putting up with a few niggles? But when do you say enough is enough with the niggles? The migrains I get are with the aura flashing zig zags. Can last half hour. Then head ache. But that's another story. Carnt beat Dr Google. But you have to put your trust in the experts. One thing I did learn is they use spironolactone for acne.
Your migraines sound the same as mine. Horrible. It’s amazing how these drugs have such surprising effects on other conditions.
yes I have them. As soon as I see the little zig zags I think here we go. Then they get bigger and the vision gets all mingled up in the zig zags. Then it goes away and then the headache. I have found that stress and dehydration can make them more common. But touch wood the medication has not brought them on too much. Iam hopping that the lisinopril which opens up the blood vessels which aid bringing blood pressure down has helped all over the body to reduce the narrowing of blood vessels. But the human body is complicated and above my expertise.
I am on eplerenone and sacubitrol valsartan, have been for 3-4 years. My EF has gone from 30% to 50-55% and feeling good. So go with it and it’s good to see your cardiologist checking you in 6 months. Dapagliflozin looks to be a Superdrug too .
Hi, I have just been started on these drugs along with furosemide and an increase in my Bisoprolol. Can I ask how long it took before you started to feel the benefits. Not feeling too good at the moment. Living is a bit of a challenge at the moment so looking forward to a return to some normality. Thank you
Hi I also take Eplerenone. I understand from my cardiologist that its used to treat peripheral oedema - fluid retention - in chronic HF. I take a small dose alongside Furosemide. Has kept the fluid build up at bay. I am more comfortable I have to say - I used to get puffy ankles and legs, and fluid in my tummy and was quite breathless at times. Not so bad now.
Hello....I also am going to put some positivity on here. I was diagnosed with left ventricular systolic dysfunction with an EF of 25 two years ago. Since commencing Nebivolol, Perindopril, Spironolactone and more recently Dapagliflozin my EF has increased to 38, I am so grateful. I have not long had my 12monthly Echocardiogram and waiting for my results. Yes there can be many side effects but for most people these settle down. Take care and stay safe
Hi, I have EF of 25-30 from HA 3 years ago. I take Candesarten, Eplerenone, Famatodine and Furosemide a couple of times a week. I’ve had migraine all my life but since the HA I’ve only had the aura and no headache and they have gradually got less, only when I get very stressed I find. All meds take time to get used to. I don’t take beta blockers as I am a chronic asthmatic. Good luck😸
I take Spirolactone 25mg to avoid fluid retention, no migraines at all for me.
I’m surprised you don’t get prescribed something more specific to help with the strength your heart pump, like Rivaroxiban or Entresto, the latter for me has been a life changing drug (for the best). Maybe worth questioning/suggesting these to your specialist.
Many thanks for you reply. He’s just suggested Dapagliflozin then one of the other two drugs a couple of weeks later. He didn’t mention Entresto but I’ll ask about that.
Many thanks for replying. At the appointment the cardiologist said he’d add one drug at a time starting with Dapagliflozin then if that didn’t improve things he’d add Spirolactone. Then when his letter to the GP came it says to start Spirolactone or Eplenerone two weeks after starting Dapagliflozin. He’s left the hospital now so I can’t ask why he changed his mind.
hI, I was prescribed Dapagliflozin and couldn't tolerate it at all, headaches, dizzy spells, feeling absolutely awful ( thought I had covid again which I didn't ). Within 36 hours of ceasing taking them I improved. Eplerenone has been fine for me, 25mg daily. No problems with that at all.
it takes a while in my experience to get the meds right, and certainly my cardiac team work very hard to get to that point, so big thanks to them. Stick with it until the balance is found.
hi. I have been on 50mg of spironolactone daily along with entresto, dapagliflozin and bisoprolol. EF was 12 when I initially diagnosed with HF. Last echo showed EF of 20 so its all working and the only side effects I do have affect libido! I live in hope! “Why ask for the moon, when we have the stars” 👍
hi I take bisoprolol, feurosomide, and spironolactone and never had any sore heads ! I am not medically trained but thought I would say try not to worry as stress will ruin things for you give it a go and see what happens I think you may get a pleasant surprise! 👍🏻
hi. My ef was 45 so the heart failure team have put me on dapagliflozin, entresto, bisoprolol and spironolactone. I’m told that these are the best meds for heart failure. I’m told that spironolactone helps to stop the heart from changing shape and that’s why I’m on it as I don’t have fluid retention. I’ve noticed no side effects with the spironolactone, dapagliflozin oe entresto. I’ve been on this combination a couple of months so I haven’t had a scan yet but I live in hope that they will improve my heart function. I hope that you manage to find a combination tha works for you. X
i am on dapagliflozin and i also take spirilactione. I dont experience side effects with either. My ejaculation is also low. If you do get mograines you can get ammotripaline to take to avoid them but i appreciate its another tablet. I also take frusimide for fluid retention. Hugs sara
I take Eplenerone 25mg every other day, reason it was changed to every other day was my blood pressure was dropping to low. No other side effects also on Dapa, Entresto, Bisoprolol all issued for Heart Failure control.
Many thanks for replying. Low blood pressure is one of my concerns as it’s pretty low anyway. I wouldn’t have thought of taking it every other day so thanks for the idea.
The British Heart Foundation has an excellent booklet explaining all the drugs and their potential side effects.
I have a low EF and i am on Eplerenone and Dapaglifozein as well as other drugs. I chose to have Eplerenone as it is a newer drug with fewer side effects especially it does not cause breast enlargement
Many thanks for replying. Also thanks for the information and I’ll definitely take a look at that. I definitely don’t want breast enlargement so will see if I can go for Eplenerone. I didn’t know that was the newer one.
I have been taking spironalactone for 6 to 9 months, no issues, Dapaglifozin for 5 months no issues, except weight loss, and possibly more night time weeing. Also take Sacubutril/Valsartan, which tends to drop my blood pressure, sometimes a little too low. Feel fitter, but no strides forward re ejection fraction. Had to stop beta blockers heart rate too low. No other blood pressure tablets.
Many thanks for replying. You must be disappointed with no improvement in ejection fraction. I guess as long as it remains the same that’s a good result. I had to stop beta blockers too.
To be honest, I feel very well, and am very unrestricted in what I can do, especially relative to other 70y olds. I keep myself fit, control my weight (and Dapaglifozin helps with this) and smile a lot. Ejection fraction is just a number, and 40 ish is ok, as long as it stays there. Because I get angina if I really over exert, I am always concerned that in the event of an accident or really frightening experience I may suffer a fatal heart attack. Otherwise all good.
Ah that’s good that you’re able to live a normal life. I’m 68 but in total denial about getting older apart from sometimes in the middle of the night when unwanted thoughts come into my head. I wouldn’t really know I had a heart problem but all the tests say otherwise 😂
HI. I was on Spironolactone, but I started to suffer from painful nipples and then gynaecomastia - the growth of extra breast tissue. This is, apparently, a side effect in 10% of cases. My GP switched me to Epleronone where the risk of gynaecomastia is 0.5%.
i have been taking both for a year and half ef stable and no side seffects so far. Just make sure you have regular kidney function tests and watch for possible side
Eplerenone (as an anti Aldosterone) allows me to reduce 2 other BP meds to 50% of previous when not even working well at that level, so it may drop your BP. How has it checked out?
I preferred it to Spiro due to already low Testosterone.
Thanks for replying. I didn’t get on too well with the Eplerenone. I didn’t realise it was causing so many symptoms until I’d run out of it for a couple of days and the fast heart beat, plus other stuff went.
I tried it again a few days later and sure enough my pulse went up to 105, felt breathless lying down and the feeling of a UTI coming.
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