I have recently been prescribed with some new heart medication, which will take my overall intake to about 5 different medications a day. Up until recently, I was only taking one heart medication, with GTN spray as and when required.
I have a previous history of being sensitive to cardiac medication. My concern is that if I take all of them together, I might experience some very unpleasant side effects which will make me feel worse.
Does anybody have experience of introducing their heart medication into their routine one at a time as opposed to taking them all together at once until some tolerance has been developed to them? I wanted introduce one heart med at a time, but I’m not sure if this is wise and whether it would reduce the effectiveness of the treatment doing it this way.
I have discussed this with my GP but the usual response is “I’m not sure” “I don’t know” “I’m not comfortable advising”. The cardiologist which has put me on these medications is based in Dubai and it is difficult to make contact with him.
Hopefully this post is allowed. If not, I’m happy for the moderators to have this removed.
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Tos92
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My husband has a history of medication intolerance. He's recently had his meds intake increased to 14/15 tablets a day, morning, afternoon & evening & he didn't any issues, although he's temporarily off most of his meds due to other issues. Most heart meds work well together, whoever prescribed them would be aware if there was likely to be any interaction issues & presumably they'd be aware of your previous intolerance. You don't say what meds you're on so it difficult to advise but if you can't speak to your cardiologist then I would suggest asking a pharmacist as this is absolutely their field of knowledge.
I’ve often been told by cardiologists that my sensitivity to cardiac meds must mean my heart is fine. But I’ve not always had the best experiences with the NHS.
I haven’t mentioned the names of the medication as I’m not sure if we can ask advice on specific meds. The medications I’m on are Verapamil, Tildiem, Apsirin, Trimetazidine, and GTN.
I’m happy to hear that despite your husband taking 14-15 meds a day, he doesn’t experience side effects to them. Perhaps I will take them all in one go for a few days and see how I get on.
Ah, can't help with those meds as the only ones in common with my husband are the aspirin & gtn.I seriously don't understand the theory that being sensitive to heart meds means your heart is ok, that makes no sense whatsoever! My husband had anaemia, he was sensitive to iron tablets which he'd been prescribed & which resulted in NHS111 sending him to A&E. That intolerance didn't mean he wasn't low on iron as he was definitely in need & eventually had 2 iron infusions!
Last year I started taking everything at one time (went from taking one thyroxine a day to needing 10 pills in the morning and more at night).
All I can give is my experience of course, and I was fine taking these. I started to get a cough that was attributed to ramipril - but otherwise seemed OK for me.
To be honest, most of the drugs are for different things, and therefore have different mechanisms of action so from that point of view, it's fine to take them together if a doctor has prescribed them.
Would just advise you read the PILs first so you're aware of any potential side effects to watch out for, and keep a note if there are any.
Personally, about 6 weeks... gives the body time to adjust
Dear you,
Your dispensing chemist/pharmacist would be able to tell you how to introduce your new medication and what ones you can move to your evening slot { you will surprised what you can move, then sleep off most of the side effects }
At this mornings count I am on 10 tablets morning and 9 evening, I tend to ' ride ' the side effects for two weeks or so { depends a lot on your weight etc } nearly all settle down with me, but I realise that I am one of the lucky { if I can use that word } ones and others like yourself suffer so.
I kept a log when I started new medication. I recorded my symptoms, blood pressure heart rate and any side effects.All my medications have been introduced slowly over time.
As already suggested I read through the patient information leaflets.
I am very sensitive to any changes to my medication.
My blood pressure dropped dangerously low by just taking 2mgs of Candesartin.
I note you have been prescribed two calcium channel blockers at the sametime which work in a similar way. This perhaps is something to discuss with a Pharmacist.
Another thought. is to consider your height and weight.
Some medications cannot be given if you are under a certain weight or you have a low body mass index.
Women can respond to medications differently. Your menstrual cycle can affect your response, as well as affecting the frequency and severity of your coronary vasospasms.
I agree with Lezzer's advice to discuss your queries with a Pharmacist.
I also follow Captain Birdseye suggestion of reading through the patient information leaflets
I would also encourage you to be referred to an NHS Cardiologist who is experienced in caring for patients living with vasospastic angina. They do exist!
Vasospastic angina is rare and it does require a Cardiologist to understand the condition fully to be able to take responsibility for the prescription of your medication. It's difficult for a Pharmacist to query your prescription if your Cardiologist is abroad.
I have a very good team at the north London hospital I attend.
My Cardiologist is fantastic. I keep in close contact with him, especially if I feel I need admitting. He always responds quickly.
He was on call last time I was in hospital, the nursing staff and other on call consultants know me well which helps improve my care.
It took me awhile to find him but it was well worth the effort.
I’m on two calcium channel blockers due to being in the process of weaning myself off of one, the Verapamil. I have read online that two calcium channel blockers can increase the risk of low blood pressure and a few other side effects. But generally, I don’t think it is normal practice to take two calcium channel blockers together.
I have been prescribed Diltiazem and Amlodipine in the past.
It is unusual and the Pharmacist would only dispense it because it was under the direction of my Cardiologist.
hi are your meds all prescribed by the non UK doc or is there a mixture of some by UK doc and non UK doc? Have they conferred on the collective cocktail of meds? You’d hope this would ensure the mixture is ok regards side effects?
I googled (I know) the Trimetazidine and it doesn’t appear on BNF and there was albeit a few years old post that it’s not licensed in UK?
I guess it’s difficult for UK docs / pharmacists to comment on non UK prescribed meds?
the one thing with phasing in you can see which one causes which side effects if they occur (hope not).
Hope the meds work as it’s difficult to find the right mix.
A majority of the medications I’m prescribed are available here in the U.K. My GP is aware of the new changes in meds. They’ve never been comfortable advising in or changing my meds so they trust the opinion of my cardiologist in Dubai.
It is just one, the Trimetazidine that does not seem to be licensed here or in the US. I would have to ask the doctor to find an alternative for this should it help manage my symptoms. I presume this would be the only one the pharmacist couldn’t advise on.
When a medication is unlicensed it is prescribed by the individual registered medical practitioner, they as an individual have to take responsibility for prescribing the medication.
This is quite a responsibility to ask of a GP.
This is why it is probably in your interest and your GP's for you to find a UK based Cardiologist to take responsibility for your care.
I won’t be asking for a repeat of this particular medicine any time soon. I still have no idea if it will help. My GP is aware of the Trimetazidine and has made a note of it. I would not be asking for a prescription of an unlicensed medicine. It would be to source out a licensed alternative. Failing that, my cardiologist here in the U.K. would be the next best to advise on which medication would be the best to replace it.
Unfortunately, after spending a fair bit of money going to the private sector already for my healthcare, I am not in a position where I could go private again and seek the opinion of a specialist. My GP is also reluctant to refer me to the lead interventional cardiologist at the hospital which you sent me a PM about via the NHS. So my hands are tied at the moment. My only option is to trial these meds with the hope that they work, if not, I have already come to terms with the fact that I will have to live with this condition the best I can.
It is a tough and challenging condition, and it’s just as tough to get access to the medical treatment that I need specific for the condition. I will look into the patient advocacy groups you have suggested and see what they recommend. Thank you.
I've always chucked all mine down together to get it done with. I used to have dizziness and feel yuk until my body got used to them, but I did take them all straight off. I take 9 in the morning and 6 at night.
Having read the replies to your post it is not the simple request I thought it was. However, I will add my twopeneth for what's it's worth. We are all different and what works for me may not suit you. I prefer to spread mine out during the day to reduce the risk of too many fighting in my stomach at the same time. Actual dosage is immaterial but I take a Doxazosin with breakfast, Ramipril and Bisoprolol plus vit. D at lunch time. Warfarin mid afternoon. Doxazosin after dinner and Ramipril and Bisoprolol at night. I like to leave about 12 hours between similar pills and 4 hours between doses. I also now take 2 Puffs of an asthma inhaler twice a day, morning and night. I don't think I have OCD, 😊 but I do like to have some control over the medication I never expected to have to take.😡
Your response has reminded me that I suffer with bad indigestion. However, I haven’t been given a medication like omeprazole to protect the stomach lining. I do however, take Gaviscon daily every night, so that might help reduce any indigestion type symptoms in the stomach and chest from the medication.
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