Unusual prescription?: Hoping this is... - British Heart Fou...

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Unusual prescription?

Keyb1 profile image
30 Replies

Hoping this is the right forum... Hi all, I'm 73 with no weight, diabetes or BP ailments. A CT scan at a Targeted Lung Check last year revealed mild emphysema and "coronary artery calcification". The ensuing ECG indicated heart block (LAFB). Following an ultrasound last Thursday, I was prescribed these:

Bisoprolol Fumarate 1.25mg. one daily. (beta blocker)

Inspra 25mg (eplerenone). One daily. (Aldosterone blocking agent)

Clopidogrel 75mg. One daily. (Anti platelet.)

Rampiril 2.5mg. one daily. ACE. (Lowers BP)

Atorvastatin 10mg. Two daily. (Statin)

I can provide more detail later but would appreciate advice on whether this is an unusual prescription. Thanks.

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30 Replies
Happyrosie profile image
Happyrosie

this forum is for people with heart and circulatory issues to give sympathy towards their fellows. We are not medical people, but we might be able to point to towards the right source of help.

most but not all of these medications you show are common prescriptions for heart issues. But what I would suggest you do is speak to your prescribing pharmacist or, even better, the pharmacist who (if you live in the UK) should be employed by your doctor’s group of surgeries. They could correlate your medical history with your prescription.

What would be even better is for you to speak to your own doctor or the cardiologist.

Keyb1 profile image
Keyb1 in reply toHappyrosie

Thanks for responding, Rosie. I was advised to call my cardiologist's secretary but got no reply when I called.

DWizza profile image
DWizza in reply toKeyb1

I had similar issue, I was able to leave a message with the secretary and was surprised when she she called back 3 days later . Keep trying 👍🏻

devonian186 profile image
devonian186

Except for Inspra, those are the medications prescribed to me after my heart attack and subsequent 4 way heart bypass. It includes a statin and something to stop clotting and something to reduce blood pressure and to make the heart beat harder and slower.

I can't say whether the medication is correct for you.

I would suggest you speak firstly to your cardiologists secretary. You may need to be persistent. You need to know if the medication is considered a complete solution or is a step on the way, in due course, to some sort of medical procedure.

Alternatively, presumably your GP will have received a copy of the notes from the cardiologist and may be able to interpret them satisfactorily. However I would go through the Secretary route first

Have you been given any lifestyle advice to ensure your condition is now under control?

Keyb1 profile image
Keyb1

Thank you so much, Devonian 186. You've put my mind at ease.

sandandkev profile image
sandandkev

You must make sure you have blood test at 12weeks for statin levels in liver,I would say others are to protect your heart but the pharmacy will help

Keyb1 profile image
Keyb1

Thanks sanandkev

Traveller007 profile image
Traveller007

I was prescribed the same drugs after suffering a silent heart attack. Cardiology Rehab subsequently telephoned me and pointed out that I should also be taking a drug to protect my stomach. They arranged for my local GP to prescribe Lansaprozole. Take care of your stomach.

Maxwall47 profile image
Maxwall47 in reply toTraveller007

Hi I was told by my doctor pharmacy try cut down on Lansaprozole because they not good for me I only take them when I have gastro problems they can cause brittle bone disease I don't know if ever you used tiktok they have a doctor on their who talks about them a lot he always says try to cut down

Traveller007 profile image
Traveller007 in reply toMaxwall47

Thank you Maxwall47 - Wow I didn't know that. Thank you - I shall ask my GP on my next appointment.

fatbarry profile image
fatbarry in reply toTraveller007

The list of things that the -azoles can cause is long and varied. Get your eGFR checked as well.

Traveller007 profile image
Traveller007 in reply tofatbarry

What is eGFR?

fatbarry profile image
fatbarry in reply toTraveller007

It's a measure of kidney function. Calculated from various other test results.

devonian186 profile image
devonian186 in reply toTraveller007

I have looked at the science papers and there is no evidence that this drug can cause brittle bone disease. Tik tok is an even worse source for medical information than google. As with all these things only take the minimum needed for effective treatment

fatbarry profile image
fatbarry in reply todevonian186

Not brittle bone disease but there are correlations between -azoles and fragility fractures. Though equally some studies don't show this.

.... Given the widespread use of PPIs, reinforced by frequent inappropriate indications, physicians should be aware that long-term PPI use is associated with a modest but rather consistent increase in the risk of fragility fracture. Consequently, long term PPI use should be prescribed only in cases of strong validated and recognized indications.

Taken from ncbi.nlm.nih.gov/pmc/articl...

Maxwall47 profile image
Maxwall47 in reply todevonian186

I was told from my doctor pharmacy she said I'm going to cut you down on the tablet because they are not good for you so who do I believe doctor Google where you look or my doctor pharmacy

Alison_L profile image
Alison_L in reply toMaxwall47

I asked my cardiologist about cutting out the Lansoprazole, but he was adamant I should stay on it.

Interestingly, my GP has recently asked me to provide stool samples (for a non-cardiac problem) and told me that one of them can only be done after stopping Lansoprazole for a fortnight. I lasted 3 days before getting the most appalling reflux. I took a Lanso tablet, and within an hour I felt back to normal. That test will have to wait!

Maxwall47 profile image
Maxwall47 in reply toAlison_L

I only take them when I get the same I get stomach some times for 2 days I used to take 6 a day just to get rid of the pain now I just try keep 2 if have the pain

Traveller007 profile image
Traveller007 in reply toMaxwall47

6 a day! I was prescribed one a day. Why would you take 6?

fatbarry profile image
fatbarry in reply toAlison_L

Mine was happy for me to stop using it regularly just keeping it for when I felt GERD symptoms. I stopped it immediately and within a couple of days thought I was going to die!! 😂. Then I googled and discovered that you should always taper the dosage down rather than stopping abruptly 🙄

Maxwall47 profile image
Maxwall47 in reply toAlison_L

Have tried taking them with hot water I found it makes them work better I get stomach anything can start it off so when I get it now I take one tablet with hot water and seems to go quick I've been taking them for about 15 years or more I used to take 6 a day because the pain will not go but now I only take one with hot water it's so much better

Keyb1 profile image
Keyb1 in reply toTraveller007

Thanks Traveler 007, especially because I've had serious stomach acid issues before. Appreciated.

Blackknight57 profile image
Blackknight57

all the above is used for heart issues. Bisprolol sliws the heart down.lessening the strain on cardiac muscle

Eplerenone is a water pill. Possibly because you have a buildup of fluid around your heart. (Makes you pee lots)

Clopidogrel is a blood thinner(frankly Surprised you arent on Omeprazole or equivalent to protect your stomach lining)

Ramipril lowers bp

Atoravastatin is to help lower cholesterol.

Keyb1 profile image
Keyb1 in reply toBlackknight57

And again, thanks Blackknight57. My BP is normally on the low side (110/65 ish) and cholesterol's never been high. One of my concerns was that these drugs could lower my BP too much - at the same time realising that it's a balance between low BP issues and the risk of a possible heart attack (if I haven't had a silent one yet; only just learned there's such a thing thanks to Traveller007).

Blackknight57 profile image
Blackknight57

the calcification is fat and calestarol build up so its high. Must be.

As for bp low bp is 90/60. But doesn’t need treatment unless its causes problems.

I was on higher dose but couldn’t stand up without fainting

As maxwell said Lansoprazole or omprazole should be on list as the anti platlet or asprin causes havoc to your stomach lining. Dont take aprin or ibabrufen either. They also thin your blood .

Im on warfarin cant take other blood thinner. Low dose asprin or clopradogril causes my blood to go too far. Your INR should be 1-2.

I have a blood clot in my lv so i need to be 2-3. Taking aspirin with it i sot up to 4.

Any concerns should be directed to your gp.

I was a lucky one went to Papworth.

Keyb1 profile image
Keyb1 in reply toBlackknight57

Thanks Blackknight57. Surprisingly, my BP's risen since I started taking the pills ...?? (131/91. 62bpm this morning). I steer clear of PPIs, relying instead on a daily dose of porridge to regulate my stomach acid. Can't prove it but it seems to have worked for 40+ years.

Had to look up INR; I'll have to ask what mine is.

The 2 doctors and the ultrasound technician who examined me on Thursday spoke of "swirling" at the "apex" of the heart but weren't sure whether a blood clot was the cause, even after injecting a dye. I fully expected them to contact me on Friday to explain further or to schedule a better scan (CT?) but that hasn't happened yet and still no luck getting through to my consultant's secretary.

I can't thank you and the other forum members enough for your responses which leave me feeling strangely calm and patient.

Blackknight57 profile image
Blackknight57 in reply toKeyb1

Your bp is around what mine is. And im on something that does the same thing as ramipril

Blackknight57 profile image
Blackknight57

difference between stomach acid and side effect from medication

As i said the meds tend to rot your stomach lining

Keyb1 profile image
Keyb1 in reply toBlackknight57

Early days but no stomach acid problem so far, just increased appetite, raised BP and lower heart rate.

Keyb1 profile image
Keyb1

"Left ventricular systolic dysfunction". Found on Mychart app.

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