Pegasys and Blood Pressure Medication

[swimswam]

I’ve been put on low dose Ramipril ( an ACE inhibitor ) by my GP nurse practitioner for borderline hypertension. I am also on a high dose 180mcg Pegasys and aspirin for ET. I inquired about drug interaction and she seemed to think it was ok, but on taking my first tablet of Ramipril, I’ve felt awful all day. It seems to have intensified the side-effects of Pegasys. Dry-mouth, dizziness and diarrhoea. Has anyone else experience of this combination, or have they been put on a different type of anti hypertensive if they are on Pegasys? Just thought I’d ask for opinions of other peoples experience, before contacting my GP surgery. The nurse that put me on the medication didn’t seem to know much about interferon at all.

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Morning. I would contact you haematology clinic if you have any concerns, they are going to know far more than the practice nurse. I would then request a follow up with your GP.

Just this week following hospital admission I have been started on Atenelol and Amlodopine following a hypertensive crisis. I have had the same symptoms, dry mouth, dizziness, diarrhoea, I am hoping these are temporary symptoms whilst my body gets used to the changes. My BP was 235/135 during this crisis so a lot for my body to get used to as it is now 122/74.

Don’t worry but do get some more medical advice. I am contacting my GP today for a review/ monitoring.

[DoubleF79]

Hi. I’ve been on 10mg ramapril for 5years now for a kidney issue, not blood pressure, with no side effects. I met with consultant yesterday and asked the question about meds interacting as I’m starting Pegasys (Interferon). She said it was absolutely ok. I would however speak to your own doc about your own specific side effects x

[swimswam in reply to DoubleF79]

Thanks for your reply, reassured by your consultants reply. Things seem a little better today so hopefully will calm down. Wondering if it was starting a new med. too close to my weekly jab.

[hunter5582]

I ran Ramipril + Pegasys through the ePocrates interaction check and this is what it comes up with.

Monitor/Modify Tx

Pegasys (peginterferon alfa 2a) + ramipril (generic)

Monitor/Modify Tx

peginterferon alfa 2a + ramipril

monitor CBC: combo may incr. risk of granulocytopenia, thrombocytopenia (mechanism unknown, possible autoimmune destruction of myeloid precursors)

Additional Considerations

peginterferon alfa 2a in Pegasys

when used to treat HCV, caution advised w/ narrow therapeutic index drugs extensively metabolized in the liver; viral eradication may improve hepatic metabolic function, decr. levels, efficacy of concomitant drugs

I would definitely check into this. For sure run it by your hematologist. The GP Nurse may simply not have the expertise to handle this one (given what you said). You can also check with your pharmacist who can advise you.

FYI - I was intolerant of another ACE inhibitor (lisinopril). Also had a bad experience with a Beta blocker (atenolol). I had a very favorable response to an ARB (losartan). Have no idea what would work for you, but interactions with Pegasys are definitely something to watch out for.

Hope that helps.

[swimswam in reply to hunter5582]

Thanks for info Hunter, as I only have borderline hypertension decided to stop the Ramipril until my tele consult with Heam in the New Year. Feel better already. Will phone my GP nurse on Monday.