Ramipril

[Juliet46]

Hello I wondered if anyone takes Ramipril alongside Hydroxycarbamide. Thank you

[Kari1961]

Hi Juliet46 Yes I do, I take 1 x 1.25 mg Ramipril daily alongside Hydroxycarbamide. I also take Verapamil and aspirin.

[dancingfiend]

Yes, I take 1 x 5 mg Ramipril daily (in the morning with aspirin and Allopurinol), and Hydroxycarbamide (in the evening).

[FG251]

I’m on PEG now and still Ramipril 5mg, but was on HU for 14 months - no problems. Higher doses of Ramipril can put your potassium levels up. I added Amlodipine 2.5mg to keep my BP under control without inducing hyperkalemia, as Ramipril can be less effective as we get older - according to my GP and my experience anyway!

[Wyebird]

what is it for please ?

[Vtr1000 in reply to Wyebird]

Hi Wyebird, I believe it’s blood pressure medication.

[Juliet46 in reply to Wyebird]

Yes, sorry I didn’t reply it is for high blood pressure

[Caryopteris]

I take Ramapril in the evening and hydroxy and aspirin in the morning. No problems that I am aware of.

[hunter5582]

I think you will find plenty of people who take an ACE-inhibitor alongside hydroxycarbamide. I did not tolerate lisinopril (another ACE inhibitor) so opted for losartan (an Angiostatin Receptor Blocker). I took losartan alongside hydroxy. No drug interactions.

Here is the interaction check on ePocrates.

Hydroxyurea/Ramipril No significant interaction(s) known or found for selected drugs. Caution always advised with multiple medications.

online.epocrates.com/intera...

online.epocrates.com/drugs/...

Please be sure to run your question by your MPN care team and pharmacist. They can best tailor an answer to your individual profile.

All the best

[Juliet46 in reply to hunter5582]

Hello, I’m on amlodopine, ramipril, bisoprolol, rivaroxaban and hydroxycarbamide. I just feel I’m on too much medication

[hunter5582 in reply to Juliet46]

That seems like a lot of meds, though I expect you are on them for a reason. Rivaroxaban is a NOAC, the newer kind of anticoagulant with a lower risk of bleeding than a DOAC. Many people do quite well on it. Hydroxycarbamide is the anti-metabolite and has a completely different mechanism of action. Cytoreduction is a very important treatment goal for any high-risk MPN patient.

It is not uncommon to mix a Calcium Channel Blocker + ACE-Inhibitor + Beta Blocker to achieve optimal HTN goals with minimal side effects due to lower doses. You may find as you age and your body changes the doses need adjusting. This is something to talk to your care team about.

Here are the interactions for the meds you listed. online.epocrates.com/intera...

Avoid/Use Alternative

bisoprolol + rivaroxaban

avoid combo if also combined w/ strong CYP3A4 inhibitor; use alternative if CrCl <80 and combined w/ moderate CYP3A4 inhibitor; otherwise, monitor bleeding s/sx: combo may incr. rivaroxaban levels, risk of bleeding, other adverse effects (P-gp-mediated transport inhibited)

Additional Considerations

amlodipine

levamlodipine is the active isomer of racemic amlodipine; similar interactions anticipated

This does NOT mean you should not take your meds as prescribed. Your care team will have factored potential interactions into your dosing and monitoring plan. It is important for you to understand what the potential interactions are and whether they do/do not apply to your situation. Understanding the potential interactions and what to watch for can help reassure you that all is well, even when taking a lot of medications. Knowledge is power.

The best place to get knowledge that is tailored to your needs is from your care team. Suggest you make a list of your concerns and anything you learn from the responses to your question here, and take the list to your care team for a response. Giving them the list in writing will help ensure you get all of your questions answered.

I am also on a fair number of meds and supplements. I always let each member of my care team know everything I am taking and ask lots of questions. I take a list of everything I am taking as well a list of all drug reactions to every appointment. It really helps keep things on track.

All the best.

[Meatloaf9 in reply to hunter5582]

Hi, I also take lisinopril and Hu, recently I have had a few attacks of gout in big toe. My uric acid level has been normal in 3 tests. I will also be switching to losartan as lisinopril can be associated with gout. Best

[hunter5582 in reply to Meatloaf9]

That pain in the big toe can also be a MPN microvascular symptom, which I have experienced. I hope that the switch from lisinopril to losartan goes as well for you as it has for me. The good news is that losartan works well and can have a secondary benefit similar to Cialis.

Good luck with the switch.

[Meatloaf9 in reply to hunter5582]

Thanks, if I had known about that secondary benefit I might have switched a long time ago 😀

[Juliet46]

Thanks for replying