Ramipril, diarrhoea and pred

[Broseley]

After doubling my dose of amlodipine due to my BP still being too high, I suffered from poor sleep quality - my fitbit recorded very little if any, deep sleep.

I dropped back to 5mg and immediately my sleep improved. But now they've put me on ramipril 2.5mg to try, in addition to the 5mg amlodipine.

The PIL says pred may limit its effectiveness. I'm down to 1/2 mg. Also the side effects worry me, especially diarrhoea - I have a history of this but had got it down to an occasional bout only. However after my second dose this morning I was afflicted while out shopping and became so sore that I bled.

Any advice please?

[SnazzyD]

Why couldn’t it wait until you got home? Not fair. You need to contact your doctor before taking the next one really. Do you feel ok otherwise?

[Broseley in reply to SnazzyD]

Yes but rather lethargic. It's not new to me, I've already seen the GP and she's referred me to the incontinence clinic. I've had colonoscopies etc, the only thing showing was 3 polyps which they removed and I've been better since then, until today, with the odd episode previously but not every day like it used to be. The problem is walking seems to bring it on! So it might be coincidental. My calprotectin levels were high suggesting IBD but all they can suggest is a low FODMAP diet which hasn't helped.

[SnazzyD in reply to Broseley]

My apologies, I read it as your Ramipril addition was the second dose that caused the diarrhoea 🥴.

[Broseley in reply to SnazzyD]

I don't know if it was or not! I guess I'll have to wait and see. I was pleased that it was getting better. Back to square 1 today.

[random901]

Hi Broseley! I'm on amlodipine for BP, too. Couldn't get on with ramipril so was changed to valsarten. I have IBS, polyps removed on several occasions during colonoscopies. Walking, bending down, stretching, can all bring on problems from internal piles. I sometimes wear sanitary pad plus period pants. I also have to avoid high fibre foods as they could cause another band adhesion in the gut (have had 3 plus surgery to correct). I wonder whether the ramipril is causing your problems? Wishing you well.

[Broseley in reply to random901]

Thanks, I don't know yet, as I've just taken my 3rd capsule today. But I hope not. The colonoscopy didn't spot any abnormalities. I find Benefiber really helps. It's soluble fibre so you can add it to drinks. It comes in a jar of powder. But I often forget to take it! Insoluble fibre though doesn't help so I have to be careful not to eat too much cabbage etc (which I love), also tomatoes.

[marionofnorwich]

I had 5mg of Amlopodine which made my ankles swell but otherwise OK but didn't bring my BP down. Upped to 10mg and my legs felt as though had been pumped up and my blood pressure rose into the 170s. Added a diuretic BP medication no different so I stopped altogether - all went back to normal (around 140 to 150 over 80). A few months later I tried Ramipril, first 5mg and then 7.5mg and no side effects as far as I could tell but didn't reduce my blood pressure either. So I stopped again and now hovering between 130 and 150 generally speaking. Quite variable but I always take 3 readings. The last went down from 161 to 136

[Broseley in reply to marionofnorwich]

Thanks. Mine is usually 160 ish on the first go, but the nurse only does one reading! And that's after I've walked to the surgery, and climbed the stairs to her room. I find it comes down to around 136 by the third go. That's why they want it lower. I hope you get yours sorted out.

[marionofnorwich]

Have you got a BP monitor at home? I take mine every few days and keep a spreadsheet record. If they (medics) are getting 'nadgy' I take it every day and then show them. They usually accept that. I have been self-managing for some time though I explain to the GP what I am doing and why, giving them the chance to disagree. I have just restarted a statin after stopping all medication apart from Pred to let me body settle down. Now that I feel I am back on an equilibrium (and 4mg Pred) I feel I can start introducing medications back in and observing the impacts as I go. My recent reading in the GP surgery was 106/62! but usually it is mch higher. Who knows what to believe?

[Broseley in reply to marionofnorwich]

Interesting. I'm not sure I would be able to stop some of mine just like that. I think your body gets used to them.

My mum was on HF and AFib meds for the second half of her life - warfarin, digoxin, statin, diuretic, and another BP med. The new GP decided to change everything when she got to 93. I objected and queried it. He said she had been on them such a long time and that some of them were no longer necessary so she was swapped from warfarin to apixaban, digoxin to bisoprolol, the statin and BP meds were stopped. She was dead within 2 months. In my mind, if it works, why change it? She was fine until then.

[marionofnorwich in reply to Broseley]

Yes, although my meds weren't working and also I had terrible pains in my lower legs which have now gone. That may have been due to low Vit D which they discovered during a recent hospital stay. They gave me a heavy duty supplement so now my Vit D is over the top but eg pains have gone. If they return with the addition of a statin then it will be clear that is the cause. But I haven't been on any of them for very long - a few months of each. Still worth watching out for meds though. My 92 year old grandmother was given Frusemide diuretic for swollen ankles in the summer when it was hot. In the winter she started having dizzy spells and nearly falling. The doctor was about to prescribe something else while I was standing by, idly reading the leaflet for the Frusemide. It said 'can lower blood pressure' so they stopped the Frusemide (no longer necessary in the winter) and her dizzy spells stopped. But it is true, aftyer a. number of years your body an get dependent

[PMRpro Ambassador in reply to marionofnorwich]

"can lower BP" - it is one of the primary reasons it is given!!!!! In fact, it is the FIRST of the list the NHS quotes:

"Furosemide is a type of medicine called a diuretic. It's used to treat high blood pressure (hypertension), heart failure and a build up of fluid in the body (oedema). It's also sometimes used to help you pee when your kidneys are not working properly."

[marionofnorwich]

Yes, well, I was a lot less educated back then (about 20 years ago) but it took for me to pick it up rather than the GP. Pharmacists and GPs seem to not always join the dots but solve one medication side effect with another medication

[PMRpro Ambassador in reply to marionofnorwich]

My experience too ...