Ramipril and Furosemide and RLS - Restless Legs Syn...

Restless Legs Syndrome

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Ramipril and Furosemide and RLS

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I was just wondering if anyone else is prescribed these medications?

I was retaining a lot of water last year and my blood pressure was through the roof at times and now I take Furosemide 40mg for the water retention and Ramipril 2.5 caps for my blood pressure.

I don’t know how long I’ll be on this medication but long term does anyone know if these medications are suitable for someone with RLS?

I stopped the Naproxen which I was taking 3 times a day and the Omeprazole after reading about it on here.

Iron pills felt like my saviour. I think I would have ended my life if I’d had to continue living like that, if it is that that has made the difference then for me it felt miraculous.

I am so glad that I am learning about dopamine agonists etc. What frightens me is that I was so sleep deprived and desperate this time last year that I would have tried anything.

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LotteM profile image
LotteM

There is a rather extensive list on rlshelp.org. Treatment page. It discusses very many meds that were or are used for RLS and/or shouldn't be used when they are known to exacerbate RLS symptoms.

in reply to LotteM

Thanks LotteM. I’ll look at it now.

in reply to

There’s so much info on there. Thank you.

Thanks Manerva.

I’ll ask my gp if she can arrange that for me. I don’t even know what electrolytes are and I asked Siri —-

Electrolyte test

An electrolyte test can help determine whether there's an electrolyte imbalance in the body.

Electrolytes are salts and minerals, such as sodium, potassium, chloride and bicarbonate, which are found in the blood. They can conduct electrical impulses in the body.

The test is sometimes carried out during a routine physical examination, or it may be used as part of a more comprehensive set of tests.

For example, your electrolyte level may be checked if you're prescribed certain medications, such as diuretics or angiotensin-converting enzyme (ACE) inhibitors, which are often used to treat high blood pressure.

As well as checking levels of electrolytes in the blood, an electrolyte panel (a group of specific blood tests) can also be used to find out whether there's an acid-base imbalance (a normal arterial blood pH range is 7.35 to 7.45).

An electrolyte test can also be used to monitor the effectiveness of treatment for an imbalance that affects the functioning of an organ.

Treatment for an electrolyte imbalance will depend on which electrolyte is out of balance and by how much. For example, if you have a sodium imbalance you may be advised to lower your salt intake (if sodium is too high) or reduce your fluid intake (if sodium is too low).

Read more about the electrolyte test at Lab Tests Online UK.

in reply to

Yay!!! That is the first time this bloody phone has let me copy and paste. I hope it wasn’t a one off.

I am really rubbish with this phone.

Thanks for your input Manerva. If you were me and she asked you why I want her to do a blood test for electrolytes what would you say?

I think she just thinks I’m a drain on the NHS, I hate dealing with her but the next one might be worse so I may as well stay where I am.

Sorry for going on.

in reply to

I found this —- I’m going to have a cuppa and a fag and try to understand. I feel anxious at the thought of asking for that test but I will. Thank you Manerva, I wish I had your knowledge.

What does the test result mean?

Electrolyte levels are affected by how much is taken in through your diet, the amount of water in your body, and the quantity of electrolytes excreted by your kidneys. They are also affected by hormones, especially aldosterone, a hormone that retains sodium in the body but increases the loss of potassium via the kidney.

In specific disorders, one or more electrolytes may be abnormal. Your healthcare professional will look at the overall balance but is likely to be especially concerned with your sodium and potassium concentration. People whose kidneys are not functioning properly, for example, may retain excess fluid in the body, diluting the sodium and chloride so that they fall below normal concentrations. Those who experience severe fluid loss may show an increase in potassium, sodium, and chloride concentration (chloride tends to mirror the sodium concentration). Some forms of heart disease, muscle and nerve problems, and diabetes may also have one or more abnormal electrolytes. Electrolyte abnormalities may also be a consequence of drug treatment.

Knowing which electrolytes are out of balance can help your healthcare professional determine the cause and treatment to restore proper balance. If left untreated, electrolyte imbalance can lead to dizziness, cramps, irregular heartbeat, and possibly death.

Test results are reported as a numerical value and must be compared with an appropriate reference range in order to determine the significance of the result. Reference ranges may vary for a variety of reasons including the patient's age and sex, as well as the instrumentation or kit used to perform the test. To learn more about reference ranges, please see the article, Reference Ranges and What They Mean. Your local laboratory will advise your healthcare professional of the appropriate reference range for your particular test.

Is there anything else I should know?

Depending on which electrolyte(s) is out of balance and the extent of that change, treatment may involve changing your diet, for example to lower salt intake, increasing or reducing fluid intake, or taking or stopping medication such as diuretics. Once treatment has begun, you may be asked to have regular testing to determine how well the treatment has worked and to make sure the imbalance does not reoccur.

What is anion gap?

The Anion gap (AG) is a value calculated using the results of an electrolyte panel. It estimates the difference (gap) between the measured positively charged ions (called cations) and the measured negatively charged ions (called anions) in the fluid portion of blood (serum or plasma).

The most commonly used formula is:

Anion Gap = Sodium - (Chloride + bicarbonate)

Note sodium (Na+) is the main cation measured in blood and chloride (Cl-) and bicarbonate (HCO3-) are the main anions measured.

The number of positive ions (cations) and negative ions (anions) must be equal (cancel each other out) to maintain electrical neutrality of the blood. However, not all ions are routinely measured. The calculated AG result represents the unmeasured ions and primarily consists of anions, hence the name “anion gap”.

If the anion gap is higher than expected (i.e. the number of unmeasured anions is increased) it indicates the unusual presence of an excess of an anion in the blood. Examples are ketones (in uncontrolled diabetes or starvation), sulphates, phosphates and organic acids (in kidney disease or damage), and other organic acids such as oxalate or glycolate (resulting from the ingestion of potentially toxic substances such as antifreeze or methanol or excessive amounts of aspirin).

It is used to help distinguish between anion-gap and non-anion-gap metabolic acidosis. Acidosis refers to an excess of acid in the body; this can disturb many cell functions and should be recognised as quickly as possible, when present.

The metabolic acidosis must be treated to restore the acid/base balance, but the underlying condition must also be identified and treated. If anion-gap metabolic acidosis is identified, the AG may be used to help monitor the effectiveness of treatment and the underlying condition.

AG is frequently used in the hospital and/or accident and emergency room setting to help diagnose and monitor acutely ill patients. A low anion gap can also occur; this is most commonly seen when albumin (an anion as well as a protein) is low, while immunoglobulins (cations as well as proteins) are increased.

Note, there are other AG formulas (some include the potassium (K+) concentration to estimate cation concentration), so reference ranges are not interchangeable. Each laboratory formula will have an established normal range that should be referenced.

in reply to

I’ve got to admit that I haven’t retained any of that information but if you’re reading this, thanks Manerva. I hope you’re well.

PHEW!

I’m glad you said that. Bloody hell Manerva, I read through it a couple of times and felt a bit bewildered!!!

Those few precise words you wrote I can definitely retain. Thanks. I’ll arrange the blood tests and go from there.

in reply to

Most diuretics lower potassium. ACE inhibitors often raise potassium. The combination usually keeps it about right. It is standard to be prescribed both together, also standard to have electrolytes checked ( includes check for kidney function ) if BP found to be raised ) before treatment and while on treatment.Did you have a blood test pre treatment?

I don’t think either of these tabs affect RLS

in reply to

Hi Alison, I had a blood test before and a couple of weeks after first starting on Ramipril and then again at the beginning of May. I’d already been on the diuretic for about 6 months before starting on the Ramipril.

I don’t know what the individual results were but the receptionist said they were “satisfactory” and “no action was required”.

It was a blood test to monitor medications. I was more interested in my ferritin levels and didn’t know anything about electrolytes.

Thanks for responding Alison. How are things with you?

in reply to

Hi again, there results will have been renal function and electrolytes then I’d be pretty sure. They are normally checked when you’re on eg ramipril & more often at 1st ( I was a GP )My RLS isn’t brilliant to say the least so thanks for asking.

I’m having another go at raising my ferritin which has dropped to 23. It’s really hard to get labs to test ferritin now even if GP’s ask, especially if not anaemic. My GP did a special request. My Hb tends to be high so you’d never expect ferritin to be low. Think my blood cells commandeer all the iron so there is less available for brain & elsewhere.

Sometimes I’ve wondered if those of us with RLS, apart from those with anaemia, might be a subset whose blood cells Nick all the iron? Anyone any idea? Might explain brain iron deficiency?

My Hb is 15 which is high for a female ( not pathological though )

TheThirdDoctor profile image
TheThirdDoctor in reply to

You could ask your doctor to switch you to a diuretic like co-amilozide which contains a potassium sparing diuretic in the mix. Try eating a good sized banana at breakfast, which is an excellent source of potassium. Calcium channel blockers are also sometimes used in the treatment of hypertension as are beta blockers (although the latter have now been superseded by the ace inhibitors) both of which have implications for RLS sufferers

in reply to TheThirdDoctor

Potassium sparing diuretics are not usually recommended along with ACE inhibitors as ACE inhibitors raise potassium too so can be dangerous, GP would likely say no though,.

TheThirdDoctor profile image
TheThirdDoctor in reply to

I have been on co-amilazide for very long time, and I have been taking Losartan as the other ingredient in my hypertension control. No GP has ever raised an eyebrow nor has anyone told me to stop eating bananas.

in reply to TheThirdDoctor

I presume your GP is keeping an eye on your electrolytes and making sure your combination suits you. Everyone is different & handles medicines differently.As far as I recall you aren’t normally prescribed potassium sparers with ACE inhibitors just in case potassium goes too high.

Actually am I right that co-amilozide contains 2 diuretics, a potassium sparer and a potassium loser to try to balance it out. Often the ACE plus an ordinary diuretic works ok to keep electrolytes balanced.

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