Ace Inhibitors and rls

I have had restless leg for a good couple of years. Is anyone aware of examples of ACE inhibitors (blood pressure medication) such as ramipiril causing or exacerbating restless leg? Thanks

[Joolsg]

webmd.com/brain/restless-le...

Ace Inhibitors and calcium channel blockers can trigger/worsen RLS.

Many people report an improvement in blood pressure when their RLS is correctly treated and controlled. Chicken and egg situation.

[ChrisColumbus]

Yes, that's been reported by some: I took perindopril without any apparent adverse RLS effects, but it did give me an annoying cough.

I was therefore switched to angiotensin receptor blocker losartan: some report that this exacerbates RLS, but it doesn't for me. It may depend on the amount taken: I started on 25mg which helped BP but didn't entirely control; 50mg works for me, and doesn't trigger my RLS.

But we're all different!

[Hidden in reply to ChrisColumbus]

Thank you to you and Joolsg for the replies Chris. I had no idea this could be a thing until my GP surgery suggested looking into it recently. My endocrinologist didn't seem to think the ramipiril was an issue but I would still like to investigate and see if a change of medication helps.

[ChrisColumbus in reply to Hidden]

Unfortunately RLS is not taught as part of medics' education in the UK, and they are therefore reliant on outdated and incomplete info from NICE and the NHS.

[SueJohnson]

Welcome to the forum. You will find lots of help, support and understanding here.

Some medicines that are safe for high blood pressure are propranolol (Inderal, Hemangeol, InnoPran) a beta blocker that may help RLS, Isosorbide Mononitrate (Monoket, Imdur) which is not a beta blocker nor calcium channel blocker. Other possibilities are: Clonidine (Catapres) an Alpha-2-Agonist used to treat high blood pressure which may help RLS and which also treats insomnia, tenex (Guanfacine, Intuniv), prazosin (Minipress) an alpha-adrenergic blocker that is also useful in managing sleep-related problems caused by PTSD and Tadalafil a vasodilator that in one study completely eliminated RLS. Clonidine can actually help RLS. Discuss these with your doctor. And then there is reducing salt by 1 teaspoon a day nih.gov/news-events/nih-res....

Is your RLS under control? Are you raking anything for it?

Have you had your ferritin checked? If so, what was it? This is the first thing your doctor should have done. Improving your ferritin to 100 or more helps 60% of people with RLS and in some cases completely eliminates their symptoms. If not when you see your doctor ask for a full iron panel. Stop taking any iron supplements including in a multivitamin that has iron in it 48 hours before the test, don't eat a heavy meat meal the night before, fast after midnight and have your test in the morning before 9 am if possible. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your transferrin saturation to be over 20% but less than 45% and your ferritin to be at least 100. If they are not, post them here and we can give you some advice.

Meanwhile some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, artificial sweeteners, carbs, foods high in sodium(salt), foods that cause inflammation, ice cream, eating late at night, oestrogen (estrogen) including HRT, dehydration, MSG, collagen supplements, electrolyte imbalance, melatonin, stress and vigorous exercise.

Some things that help some people include caffeine, moderate exercise, weighted blankets, compression socks, elastic bandages, masturbation, magnesium glycinate, fennel, low oxalate diet, selenium, 5 minute shower alternating 20 seconds cold water with 10 seconds hot water finishing with hot water for another couple of minutes, hot baths, distractions, CBD, applying a topical magnesium lotion or spray, doing a magnesium salts soak, vitamins B1, B3, B6, B12, D3, K2, if deficient, and potassium and copper if deficient, massage including using a massage gun, vibration devices like therapulse, using a standing desk, listening to music, meditation and yoga. Keep a food diary to see if any food make your RLS worse.

Many medicines and OTC supplements can make RLS worse. If you are taking any and you list them here, I can tell you if any make RLS symptoms worse and if so may be able to give you a safe substitute.

By the way it would really help us to give you advice if you would indicate on your profile what country you live in and your gender.

[Jumpey]

I have taken ramapril without worsening my RLS.

[Eryl]

The reason you need ACE inhibitors is probably also the cause of your RLS. Foods can cause inflammation which affects all parts of the body including the blood vessels and the nerves. In the bolldvessels this inflammation causes narrowing and hypertension while in the nerves it causes hypersensitivity leading to RLS. There are lists of these foods on the internet, I've found all to be true except that some lists include red meat (that's probably because the meat was from animals fed on grain rather than grass fed).