Ramipril

[jackrussell]

Has anyone with Urticarial Vasculitis had it suggested that Ramipril ( for blood pressure ) could be the cause of flares, and if yes ,did it prove to be the case,

[LynneJ Vasculitis UK Volunteer]

Hi there

I don't know the answer but have found this link drugs.com/ramipril.html it says that 'you should be sure you can take it if you have connective tissue disease such as lupus, rheumatoid arthritis etc' so it might be worth inquiring. Maybe it depends which type of Vasculitis people have.

Hope you get someone who can answer the question better.

Good Luck

Lynne

[jackrussell in reply to LynneJ]

Thats very interesting I shall have a look at that, I thought it seemed to be such a " simple answer," if It turned out to be the cause however so far It hasn,t been suggested I switch medication, but it is something I would want to try before going on to more intrusive medication,otherwise I may " never know ". Thankyou,

[HiveMind]

Hi

I don't have UV but I DO take Ramipril as my CSS damaged my heart (I also take Bisoprolol & Spironolactone)

I have had a few teething problems taking the maximum dose, of both Bis' & Ram', in a single dose, so I now take it in two doses of 5mg both morning and night.

I have low BP anyway so taking both these medications has been tricky and I still sometimes feel their BP lowering effects but on the whole I tolerate it pretty well.

Touch wood, I've not had any flares!

[PatriciaAnn]

Hi JackRussel

Ramipril is an ACE inhibitor. See below about the aetiology of urticarial vasculitis. If it can be associated with the onset of using ACE inhibitors then I guess it can contribute to possible flares.

What is the aetiology (cause)?

The cause of Urticarial Vasculitis is not known in 50 per cent of cases. However it can be associated with or triggered by autoimmune/connective tissue diseases like Systemic Lupus Erythematosus (SLE or simply Lupus) Rheumatoid Arthritis, or occur in the context of a systemic vasculitis syndrome, such as Churg Strauss syndrome (Eosinophillic Granulomatosis with Polyangiitis); infections or viruses such as hepatitis; a reaction to certain drugs such as ACE inhibitors; certain types of diuretics; penicillin and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs); cancer; and Glandular problems, such as Graves’ Disease (overactive thyroid).

You can read more about UV on the Vasculitis UK website at: vasculitis.org.uk/about-vas...

PatriciaAnn

[fillyhome]

Hi, I know this isnt exactly what you asked, but my experience with Ramipril for high blood pressure isnt one I want to repeat in a hurry. I got the most hiddeous cough and at a time when going through chemo was the last thing I wanted or needed.

And my consultant ( the only time I felt let down by her ) was about to do further scans and investigations, until I reminded her I was on this particular drug and she immediately took me off it. Hence the cough cleared and I was finally able to get a proper nights sleep.

It is a sharp reminder that these drugs we take for vasculitis related illnesses do not work on everybody and can cause other major problems !

[deniseann]

I too had major coughing problem.with this drug .Ramipril. and was about to be sent for x ray extra.It also caused me to have a very dry mouth .I have WG,

[Sarahjh2004]

Morning

I take Ramipril and have vasculitis. It has been ok.

What I would say is though I get on without any side effects I have had to introduce another BP tablet so as for effectiveness not 100% sure. (it is difficult to be accurate as my BP is due to high dosage steroids)

Regards

Sarah

[LynneJ Vasculitis UK Volunteer]

I believe the Cough is a possible side effect of the drug with or without Vasculitis. My sister who is otherwise healthy (apart from the blood pressure) was warned about this so it must be quite common. As it happens she has been OK.

[Ezrela]

I take Ramipril but get nasty effects from it, it makes me bleed down below makes my gums bleed and of late I have started getting nosebleeds, I dont think it is very good in controlling a flare but it does however help the stiffness in my fingers and joints, I would say it is 65% effective, but if you cant take asprin dont take this tablet, they are VERY strong because they have to be taken with food, you may even need to take some tablets for your stomache as they can cause a lot of irritation, if I didnt bleed so much as a result then I would be taking these regular, but for someone who CAN tolerate asprin Id say it was good and at least 65% effective.

[RichardE Volunteer]

Hi, I also take Ramipril and have a variant of UV. But the Ramipril was first given to me at the time of diagnosis to help with my heart condition.

So far I've had no real problems with it. A bit of Ramipril cough initially but that has gone now. Maybe because we had to slowly ramp the dose up to the full 10mg, 2.5mg at a time.

Like BerkshireBird I have low blood pressure anyway so we also split my Ramipril into two 5mg doses, in the morning and at lunchtime. I also take Bisoprolol but can only manage 7.5mg of that without fallng over and still have to take that in the evening.

My Rheumatologist is aware that I take the heart drugs and I suspect it's another case of the benefits outweighing the risks.

[jackrussell]

Thanks all ,for the replies,as yet I,m still taking the Ramipril ,but will ask to try a change as 2 consultants have made reference to Ramipril being suspect in my case. My problem being that although the biopsy shows Urticarial Vasculitis, they cannot as yet work out why I am suddenly having the flares on average once a month, ( 13 so far ) and I feel very ill each time.I have recently been referred to Addenbrookes and I,m waiting now to see if a change of medication is going to be the next move, or if someone has come up with another option.Any experiances are always worth a consideration I feel.!!

[fpiccioni]

Had a bad case of vasculitis with lesions on feet and leg. Ramipril was prescribed to replace ACE Butolol which gave me the problem. When the dose was doubled because of poor blood pressure control, the vasculitis became far worse. Dropped Ramipril and started on ARB Telmisartan 40mg per day. Immediate improvement. Vasculitis healed in 8 days . My research shows that any ACE Inhibitor can cause Vasculitis. Good Luck.