The People's Perspective on Medicine

New Blood Pressure Recommendations Could Cause Some People Problems

After five years of deliberation, a committee of experts has revised treatment protocols for hypertension. For one thing, people over the age of 60 will no longer require medication unless their systolic (upper) blood pressure number exceeds 150. For another, beta-blockers like atenolol, metoprolol and propranolol are out as first-line therapies.

The drugs that are now preferred include ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers). For many people these drugs are highly effective and do not cause side effects. That’s the good news. The bad news is that some people do experience complications from either ACE inhibitors or ARBs. Doctors may not always warn patients about such side effects. Here are some examples of commonly prescribed ACE inhibitors and ARBs and some stories from visitors to our website.

Some Popular ACE Inhibitor Drugs

  • Benazepril (Lotensin)
  • Captopril (Capoten)
  • Enalapril (Vasotec)
  • Lisinopril (Prinivil, Zestril)
  • Quinapril (Accupril)
  • Ramipril (Altace)

ACE Inhibitor Side Effects:

  • Dry cough, uncontrollable cough, nausea, vomiting
  • Dizziness, excessively low blood pressure
  • Kidney function changes, BUN & creatinine elevations
  • Headache
  • Digestive distress, diarrhea, abdominal pain
  • Tiredness, fatigue, malaise
  • Excessive potassium levels (requires immediate medical attention!), irregular heart rhythms, chest pain
  • Elevated uric acid levels
  • Sensitivity to sunlight (photosensitivity), skin rash
  • Angioedema (swelling of face, lips, tongue, throat)
  • Angioedema (swelling in abdomen, severe abdominal pain)
  • Severe allergic reaction (anaphylaxis) requiring emergency treatment
  • Toxicity to liver or pancreas
  • Blood disorders
  • Potential birth defects if taken during early pregnancy
  • Sexual difficulties

Here are side effect reports from visitors:

“I took lisinopril and complained to my doctor for months about side effects with no results. She pretty much shrugged them off. I was coughing, gagging, waking up at night choking and sometimes vomiting.

“Finally, when I was seeing another doctor about a different matter, he casually commented, when I kept trying to clear my throat, that ‘that’s caused by the lisinopril, you know.’ I almost kissed him! I was so happy to have that problem solved!

“Why don’t doctors recognize this side effect?” D.W.

“Lisinopril put me in the ER from violent coughing; I passed out twice from frequent and uncontrollable coughing spells. I was 75 at the time. FINALLY the VA woke up and put me on metoprolol. But the after-effects of lisinopril continue. Before I took it, I could walk miles without problems, climb ladders, crawl under buildings, use a complete range of tools.

“Now I get winded walking 150 feet to the mailbox and back, get short of breath just washing dishes. Lisinopril pretty well ruined my life.” R.M.H.

PEOPLE’S PHARMACY RESPONSE:

Here is something for you to discuss with your doctors R.M.H. The beta blocker you have been switched to (metoprolol), may be contributing to your shortness of breath. You may no longer be coughing, but some people cannot tolerate beta blockers because they affect the lungs. You should not be getting short of breath just walking 150 feet or washing dishes. Please have your doctor consider the possibility that your “new” medicine is contributing to this problem.

“I had a similar incident with lisinopril and consequently with every ACE inhibitor I have tried. The thing that made me so mad was the fact that I went back to the doctor who prescribed lisinopril and asked her if the ACE inhibitor was causing the cough. She said ‘no’ and proceeded to prescribe meds for the cough including an antibiotic.

“When I went to the pharmacist with the prescription he said I probably didn’t need the antibiotic; that he was sure it was the lisinopril. I didn’t fill the antibiotic prescription and called the doctor. She still insisted it was not from the lisinopril and said I should fill the prescription she just gave me.”

“I didn’t and I also got a new doctor.” Mary

We honestly do not understand why so many physicians seem to ignore ACE inhibitor-induced coughs. This is basic pharmacology. Every medical student learns that drugs ending in “pril” such as a captopril, enalapril or lisinopril can cause an uncontrollable cough. And yet many patients are not warned of this side effect, and when they complain are told it is not caused by the drug. Sometimes they spend hundreds or even thousands of dollars seeing allergists, pulmonologists and asthma specialists. They are prescribed cough medicines, antibiotics or asthma drugs, all to no avail. To learn more about this incredible problem, check out our book, Top Screwups Doctors Make and How to Avoid Them.

Although ARBs are less likely to cause an uncontrollable cough, they too can trigger symptoms in susceptible people. Here are some ARBs and side effects to be aware of:

Some Popular ARBs:

  • Losartan (Cozaar)
  • Olmesartan (Benicar)
  • Telmisartan (Micardis)
  • Valsartan (Diovan)

ARB Side Effects:

  • Dizziness, fatigue, low blood pressure
  • Cough
  • Headache
  • Upper respiratory tract infections, sinusitis, stuffy nose,
  • Digestive discomfort, diarrhea, stomach pain, back pain
  • Joint pain, arthritis
  • Swelling of the face, lips, mouth, tongue or throat (Requires immediate emergency medical treatment )
  • Potassium retention and buildup (hyperkalemia)
  • Kidney damage, liver damage
  • Hair loss

Some reports from visitors to our website regarding ARB side effects:

“Cozaar and Benicar caused severe cough. My cardiologist told me it couldn’t be the Benicar. My internist told me every doctor should know these drugs do cause cough. The pulmonologist did a complete work up and concluded ‘it may or may not have been caused by Benicar.’

“It took 18 months for the worst of cough to subside. I still have residual effects 24 months after going off it.” E.M.F.

“When I asked my doctor about my horrible dry cough after taking Benicar for a long time, she assured me it must be allergies as my lungs were clear. Also, I had experienced nerve pain in my feet and itching all over.

“I stopped taking Benicar. My BP went up to 135/75 and my cough stopped as well as the pain in my feet and itching.” G.G.

“I take Cozaar and HCTZ and have a terrible cough that can awaken me at night. Doctors don’t want to explain why I’m having this cough. They told me to see an ENT [ear, nose and throat] doctor.  The ENT says go to your primary doctor.

“This is such a terrible cycle. I feel like I am going in a circle.” Carolann

For reasons we don’t understand, some doctors seem to be oblivious to the cough-inducing characteristics of ARBs (angiotensin receptor blockers) like Cozaar (losartan). Although far less likely to cause an uncontrollable cough than ACE inhibitors (like lisinopril), drugs like losartan and valsartan can cause this side effect in susceptible individuals. The FDA’s official language in the prescribing literature states:

“Cases of cough, including positive re-challenges, have been reported with the use of losartan in post-marketing experience.”

THE BOTTOM LINE:

The bottom line on the new blood pressure recommendations is: Do your homework! Never stop a beta-blocker medication suddenly, since that could trigger chest pain, irregular heart rhythms or even a heart attack. Learn about the side effects of ACE inhibitors and ARBs before starting these medications. If you are fortunate and do not experience any complications, great! If, however, you develop any of the symptoms described above, please contact your physician immediately. You may need a different approach to controlling hypertension.

To learn more about the mistakes doctors commonly make when prescribing drugs in general and blood pressure pills in particular, do consider Top Screwups Doctors Make and How to Avoid Them. It just might save a life.

Share your own experience with blood pressure medications below in the comment section.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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Amlodipine is the only blood pressure pill that does not bother me. The only side effect is some edema in the legs. The arb medication caused me to have sinus problems and cough. I have read
horror stories from other sites but I have been very lucky on amlodipine.

Has anyone had bad side effects from Amlodipine?

Reading all these comments from patients, one thing came to mind, namely: most of the comments fail to include names of other medications (prescribed or OTC) that they are taking along with their prescriptions. Medical websites are full of cases where interacting meds create all sort of problems, some of them very serious.

I would like to see you asking readers to list other medications they are taking, including homeopathy drugs when they describe their conditions.

Reading all these complaints, I wonder what is coming for me. I’ve been on
Lisinopril for years, and also take at night Amlodipine (Norvasc) which is a calcium channel blocker. HOWEVER, I also have a lot of degenerative arthritis, osteoporosis, stenosis, sciatica…Take calcium 1200mg in morning.

But it is killing my bones…and now I know the dry cough is from Lisinopril. WHY would they put me on a calcium channel blocker knowing the bone loss and pain I’m in? Have apt this week..Looking for changed!

During this time last year, I got a concussion while cleaning the bathroom. Before this concussion, my blood pressure was pristine. Due to the concussion, my BP went very high, so, my doctor put me on Lisinopril. About two months after being on it, I got my first bout with acute pancreatitis. Prior to this episode, my stomach was in perfect shape and my recent physical exam was excellent. Since that first acute episode and taking Lisinopril, I have had two more acute attacks; my most recent one almost on the anniversary of my first acute attack. Along with pancreatic divisium (never knew until now) and diagnosed acute pancreatitis-idiopathic (yes I drink alcohol but that was not ruled the cause), my primary looked at my pattern of attacks, and along with me noticed that the only variable that changed since getting the attacks was the BP med. Just FYI that I would pass along. Also, while taking Lisinopril, my muscles were always sore as my body, joint stiffness and weakness, and overall fatigue.

People need to take ownership of the health of their own bodies. Don’t just take a drug because your doctor tells you to. Research it. Research your options. Talk to your doctor. Voice your concerns. If you do decide to take a drug, monitor your body for side effects and keep an open line of communication with your doctor. If your doctor won’t listen to you, find another doctor who will.

Instead of prescribing Lasix as a first resolution to my high blood pressure the doctor prescribed Norvasc which after one 5 mg tablet resulted in lots of side effects. I called the doctors office and they said if the reaction worsened I should go to the ER. Well next he started me on Metropolol. The day after my coughing started followed by congestion. Before 2 weeks passed it sounded as if I had pneumonia the congestion became so bad.

After finally convincing him when he heard my severe wheezing and congestion he put me on Lasix. Well the blood pressure is now perfect. But the congestion and coughing continue. Sleeping is on an incline (several pillows) otherwise I feel like I am drowning in my own mucus. How long will this go on? It took 2 weeks to wean off the Metropolol and have been on only Lasix about 2 weeks since that. Again cannot get any answer on this. Why? Feels like that med ruined my lungs for life.

I was prescribed Linsinopril contradictory to the manufacturers recommendations, it is NOT supposed to be the first choice for blood pressure treatment. Per the manufacturer guidelines it is only to be prescribed after all other remedies have been exhausted. I developed a dry cough that was persistent. Coughed enough that my ribs became sore and then painful on the right side. Doctor ignored my symptoms until I had finally coughed enough that I separated the ribs (tore the cartilage) on my right side. Now my ribs pop past each other.

I developed a cough while on Lisinopril that grew worse and worse (horrible coughing until I’d almost faint, gagging, continual sinus infections). My family practice doctor performed hundreds of dollars worth of allergy tests (no allergies found). So family practice doc put me on Losartan for 9 months – still had the horrid coughing. Family practice doc finally did an asthma test (showed asthma – which a pulmonologist said was cough-induced). So, pulmonologist put me on Metoprolol which raises my blood sugar and makes my ankles swell. Help?! Oh, I’m 59 and a full-time caretaker for my adult daughter with special needs.

Doctors are legal drug dealers.

Is Valsartan a better drug all around as to allergies, side effects, etc., than Losartan

I take 10mg of Propanolol which was prescribed for blood pressure because of my intolerence to other drugs. I had no problems taking it, and for a while my BP was fine. Then it started to rise, and I was prescribed 5mg of Enalapril Maleate which they had to increase to 10mg. Since then I’ve had terrible headaches, dizziness, terrible anxiety, and panic attacks.I have spoken to my practise about the side effects but because I have a history of anxiety they’re putting my symptoms down to that. But I know it’s the medication. I have suffered anxiety for years but I’ve never felt as bad as I’m feeling now. The last panic attack I had before I started taking this medication was in March, 2015, and that was also due to prescription drugs for BP. Has anyone else experienced greatly increased anxiety levels while taking this drug?

My doctor said Norvasc will not cause throat dryness , Toprol will. Taken off lisinoprol caused kidney count

I just started bp meds and am feeling a lot mate anxiety and panic attacks. Doctor told me not to worry about it that I was just anxious. Ugh!!

On Lisinopril 20 mg per day for four months. It was contraindicated as I have asthma but was prescribed Lisinopril anyway. As expected, I have a terrible violent coughing problem now with clear but plentiful phlegm and wheezing. I am going to the doctor next week and demanding to be taken off of this poison!

I took lisinopril for HPB for several years. Several years that I also suffered from the worst coughing, gagging, wake you up at night upper respiratory horror you can imagine. My internist said it was allergies, until the day I woke up with such severe swelling around my pharynx I went to the ER. They gave me an antibiotic and sent me on my way. I followed up with an ENT specialist, who told me, “you have no infection, it’s the Lisinopril.” Whaaaat?? Come on providers, get it together, I went through a LOT of unnecessary suffering for this, all to change one pill all along?

I was prescribed Alendronate one a day 5mgs and I was told to stop because it was drying out my mouth. So now I’m taking 35mgs once a week and I am so afraid of the side affects that I read about. I have osteopenia and I’m 70, all I can say May God bless us all.

I started taking an ACE inhibitor and immediately developed a dry cough. I stopped the drug for five days, cough did not go away so continued taking it while on vacation. Took a total of 29 Ramipril 10 mg tablets. I still have cough only now there is more phloem in my throat. Just went to ENT Doctor. Found out one of the nerves to my larynx (voice box) is paralyzed and I have some thickening of my esophagus. I can’t find this listed as a side effect of ACE inhibitors. Has anyone else ever heard of this?

I have been on Vasotec (Enalapril) for 15 years now. I noticed that less than a year after starting it, I lost my singing voice and was told my vocal cords were swollen. In the last five years I have been suffering with muscle weakness and can’t walk too far and have had to stop going to the gym 5 years ago. Have fatigue as well as shortness of breath every now and then.

My cardiologist just changed the dose from 10 mg twice a day to 20 mg once a day. This is not helping me at all. I feel as though I am going to wind up crippled. I tried to switch to a beta-blocker and was severely allergic to it, literally almost had a heart attack. I cannot find anything I can take for my hypertension that doesn’t have any kind of side affects and am thinking of trying to do this with natural treatments.

I want my singing voice back, and my quality of life back. I was always very active, and a person who would work 12 hour days five days a week and still have a lot of energy. This medication is taking away my quality of life, and my PCP and Cardiologist keep saying that this medication isn’t doing this to me. However, after looking up the side affects, it states that muscle weakness and fatigue are side affects from this medication. I have the same problem with Cholesterol medications. Lipitor crippled me so badly it actually made my bones feel like they were broken. I don’t know what else to do except just wean off this Enalapril and try controlling my BP with natural remedies.
Nancy

I went to my Doctor due to headache and stress. She said my BP was elevated so She put me on lisinipril 5mg 1 x day. After about 2 months I started coughing, alot! I even have a buzzing fluttery feeling in my chest, and Clearing throat most annoying to anyone on the phone with me. cant remember the last time i was at the movies lol. People Do NOT like coughing and gaging noises during movietime lol i got BOOED.

I started googling side effects, and behold..I’m not the only one. Doctors omit a lot of info, basically taking OUR Choices away. To live with bp or horrendous side effects. I called doc told her I’m done with the meds. I will risk my own life, before I allow someone to drug me to the point of the meds killing me.

She wanted to give me a different bp med, no thanks, lowest my bp has been was 90/60 FOR REAL?!? Then one time it was at 155/100 serious stress car accident, so i can see why that was high. Bottomline, once they get you on them, they push more and more things. Blaming cough on asthma or cold pneumonia etc…BITE ME. I will do it my way..;)

About your doctor refusing to admit the med they prescribed(lisonopril) causing your chronic cough. I just got out of the hospital, andnoticed these doctors WILL flat out NOT admit anything the prescribe caused ANYTHING. They do, secretly know, but I think they are so over trained by hospitals to deny any culpability, it just comes as second nature to deny it. I had one put me on MULTAQ before my cardioversion, and that stuff, was $520 a month and made me feel like I could not function, smile, laugh or even look forward to anything. Thank God he took me off it the day I converted back into sinus. I had JUST gotten used to the metorprolol, when the MULTAQ was added. The pharmacist told me some people could not tolerate it, so I am so glad I didnt fill the whole script with no insurance. Back to my point. Always get a 2nd opinion, when you clearly know the side effects of your med is causing your discomfort. i hope this helped someone somewhat.

I am a 52 years old Asian with high blood pressure and have been under med since 2007. I had Micardis HCT until 2012 then my family dr changed to Losartan 100mg plus 5mg Amlodipine. I had a Thyroid infection in June of 2015 and it recovered in Sep. But after that I found I frequently lost heart rhythm and my family dr said in January 2016 it might be the Amlodipine caused so I stopped it.

The rhythm is fixed but blood pressure become high (150/95). I visited the cardiologist last week and was told Losartan is not working. And switch to BenicarHCT. Started from 2/24/2016. Now blood is better (122/82) however my heart beat changes from lower 60s to high 70s.

Any movement will cause the rate changed even higher (walk uphill slowly, cause 98/min). I have just taken BenicarHCT a few days. Should I give more time? I am going to see my Cardi Dr. in two weeks.

After ten days on Captopril I was up most of the night and this morning alternately coughing uncontrollably and gagging. Would rather have a stroke or heart attack than this….

After months of HPB, and not wanting to take a BP meds, my doctor finally convinced me of the danger of not “doing something soon” knowing that I have tried everything. I am very healthy otherwise, walk, exercise, etc. so that was not the cause. At any rate, I started on Lisinopril 5 mg and by the next morning, I felt better than I had in months! My doctor did caution me about side effects and to notify her immediately if I started coughing and the dizziness was too much to handle, we would try something else. I can honestly say, she is on top of all the side effects and is keeping a close watch. To the individuals that their doctor is “not listening” to the complaints about side effects, I say find a new doctor.

Please don’t say that you’d rather have a stroke or heart attack, you don;t mean it, but I certainly understand your distress. Good luck with finding a med that works. I’m sorry for your discomfort.

My 85 year mother is on Diovan (valsartan). Besides a dry throat, eyes, mouth, esophagus is more irritated; dizziness, joints hurt,etc., there is one side affect that has me really concerned… she just gets so angry so quickly over nothing and she is not usually an angry person…

My question is: has any of you noticed that with this medication? She’s on 320 mg. 1x daily. I hate what it’s doing to her! Can you help me by letting me know your experience? Thanks!

I too have had anger and extreme irritability issues with Diovan. My friends noticed a change in my personality and begged me to get off this BP pill. I did and what a drastic change for the better. Diovan is an extremely bad and dangerous BP medication and should be taken off the market ASAP. It is also one of the most, if not the most popular BP meds on the market. I have been off this poison for almost 5 months now and feel soooooo much better. My friends have also seen the change. Big Pharma are nothing but Greedy Fat Cats, who should be ashamed of themselves for preying on the innocent public for the sake of the almighty dollar ! !

I’ve had higher blood pressure WITH meds than without! I’m 72 female and take no medications for anything. I’ve always been extremely active, an avid gardener and walk my dog a couple of miles every day. My dr. started me on atenolol in June, 2015. I gained almost 10lbs in 2 weeks, had chest tightness so bad I couldn’t walk 1/2 a mile andwas so dizzy I literally couldn’t lean over without falling. My BP went from an average of 140/85 to 190/110! My doctor said he’d never heard of it raising BP so I did some research and found several links indicating it will in some people. Then he switched me to lisiniprol and did warn me that in a “few” people, it can cause an “irritating” cough. Well, at first it was just a tickle and not too bad, but then it got worse and worse till I would gag and/or throw up and could barely stop coughing. Along with that, I had terrible cramps in my feet/legs that kept me up most nights. I kept drinking water since he assured it it couldn’t be from the meds and I was dehydrated! Well, between the cramps and drinking so much, I literally wasn’t getting more than an hour or so of sleep a night for 3 weeks. I finally said I refused to take it and my BP wasn’t that high but the frustration and cramps and lack of sleep was driving it higher than it had ever been w/o medication! Now I’m on losartan…started last week but still have the terrible cough that doesn’t seem to be getting any better. I’m ready to just ditch it all and live with BP that is mostly pretty normal with only a few higher spikes. It’s not worth it. I have no energy and my life is basically ruined since I’m afraid to drive because of the cramps in my feet and can’t go out with friends because of the terrible cough.

It’s one thirty am, Im up looking up side effects of benazepril, I’ve been coughing till I threw up, so tired, but unable to sleep. I’m a 55 year old female, I’ve been on benazepril for about 10 years now, it does control my BP, but the tickle in my throat has been really bad, and the sinus drainage, I never even thought it might have to do with this med. I am wondering now, whats worse, the BP or the side effects.

I also would like to add – regarding my 88 year old mother – they had her on Atorvastatin after her heart attack in Feb. last year and she nearly died! She’s a very petite woman, but her weight got down to 73 lbs in January of this year, because she had zero appetite and was constantly sick to her stomach. I finally went online to look up side effects on the FDA website, and one of the things that came up for Atorvastatin was anorexia and upper abdominal pain…. So WHY didn’t her doctor suggest this could be from the medication? I had her stop taking it and within a few days she was eating again. THANK GOD!!! I KNOW she would not be here right now if she had not done so!

Please beware of these drugs! It’s AWFUL but I think doctors don’t want to be bothered acknowledging these terrible side effects. Are the drug companies compensating them for prescribing them, and are they that heartless that they just don’t care if people are suffering? We are human guinea pigs and it is very SCARY!

My 88 year old mother was hospitalized three times last year with heart issues. They have had her on Lisinopril. She is experiencing the very same side effects you have – persistent cough, constant throat clearing, and pain in legs that keep her up at night. THANK YOU for posting this! Her PCP has not said these symptoms are side effects, rather, he says that she now has neuropathy in her legs but he doesn’t want to treat it because they medicine will make her even more dizzy than she is now. Her cardiologist, however, DID say that Lisinopril causes a cough.

The past few days she has said she cannot clear her throat but nothing comes up when she tries. It’s AWFUL that these doctors are NOT telling people the truth about these side effects! I’m her acting caregiver and now I don’t know what to do about this. I don’t want her to be taken off this medication entirely if it causes her BP to go up. But what should I do since these doctors don’t seem to listen and acknowledge these side effects!?

I began taking Benicar 40 mg yesterday and experienced insomnia and muscle cramps. Today I again took the 40 mg (no HCT) and my joints are swollen and my backache is so bad I cant sleep. Its 2:00am now and I am trying to find some relief from the pain. Cant take NSIDs as they raise BP I’m 75 years old and very active normally. I have a positive attitude, I pray but this is just not helping tonight. I am unable to take Calcium channel blockers, ACE inhibitors, and beta blocking agents. Help! any one have answers? (not going back on Vicodin or Tramadol) They totally drug me out

your story matches Exactly to the T what happened to my husband when prescribed Lisinopril. My hubby was a perfectly healthy , non-smoker , never sick man all his life. Shortly after starting this drug he started that chronic dry cough till he would choke & even pasted out several times. A ambulance had to pick him up one night when we were out on a date. I was the only one that kept telling him it was the BP med. I am a nurse & already was aware of these possible side affects. I am very very serious about teaching my patients at discharge medication education since most doctors do not. They Do count on us to patient education. I insisted he get off his med. He is currently on nothing because last 2 he tried did this to him to the point he could not be left alone in fear of him passing out or working. It has been approx. 2 months since he is off these Meds. & still he coughs but not as severe as it was. Hoping it will eventually stop & he can get back like he once was! My mom had same problem on the B/P medication ‘DIOVAN ‘! Beware of that one also!!

Has anyone gotten the cough from taking norvasc or the
generic. It doesn’t seem to be listed as a side effect,but
I have so bad I can’t sleep at night. I am 74 and have been in it
amout 5 yrs now.

Did your mother seem to get angry quickly, more than usual? On Diovan? What dosage was she taking?

Afrer10+ years on benicar, I developed muscle, back and and pain. Switched to amlodipine with resulting back and abd pain. Then switchedto lisinopril …Resulting in abdominal pain/ discomfortam fatigue. What next?

I am also finding out very rapidly how the BP medicines can give you the worst dry hacking cough you can imagine. My husband was on Valsartan and carvedilol (at the same time). I am not a nurse but I do work in a hospital. At one time I took my husband off amiodarone for the same reason. His heart dr. would not take him off of it. Finally the surgeon who did his ablation took him off of it because of the cough. Now his allergy dr. stopped the valsartan, the heart dr. won’t let him stop the carvedilol but lowered the dose. I also took him off of Ranexa since his kidney dr. saw a problem coming with his kidney. What is wrong with some of these doctors. I’d like to see them cough until they pass out.

oh no, this scares me. I started taking lisinopril, and I cough and cough,…. I thought it was getting better, cause my doctor said to give it time… I can’t take it anymore… but if I switch, something else could be worse. but I have to try. yikes :/

I was on both Benicar and Lisinopril and both caused anxiety resulting in vivid dreams, otherwise known as night terrors. During night terrors I dove out of bed to escape rapists, Nazis and all kinds of animals, of course, waking up on the floor. During the worst night terror I broke my hand fighting off monsters (slammed my hand against head board).

Every time I discussed this with doctors they said it couldn’t be the medication, so to prove the point to myself and my would-be physicians, graphically charted the incidents while on the medications and after I removed myself from them. I still have dreams and may talk in my sleep, but no more terrors or violence. I’m controlling my BP with two daily bouts of exercise, by eating lots of greens and high potassium/low sodium foods, and by taking magnesium citrate supplements 4 x daily, as well as 1/4 mg Guanfacine in a.m. and p.m.

Essentially, food and exercise are my medicine, and my blood pressure (for the most part) averages 129/60 to 139/68 — however, it requires a commitment I’m willing to do because I don’t want to break any more bones. I’m 71 years old, weigh 133 pounds and am 5-feet 4-and 1/2 inches tall. I plan on losing at least 10 pounds to see if it helps lower my blood pressure a bit more.

My 77 yo husband has been on metropolol for years after suffering a heart attack 25 years ago, and yesterday his cardiologist said to immediately discontinue 50 mg metropolol tartrate twice a day due to sinus bradycardia and first degree A-V block. I asked if it should be done gradually as I often have read, especially on this website, and he replied no. I was shocked!
He also has been taking 5 mg amlodopine; 100 mg losartan; and 4 mg doxazosin to reduce nighttime trips to the bathroom, all of which keep his blood pressure very low. He did experience two trips to the ER after his back surgery due to hypertension crises, so all of the above meds were added to his regimen.
I am in favor of him getting off the metropolo and increasing the amlodipine to 10 mg because I think the metropolol interacted with the amlodipine. I think I will now visit with our pharmacist today for another opinion.

Six months back my friends father used ACE fro blood pressure control but he didn’t experienced any kind of side effects! I think these side effects are experience only by some people.

Hi! I took amlodopine and had a horrible reaction with hives, skin itching terribly, anxiety and weirdest of all my skin started folding, wrinkling and sagging!!! This drug has been banned in Norway…. get off it ASAP!!!

I am well controlled on my atenolol and it’s a high dose I’ve taken for years without side effects. I certainly don’t want to suddenly stop it and run the risk of a heart attack if it’s doing the job! Yes, indeed, if it ain’t broke don’t fix it!!!!!!!

A good “rule of thumb” in life is, “if it ain’t broke, don’t fix it”, huh?

Lotrel is a combination product consisting of an ACE Inhibitor (Benazepril)and, a CALCIUM CHANNEL BLOCKER (Amlodipine or “Norvacs”).
The same cautions apply to Lotrel as do to any blood pressure medication, including the possibility of persistent cough from the ACE Inhibitor component that some patients experience necessitating in the discontinuation of the product, which is by the way due to the inhibition of a neuro-chemical “Bradykinin” by ACE Inhibitors, to which some patients are predisposed.
Also, there is a possibility physical injury due to falls in the senor population due to dizziness and syncope (lowering of the blood pressure too much) caused by blood pressure medications in general, so caution must also be observed when taking any of these products.
That said, if you’re doing well with Lotrel then, there shouldn’t be any reason to change medications, since Lotrel is available generically and should be quite affordable to most people.

Where does Lotrel fit into this problem ?
People’s Pharmacy response: Lotrel is a combination of a calcium channel blocker (amlodipine) and an ACE inhibitor (benazepril). Both are in the approved category.

I am currently on atenolol, felodipine and chlorthalidone. My blood pressure is very well controlled and no way do I want to change the medications I’m on no matter what the current recommendations are!

In all fairness to Medical Doctors, many weren’t trained in the Holistic or Natureopathic approach to healthcare, but many more are now starting to realize that some real tangible health benefits can be derived from going there, without necessarily having to abandon Western or Allopathic Medicine entirely. (people like “Dr Oz” have come to realize the benefits that can be derived from looking at all sources of healthcare that are available in the world to us).
The United States spends vastly more per capita on Medical Care than anywhere else in the world, but our healthcare outcomes overall are at best only mediocre.
We still have the best healthcare system when it comes to hospitalization and surgical procedures of almost anywhere in the world, though albeit highly expensive.

Tekturna is a relatively new drug that came out in the U.S. a few years ago. It was developed in Japan and is what’s known as “a Renin Antagonist”.
Someone with your condition should definitely be under the care and strict supervision of a Cardiologist, but some additional help from a nutritionist can help you avoid all the “sodium” that processed foods in this country contain.
Just look at video clips of how people in this country looked just 40 or 50 years ago, to see how far wrong we’ve headed in the opposite direction based on the proper nutrition and, and adequacy of the American diet since then.
Exercise should (and must) be an integral part of your daily routine (30 minutes of walking would be genuinely helpful to you health). Incorporate the proper dietary balance into your daily life, as well as perhaps visiting a “Natureopathic” or “Holistic” practitioner in addition to get some real information from “their side of the fence”.

Western (“Allopathic”) Medicine has some advantages but mostly in the surgical end of therapy, as far as health outcomes go.
Eastern (“Holistic” or “Natureopathic”) Medicine has many advantages as far as “Natural Therapy” goes, as is the type of medical therapy that this website writes about.
You can have the “best of both worlds” by undergoing, “Integrative Medicine” which combines the best elements of both,but not everyone is predisposed or able to go to “The Mayo” or “Cleveland Clinics”.
The sad truth is that your economic level and the area of the Country where you reside will greatly determine your lifespan and your quality of life.
That said, there are still things that you can do to affect your healthcare outcomes positively (and you don’t have to live in Rochester, Scotsdale, or San Diego to do it)!
You need to only do as you’re doing and getting educated on the appropriate and safe approaches to maximizing the healthcare that you receive,and to find the appropriate medical practitioner to help you along the way.
I might suggest,seeking out a “Holistic” or, “Natureopathic” practioner to do this. There are many MD’s who are opening up to “Integrative Medicine”, in many parts of the Country now, something that wasn’t as commonplace even just a few years ago.

To Mouse: Please see my post also on 12/27 at 8:59 pm – my suggestion to you is to follow the South Beach “Diet” – I did a couple of years ago, lost a bunch of weight, got much healthier, and no longer needed my BP meds! I never felt or looked so good. January 2nd, I’ll be getting healthy once more … As several people have posted here, I think we are all realizing that the doctors are simply lying to us about our meds – they KNOW problems and side effects, but choose to turn a blind eye.

Sular is another Calcium Channel Blocker for hypertension. low side effects but remember that significant “genetic variation” exists among our population, so what works well for some people dosen’t necessary work the in the same way for others.

Verelan is “Verapamil” or what’s known as a Calcium Channel Blocker.
New guidelines for blood pressure for people over 55 years of age now start treating your blood pressure with prescription medication only if it exceeds 150/90 because of the many side effects that blood pressure medications have that can harm the elderly, including the high probability of injury from falls from taking prescription medication.
It’s never a good idea to discontinue any prescription medication on your own without the guidance of your healthcare provider involved in the process because of the danger of rebound,high blood pressure (sort of like twisting a garden hose to slow down the flow of water, and then suddenly untwisting it, resulting in a spike in pressure to your heart and cardiovascular system).
Consult with your healthcare provider before making any potentially dangerous decisions about the very powerful drugs that you get from a Pharmacy.

Some good information on Norvasc is available on the Web.
Pharmaceutical Companies are not required to list their post-marketing side effect data on their published drug information to Doctors and to the general public, and now that Norvasc has long been off patent, the original manufacturer, Pfizer has little or no motivation in digging into this issue.
You should establish a good rapport with your Healthcare Provider and with your Pharmacist and, choose wisely from services that provide you with good, honest medical advice, along with the time availability required to discuss these very critical issues with you.
Your local Poison Control Centers are staffed 24/7 with Pharmacists who have access to this information on demand, as well drug information and studies that are available from their “Drug Information” departments, as do various other websites online.
The short answer is that you have to take charge of your individual health and have an “advocate in your corner”.
Here’s some information regarding your question that I found.
Note: “Norvasc” is “Amlodipine”.
________________________________________________________________________
Correspondence
Does Amlodipine Increase Cancer Incidence?
Mark R. Goldstein, MD, FACP
To the Editor:
The Prospective Randomized Evaluation of the Vascular Effects of Norvasc Trial (PREVENT)1 amplifies the controversy over calcium antagonists and increased cancer risk.2 In this 36-month, placebo-controlled, randomized trial, the calcium antagonist amlodipine had no effect on the angiographic progression of coronary atherosclerosis or on the risk of major cardiovascular events. In the group assigned to amlodipine, the annualized rates of coronary artery bypass grafting and unstable angina were reduced by 1.0% and 2.1%, respectively.
Unfortunately, incident cancers increased in the group assigned to amlodipine. The annualized rate of incident cancers was 1.8% in the amlodipine group and 1.0% in the placebo group. Thus, the 0.8% annualized increase in incident cancer in the amlodipine group was similar in magnitude but opposite in direction to the 1.0% annualized reduction in coronary artery bypass surgery.
Because some observational data suggest that calcium antagonists may cause cancer,2 this finding in PREVENT warrants further investigation. From a public health perspective, for every 1 million patients taking amlodipine for 1 year, the incident cancer rate will increase by 8000 because of the drug. Perhaps we are trading one problem for another.
References
1. Pitt B, Byington RP, Furberg CD, et al. Effect of amlodipine on the progression of atherosclerosis and the occurrence of clinical events. PREVENT Investigators. Circulation. 2000; 102: 1503–1510. Abstract/FREE Full Text
2.Pahor M, Furberg CD. Is the use of some calcium antagonists linked to cancer? Evidence from recent observational studies. Drugs Aging. 1998; 13: 99–108. CrossRefMedline
Bertram Pitt, MD
University of Michigan Medical Center
Robert P. Byington, PhD;
Curt D. Furberg, MD, PhD;
Michael E. Miller, PhD;
Ward Riley, PhD
Wake Forest University School of Medicine
Donald B. Hunninghake, MD
University of Minnesota Hospital/Clinic
G.B. John Mancini, MD
+
Author Affiliations
University of British Columbia
Response
We appreciate the comments of Dr Goldstein regarding the incidence of cancer seen with amlodipine in the Prospective Randomized Evaluation of the Vascular Effects of Norvasc Trial (PREVENT).1 Because of the concern raised by Pahor et al,2 we carefully reviewed each case of cancer with an independent group of oncologists. In view of the relatively small number of events, no firm conclusions could be reached regarding the risk of cancer associated with use of amlodipine. Additional cancer data, however, will be available in the next 2 to 3 years from several large-scale trials in which amlodipine is being compared with placebo or other antihypertensive strategies.
We believe that the reduction in the incidence of hospitalization for angina pectoris and the need for revascularization observed in PREVENT suggests a role for amlodipine in patients with coronary artery disease.
Previous Section
References
1.↵ Pitt B, Byington RP, Furberg CD, et al. Effect of amlodipine on the progression of atherosclerosis and the occurrence of clinical events. PREVENT Investigators. Circulation. 2000; 102: 1503–1510.
2.↵ Pahor M, Furberg CD. Is the use of some calcium antagonists linked to cancer? Evidence from recent observational studies. Drugs Aging. 1998; 13: 99–8.

I too had a bad cough using lisiniprol. I switched to Losartan-HCTZ and am doing fine. Been on it about two years with no side effects. At 68 I do have arthritis but that was developing well before I started the Losartan.
Now I did have bouts of low bp but since taking Natto-Kinase those have tailed off to extremely rare. (Once in three months, down from several times a week.)

Weight loss, regular exercise, reasonable dietary changes with appropriate salt reduction, plus other lifestyle changes are key, and can produce measurable results in a person’s overall health, quality of life and longevity.

I have been on Metoprolol for a long time without problems (so I thought), until a few months ago, when I could no longer deny that my hair had thinned A LOT. I mentioned this to my PRP and she suggested I use a topical hair product like rogaine. I did research on the internet and came to the conclusion my hair loss was caused by Metoprolol. I cut my pill in half, and within a very short time, the hair loss stopped. Next visit, I told my PCP and she acted ‘surprised’. I believe ALL the doctors know FULL WELL, but deliberately choose to ignore the issue because ALL BP medications have a whole bunch of side effects, leaving the doctors with no good choices and more ‘work’ than they want, trying to sort out your problem!
Now, even on the 50% reduced Metoprolol of 50 mg, my hair has again started thinning. I tried cutting the dosage even further, but my blood pressure has now gone up to nearly 150/95 and I am at my wits’ end.
My solution: Come January 1, I will be on a healthy path to weight loss once again (such as South Beach), as I did a few years ago, when I said ‘goodbye’ to the BP meds!

I read since Peru everything about Beta Blockers and the side efects. I have high blood pressure, but I want to know what medicine is not bad for our high blood pressure or what can I take for my BP, because all the medicine is not good for us. I am taking enalapril now.
Excuseme my poor English
Americo S.
Trujillo Peru

A persistant cough due to taking “ACE Inhibitors” such as Lisinopril is NOT a good thing, and at the very least is a Quality of Life issue!
Prescription Drugs don’t have “side effects”.
If you’re experiencing it, it’s a definite “EFFECT”!

Hello my friend, You need to find yourself a good “Holistic or Natureopathic” Physician.
You’ll be pleasantly surprised with the results, I’d say !
Good Luck.

Reading the article today about the ACE’s and ARB’s is enough to make my blood boil. Almost every day we read about this sort of thing and the Dr’s stare at you and virtually lie by omission or straight out lie. We could tick off about half of the side effects listed as being applicable to us!
My husband is 71 and I am 66. My husband is also a Type2 Diabetic. We’ve both had heart attacks and are on a raft of pills including those mentioned above. My husband was told it’s not the pills, you’re 71 and that’s why you’re tired etc. We’re both “stuffed” and can’t do our normal day to day chores without feeling washed out.
Numerous times we’ve mentioned these to a Dr and had it shrugged off. We thought the Dr’s had a “do no harm” clause in their oath (or perhaps that’s been removed since Big Pharma has taken an increased interest in their “bottom line!”) We’ve seriously considered weaning ourselves off these iniquitous drugs but the “fear” factor comes into it and IF we were to have another “event” and they knew we had discontinued our medication, then they’d probably refuse to treat you or put you on worse medication!!
We actually feel quite helpless at the moment. Getting honesty out of the Dr’s seems an elusive thing. We’ve started to see a Chinese therapist but she’s away for 6 weeks now so we’ll have a big gap in our treatment. We’re really hoping for help from her but will have to come to the point where we have to decide about our pills, or her treatment will just have been an expensive exercise. Western and Eastern medicine can’t always run parallel. Any constructive comments would be appreciated. We’re just about to the end of our tether.

I was in the ER last Friday almost died due to high blood presser medicine. It also damaged my lungs. I told my doctor I can’t take generic medicine. I’m also losing my hair. I want off all medicine. My doctor told me to get another doctor. my bp runs about 125/65.. only goes high if I’m on generic medicine that makes me sick, coughing so bad my lungs don’t work. Must go on a pulmo-aide machine. Please can someone help me?

You might want to ask the authors of this website to investigate the answer to your question.
Lisinopril is derived from “snake venom” (a fact that is probably not widely reported to the American Public as common knowledge). Weight management, lifestyle and dietary changes (such as completely eliminating salt from your diet) will go a long long way towards correcting your hypertension as well as any other medical problems that you may currently be experiencing.
The United States is “highly,over-medicated”,”highly over stressed”, and most of all, “highly over-fed” with the wrong kinds of foods in our diet, (and by the way,”highly over charged” for prescription medication).
People’s Pharmacy response: The story on ACE inhibitors (actually captopril, the first ACE inhibitor) being derived from the venom of the Brazilian jararaca snake is quite interesting. Hunt down a copy of People’s Pharmacy 3, now out of print, for the story.
Despite the derivation, ACE inhibitors are very useful drugs for those who can tolerate them. Art is correct, though, that following a low-sodium DASH diet (https://www.peoplespharmacy.com/2013/10/03/ward-off-cognitive-decline-with-vegetables-whole-grains-nuts-and-legumes/) can lower blood pressure remarkably well. Adding exercise makes the dietary regimen even more effective for controlling blood pressure and the risk of heart disease.

I have been on Verelan PM for a number of years with no disease effects. My blood pressure varies from the low 100’s to the mid 140’s. I am 78. Does this mean I can stop my blood pressure medication?

I take 3 kinds of ARB’s and ACE inhibitors and have always suffering from headaches, dizziness, no energy, palpations and stomach problems, but every time I complain was told that it was all in my head. Blood pressure during visits,was within normal of 140/90,but instead of removing medication it was upped on dosage.
Love this new guide lines,for maybe more doctors will pay attention to there patient,when the complains were with in just

A few months ago, your newsletter reported that taking norvasc (or its generic I presume) could lead to breast cancer if
taken over a 10 year period. My drs know nothing about this. How should one proceed with this info? I only take 5 mg
a day, but there was no amount included the info. Appreciate response.
People’s Pharmacy response: Here is a link to the article you saw:
https://www.peoplespharmacy.com/2013/09/12/cancer-warnings-on-medications-make-patient-furious/
and here is a link to the original research report your doctors will want to read:
http://archinte.jamanetwork.com/article.aspx?articleid=1723871
It was published in JAMA Internal Medicine on Sept. 23, 2013 and was based on a very large database of patients in Washington state. The authors do warn that more research is needed to confirm this finding.

“ACE INHIBITORS”, such as Lisinopril definitely do cause a “persistent, dry cough” in some individuals.
I’ve heard of many cases where people who simply lost weight, ate a better diet, and exercised regularly, whose symptoms of hypertension, diabetes, and other conditions simply vanished when multi-prescription drugs could not even come close to controlling their symptoms, and they were in fact, in a downward spiral!
There are better ways of getting your high blood pressure under control than necessarily resorting to taking Prescription medication for the rest of your life.
People’s Pharmacy response: In our interview with leading cardiologist Sidney Smith, he emphasized the importance of lifestyle changes to lower heart disease risk.
https://www.peoplespharmacy.com/2013/12/21/928-supplements-vitamins-blood-pressure-and-cancer-screening/

So what am I supposed to do? My upper bp reading can go above 140, sometimes up to 170. I was taken of Lisinopril because of lip swelling, put on Amlodipine that seemed to work well until I had irregular heart beat (a-fib) in March this year and am now on 25mg of Antenolol + Amlodipine.
I have been on ARBS, Tekturna and a thousand and one other BP meds for years. I have lost weight, get moderate exercise for age 75 years.
Doctors don’t want to try anything else, they have washed their hands of me and I dislike all the meds.

My cough didn’t start for a month on the ACE inhibitor, so my doctor concluded it wasn’t the fault of the drug. I went through a series of drugs and inhalers and finally insisted we change the BP treatment.
Now I am not only off drugs, I am off doctors and doing great. Years of taking drugs showed me that one drug leads to another.
This new AMA policy with BP is a good thing but it will probably result in younger and younger people being given drugs or being given wrong-headed diet advice like “avoid fats” .

This is interesting since I am on Lisinopril because I am a type 2 diabetic. My BP has never been as high as 150… usually 120/80 off the med… 105/58 on the med. Who made up this “panel of experts”? Has there been a real study done?
People’s Pharmacy response: The people on the panel reviewed a lot of real studies. People with diabetes are at higher risk for heart disease, so your doctor may be treating you although you don’t actually have hypertension.

It might be good to try weight reduction and, a serious attempt at incorporating lifestyle changes into you daily routine, followed by natural therapy to try to treat your hypertension as a first approach.

My doctor actually told me that the lisinipril cough was good for me! He gave me some medical mumbo-jumbo explanation of how coughing uncontrollably all day and night was not bad!!!

I take Sular twice a day for hypertension. It works and I do not have any side effects. I used to take Atenolol, which caused low heart rate and low energy. After switching to Sular, all was well!

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