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#1
Injecto

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Is anyone here on any ACE Inhibitors? When did you start?

My doctor gave me a prescription for Altace over Christmas, and although I liked the idea about taking a medicine that will protect my kidneys, he told me that I need to get some bloodwork done 10 days after starting to see if my vitamins and minerals in my blood were affected. That got me to thinking, that means it will possibly be doing things to my body that are not good, so, I have the bottle sitting at home doing nothing. Just wondering what people's thoughts are.

#2
issysmommy

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My endo has recommended these for a long time, but I have been hesitant. I am seeing a new endo at the end of the month and plan on asking him. I look forward to seeing what some of the vets here think about it.
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#3
princesslinda

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I've been on ace-inhibitors x 5 years now, long before my diabetes diagnosis. I have HTN and since I had a family history of diabetes, the doc felt this would help protect my kidneys. I've had no side-effects (other than a mild cough the first 2-3 weeks--which is common) and it has controlled my blood pressure. I take Accupril 20 mg 1 at bedtime. Here's some info that might be helfpul:



Angiotensin Converting Enzyme (ACE) Inhibitors
Pharmacy Author: Omudhome Ogbru, Pharm.D.
Medical Editor: Jay W. Marks, M.D.
What are ACE inhibitors, and how do they work?

Angiotensin II is a very potent chemical that causes the muscles surrounding blood vessels to contract and thereby narrows the blood vessels. The narrowing of the vessels increases the pressure within the vessels and can cause high blood pressure (hypertension). Angiotensin II is formed from angiotensin I in the blood by the enzyme, angiotensin converting enzyme (ACE). ACE inhibitors are medications that slow (inhibit) the activity of the enzyme, which decreases the production of angiotensin II. As a result, the blood vessels enlarge or dilate, and the blood pressure is reduced. This lower blood pressure makes it easier for the heart to pump blood and can improve the function of a failing heart. In addition, the progression of kidney disease due to high blood pressure or diabetes is slowed.

For what conditions are ACE inhibitors used?

ACE inhibitors are used for controlling blood pressure, treating heart failure and preventing kidney damage in people with hypertension or diabetes. They also benefit patients who have had heart attacks. In studies, individuals with hypertension, heart failure, or prior heart attacks who were treated with an ACE inhibitor lived longer than patients who did not take an ACE inhibitor. Because they prevent early death resulting from hypertension, heart failure or heart attacks, ACE inhibitors are one of the most important group of drugs. Some individuals with hypertension do not respond sufficiently to ACE inhibitors alone. In these cases, other drugs are used in combination with ACE inhibitors.

Are there any differences among the different types of ACE inhibitors?

ACE inhibitors are very similar. However, they differ in how they are eliminated from the body and their doses. Some ACE inhibitors need to be converted into an active form in the body before they work. In addition, some ACE inhibitors may work more on ACE that is found in tissues than on ACE that is present in the blood. The importance of this difference or whether one ACE inhibitor is better than another, has not been determined.

What are the side effects of ACE inhibitors?

ACE inhibitors are relatively well-tolerated by most individuals. Nevertheless, they are not free of side effects, and some patients should not use ACE inhibitors. ACE inhibitors usually are not prescribed for pregnant patients because they may cause birth defects. Individuals with severe kidney problems and people who have had a severe reaction to ACE inhibitors probably should avoid them. The most common side effects are cough, elevated blood potassium levels, low blood pressure, dizziness, headache, drowsiness, weakness, abnormal taste (metallic or salty taste), and rash. It may take up to a month for coughing to subside, and if one ACE inhibitor causes cough it is likely that the others will too. The most serious, but rare, side effects of ACE inhibitors are kidney failure, allergic reactions, a decrease in white blood cells, and swelling of tissues (angioedema).


**Probably more than you wanted to know, but it pretty much tells you everything.

#4
Injecto

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The most serious, but rare, side effects of ACE inhibitors are kidney failure


You see, I forgot to mention this one, but this reason to me seems so contradictory to using an Ace Inhibitor. Just seems ironic that the use of a medicine to prevent kidney failure is also putting you at a risk of causing kidney failure. That alone scares me.

#5
princesslinda

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For me, I look at it this way:....my blood pressure has been well-controlled on this one little pill (while many of my friends/family are on 2-3 BP meds and aren't even diabetic) and my kidney function is within normal limits now (I keep a really CLOSE eye on it). With uncontrolled HTN (not to mention diabetes), I'd have an even greater risk of kidney failure. The doc who put me on the ace-inhibitors was herself a diabetic and took ace-inhibitors as well. She mentioned that she recommends it for all her diabetic patients.

I'm not minimizing kidney failure as a risk at all, as I watched my mother die of kidney failure at age 54 and her mother also died of kidney failure at 57 (both were diabetics, my mom a VERY non-compliant one).

Also, if I took to heart all the possible side effects of the meds I take, i'd probably worry myself into an early grave.

You have to make your own decision on this of course, but I've had a very positive experience on the Ace-Inhibitor.

As an aside, I also work in a doctor's office and we have TONS of patients on Ace-Inhibitors without kidney failure (I'm in a urology office, so we test for that a lot).

#6
princesslinda

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Regarding side effects, check out the possible side effects of aspirin:

Common side effects

The most common side effects of aspirin are heartburn and other symptoms of stomach irritation such as indigestion, pain, nausea, and vomiting. The stomach irritation may lead to bleeding from the stomach, which may cause black stools. These symptoms may be reduced by taking aspirin with meals, with an antacid, with a glass of milk, or by taking enteric-coated or timed-release aspirin. Also, it is best not to take aspirin with alcohol or coffee (or other beverages containing caffeine, such as tea or cocoa and many soft drinks). Alcohol and caffeine make the stomach more sensitive to irritation. The non aspirin salicylate preparations sometimes are less irritating to the stomach and may be substituted for aspirin by your doctor.
Other effects

A few people develop asthma, hay fever, nasal congestion, or hives from aspirin or NSAIDs. These people should never take aspirin, nor should people who have active stomach or duodenal ulcers. Anyone who has ever had a peptic ulcer should be very careful about taking aspirin because it can lead to a recurrence.

Aspirin is known to interfere with the action of the platelets (blood cells involved in clotting). As a result, some people who take a lot of aspirin experience easy bruising of the skin. Therefore, people who have major bleeding problems should not take aspirin. Also, keep in mind that aspirin should not be taken for 10-14 days before surgery (including surgery in the mouth) to avoid excessive bleeding during or after the operation.

High doses of salicylate may cause ringing in the ears and slight deafness. If these effects occur, reduce your dose and call your doctor for further instructions. Your physician may decide to check your blood aspirin level and may even ask you to tolerate these symptoms without cutting your dose. Sometimes, however, these symptoms indicate mild overdose, which could become more serious. This problem should be discussed carefully with your doctor.

Aspirin and NSAIDs sometimes affect the normal function of the kidneys, or they can cause fluid to accumulate in the body. If you have liver, kidney, or breast disease, get your doctor's advice before taking these drugs. If you begin to swell up, gain a lot of weight, or feel ill while taking one of these drugs, stop taking it immediately and contact your doctor.


***Seems that just about everything COULD negatively affect the liver, kidneys, etc.

#7
lgvincent

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I've been taking Monopril since the fall of 1996. The doctor gave me the prescription to protect my kidneys. Other than screaming in my sleep for a few hours each night, I've not had any problems with it.
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#8
BlueSky

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.... Just seems ironic that the use of a medicine to prevent kidney failure is also putting you at a risk of causing kidney failure. That alone scares me.

..... it is indeed ironic. It is bit like taking statins. They are supposed to reduce the risk of heart attacks. But they increase the risk of congestive heart failure..... :confused:

The harsh reality is that any drug that interferes with the way the body works can cause it to malfunction. And the fewer drugs you take, the smaller the chances of something going wrong are. Over-medication is a big problem. So my feeling is that we shouldn't take drugs unless they are absolutely neccessary. And the "just in case" rationalisation is really not good enough. :wink:

#9
BriOnH

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Ace inhibitors are a god send imo. The blood test is just to make sure that the ACE inhibitor isn't halting kidney filtration too much. Potassium is the biggest indicator of this with this medication. If you feel ok on it I'd reccommend taking it as it will help reduce stress from sugars on your kidneys. If the ace inhibitor makes you feel light headed, or uncomfortable I would only take it if you start to spill MicroAlbumin. 10 mg is a very safe and effective dose. Everyone I know in the real world that has taken it (at the 10mg dose) hasn't had any adverse reactions from it at all.

#10
tanyatype1

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Hi Injecto! I've been on the Ace Inhibitor, Altace, for 3 months now and just renewed it yesterday. I consider it to be preventative maintanence! No side effects - so far so good. Mine are only 2.5 mg per day. My diabetes educator (also a type 1) recommended them, and said that Ace Inhibitors keep your kidneys in the same state as when you first start taking them. So if you start to take them while your kidneys are in good shape - they will stay in good shape. But, if you wait, and start taking them when your kidneys are in average shape, they will stay in average shape. The sooner the better, I was told.
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#11
It Ain't Over

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For me. Altace was cough medicine. The cough didn't show up until the dose was increased from whatever they started with, then the coughing started and it stayed on for at least a month after I stopped taking it.
Put me on the alternative med which is called Diovan. From what I read the final evaluation on the benefits of Diavan are not in yet. Endo told me the primary purpose of both of these is to protect your tissues from damaging enzymes released when the hi bg's set in.
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#12
BriOnH

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My diabetes educator (also a type 1) recommended them, and said that Ace Inhibitors keep your kidneys in the same state as when you first start taking them. So if you start to take them while your kidneys are in good shape - they will stay in good shape. But, if you wait, and start taking them when your kidneys are in average shape, they will stay in average shape. The sooner the better, I was told.


This is old school thinking of diabetes as an irreversible progressive condition. There is a lot of proof out there that kidney, eye, and nerve problems can be reversed. I have witnessed it first hand.

That said; Most Doctors will tell you it's progressive and irreversible because that's usually all they see.

#13
tanyatype1

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Hi BriOnH! I understand your point, and it is good news. I wasn't exactly told that it was an irreversible progressive condition though. Um, I don't know, I feel like even though we can try super hard our entire lives, eventually something diabetes related will come up. Maybe not EVERYBODY, some will be lucky. Maybe I'm totally wrong but it seems like a lot more diabetics end up with problems than not. I'd hate to not listen to the experts, and 10 years down the road, find out that my kidneys aren't in as good shape as they could have been. LOL! I just thought,.....watch - in ten years the doc will say, "yaaaaa, sorry about that Ace Inhibitor thing,...we made a mistake.....!" All we can do is try to do the right thing eh? Cheers!
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#14
Gabby123

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I have been on an ace inhibitor for 15 years. First I was on a calcium channel blocker for blood pressure and switched. I have done well on it. I did get a drug notice from my pharmacy that it can cause diabetes. I take I atenelol. I asked my Doctor about this after I had been DX'd and he just kind of sluffed it off. I didn't like that too much but I normally like my Doc.Diabetes runs in my family Grandpa, Dad , brother so I always thought it gets the men --WRONG--- it got me the first girl.

#15
v3xtr0n

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High blood pressure runs in my family and thanks to my regular H tests where my BP is taken it has been spotted early and I am now on an ACE Inhibitor called Lisonopril.

Not only will it keep my BP at a normal level but it will help protect my kidneys.

When I 1 started it a couple of months ago i was on 2.5mg tablets and 10 days after starting I had a blood test to check my kidney function was still OK.

Then i went up to 5mg tablets, again 10 days later another blood test...

Then i was put on 10mg tablets and had another blood test and it seems mi kidneys are still OK!

So don't worry about one of the side effects being kidney failure, your doctor should take blood tests to check this out.

:)
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#16
REDLAN

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I was on an ACE inhibitor for about 5 years - at the time I was in the process of changing jobs and it was very stressful - ergo I had high blood pressure...

doc persuaded me to take an ACE inhibitor, and prescribed lisinopril. The only real side effect or so I thought was light headedness particularly when standing (orthostatic hypotension).

Anyway in the meanwhile I gotta new job, got into mountain biking, started smoking again, stopped again, and then...

I noticed that over the past year that I was getting cramps frequently and these were leading to muscle injuries. About 3 months after I stopped smoking I got up with a high blood sugar, and a cramp in my thighs - sorted the insulin resistance, but the cramp stayed - lasted for 3 days could walk about 1/4 mile before I got a bad cramp - went to docs she suggested I might be calcium deficient.

read about side effects on the internet - and decided to cut my dose to 5mg (extra calcium made no difference) - cramps almost completely went away - went to GP and stopped altogether - hasn't been a repeat in the last 3 months of a cramp while exercising.

The other bonus was that I stopped feeling tired - some evenings I would come in and just crash - I thought it was just age and diabetes getting the better of me.

so at the mo I'm on no meds for blood pressure...

current resting BP is 112/71 pulse 63

I manage my BP with exercise/meditation/and staying calm

guess I didn't need the meds which might be why I got the side effects

PS ACE inhibitors raise serum potassium, but they also lower sodium levels

(explains why some days I used to come in and lick salt, and had an insatiable craving for salty foods like crisps)

#17
princesslinda

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Hi RED:
Sounds like you're doing great with your blood pressure! Guess exercise is the key to so many things working better in our bodies. I have a tough time dealing with stress (I internalize), so i'll probably be on the ace-inhibitors forever...or until I lose that 100 lbs...so somedays I feel it will be forever. Glad things have worked out so well for you!

#18
Dewey

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Injecto,

I've been on an ACE Inhibitor since around August of 1996, which was started as preventative maintenance. The endo said chances of experiencing kidney troubles down the line was 50/50, so might as well try to use preventative measures.

I was very apprehensive of starting the med (cause I Don't have high BP and was leery of taking something I didn't feel was necessary). However, my endo worked with me & said that if I even had the slightest side effects (i.e. cough, etc.), he'd take me off them immediately. Luckily, I've never experienced side effects. I have had a dry cough lately, but it wasn't due to my meds, rather was due to thyroid issues...I'm on a very low dose (2mg) of Mavik (real name is "Trandolapril"). In fact, at one point, I thought the kidney functions were up a little (it was my bad, lol), so I upped my own dose to 4mg - I know, Bad Dewey....Was honest & told my endo what I'd done (& why). He informed me that my kidney functions were fine & there was no need to up the meds, so I dropped back down to 2mg. :D No side effects, no nothing...it was as simple as that. My kidneys have been in decent shape the whole time.

I completely understand you being apprehensive, Injecto. If you have any concerns, talking to us & looking up documentation may help. If that raises any other concerns, perhaps talking to the doctor might help. It seems that many people are on Altace & other meds, but Mavik (Trandolapril) may be a decent alternative if it has fewer side effects (not sure if it does, but it's just an idea). :stupido2:

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#19
SunniD

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After having type 1 diabetes for 43 yrs. my doctor final decided to put me on an ARB as they are gentler than ACE's which I cannot tolerate at all.
ARB's have the same benefit but for me they made my blood pressures higher
so guess what - the doctors added another ARB to lower. They say that some people with diabetes are on 3 blood pressure pills and it looks like I'm headed that way too. I take one in morning and one at 6 pm. The morning one has a diuretic in it and they aren't sure of long term affects of being on a diuretic. Isn't it quite ironic that what is given to you to save your kidneys makes ones blood pressures increase which causes complications for heart and kidneys. I am having a marked allergic rxn to a lot of things now but what can you do about it?

I'm being compliant so I can keep a doctor. They think they know best.
I felt the same way Dewey felt when I started them as my blood pressures were still quite acceptable so why bother.

SunniD

#20
Gangrel

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I've been on Altace for about a year or so now. Started at 2.5mg, up to 5mg. I was put on becuase I had high BP, though I'm not sure why. I was, and am, fairly active, though I would say my diet as a bachelor wasn't always the best. ;)

Injecto, my endo sent me for the 10 day test too, it's pretty routine. I know my endo checks my kidneys via a test every year anyway, even before the Altace.

Everything has a possible side-effect. If you worry about each and everyone, we'd never do anything...... at least, that's my thinking.
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