Pete
04-13-2013, 02:00 AM
Over the past several months, my creatinine level had been creeping up until it finally broke the 1.30 mg/dl upper norm at 1.32. I had a consult with a nephrologist who was on the team that diagnosed me. We reviewed my meds and he noted that I had been taking a small dose (5mg/day) of enalapril (Vasotec), an ACE inhibitor. He thought that might be having an adverse effect on my kidneys and their ability to handle creatinine. He took me off enalapril, and when I had my labs a week ago, the creatinine level was back within normal limits at 1.28 mg/dl. He also said that he noticed no kidney involvement from GPA so far (urinalyses for the past year have been normal).
I had a consult with my PCP last week, and he took me off the remaining BP med that I was taking, 12.5 mg/day of Metoprolol - a beta blocker. I had been on these BP meds plus HCTZ for about 10 years because my cardiologist saw a small anomaly in an EKG and that my BP was slightly above target (130/80) on a consistent basis. Four stress tests and two years later, the cardio decided the EKG anomaly was nothing to worry about, my heart looked good on the imaging, and my BP was now fine. The dose of metoprolol was so small that he couldn't decide if it was having any effect one way or the other.
When I was dxed with GPA, my BP went way low -- try 80/60. PCP decided to take me off HCTZ and reduce metoprolol by half to boost my BP, which happened. Got back to normal within a week and have continued to maintain BP averaging 125/75 for the past year. I have stayed at this level since discontinuing all the BP drugs. I also try to maintain some degree of cardiovascular fitness by walking 2 - 3 miles 4 - 5 times each week.
I'm still taking Flomax 0.4 mg/day to manage urinary symptoms (without it, I have the urge to pee about every 20 minutes). I'm staying on Flomax because I value the main effect more than any side effects that might be related to BP.
I've also been off prednisone for two weeks. I've noticed that my energy level is slightly lower and that if I'm on my feet too much, the soles of my feet ache (new phenomenon). If the feet ache too much, I take 650 mg of tylenol in the evening, and the ache goes away and I sleep well.
All in all, I feel well.:smile1: My C-reactive protein is way above normal at 12 mg/L and my sed rate has fluctuated between the mid-20s and mid-30s. My wegs doc and my PCP are not overly concerned with these because I feel well and everything else looks pretty close to normal.
I guess the point of all this is that drug interactions can be very subtle and that a full discussion with your treatment team is a must to figure out what might be causing some abnormal phenomenon.
I'm pleased that I've been able to get off a number of meds. Now, if I can get rid of the pred pounds!:predrage:
I had a consult with my PCP last week, and he took me off the remaining BP med that I was taking, 12.5 mg/day of Metoprolol - a beta blocker. I had been on these BP meds plus HCTZ for about 10 years because my cardiologist saw a small anomaly in an EKG and that my BP was slightly above target (130/80) on a consistent basis. Four stress tests and two years later, the cardio decided the EKG anomaly was nothing to worry about, my heart looked good on the imaging, and my BP was now fine. The dose of metoprolol was so small that he couldn't decide if it was having any effect one way or the other.
When I was dxed with GPA, my BP went way low -- try 80/60. PCP decided to take me off HCTZ and reduce metoprolol by half to boost my BP, which happened. Got back to normal within a week and have continued to maintain BP averaging 125/75 for the past year. I have stayed at this level since discontinuing all the BP drugs. I also try to maintain some degree of cardiovascular fitness by walking 2 - 3 miles 4 - 5 times each week.
I'm still taking Flomax 0.4 mg/day to manage urinary symptoms (without it, I have the urge to pee about every 20 minutes). I'm staying on Flomax because I value the main effect more than any side effects that might be related to BP.
I've also been off prednisone for two weeks. I've noticed that my energy level is slightly lower and that if I'm on my feet too much, the soles of my feet ache (new phenomenon). If the feet ache too much, I take 650 mg of tylenol in the evening, and the ache goes away and I sleep well.
All in all, I feel well.:smile1: My C-reactive protein is way above normal at 12 mg/L and my sed rate has fluctuated between the mid-20s and mid-30s. My wegs doc and my PCP are not overly concerned with these because I feel well and everything else looks pretty close to normal.
I guess the point of all this is that drug interactions can be very subtle and that a full discussion with your treatment team is a must to figure out what might be causing some abnormal phenomenon.
I'm pleased that I've been able to get off a number of meds. Now, if I can get rid of the pred pounds!:predrage: