Blood Pressure Meds and GPA/Wegs

[Pete]

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. 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!

[mishb]

Wow Pete,

I have been on BP meds for about 8 years and it has kept the BP under control.

I commenced on plaquenil tablets in 2012 for RA and OA and these are supposed to be little miracle tablets for the heart.
So much so that I don't need to take BP tablets anymore.
I still take BP tablets because the doctors say they are protecting my kidneys from WG.

In regards to tablet interactions - I posted on here last year about my LFT being well outside normal range. My liver was in distress.
Had I been doing/taking anything different since my last test the month before.......the answer was YES, I started taking multi vitamins to try and help me get through the day. I stopped taking these for the next month, another blood test and low and behold, LFT back to normal. Doctors said they had only seen this once before.
So, no multi vitamins for me.

Best of luck with the weight

[greenjeep]

I searched the forum for blood pressure and found this old post. During my last relapse, I went into renal failure. I have since improved in regards to kidney function, but now my blood pressure is high (140's / 90's). I am scheduled tomorrow to see my nephrologist about it. I've never had issues with high blood pressure before, it is just creepy. Don't know why, this disease has screwed up my body in so many ways I've lost track.

[Jaha]

Pete,
Thanks for the info on BP meds. It sounds like you are doing wonderful! I so glad you have gotten to the point of being off preds. Good luck with the weight loss. Greenjeep sorry you are having BP problems, hope you get good news, maybe it is elevated because of pain.

[greenjeep]

Well, I am now on BP meds. My blood pressure was 160/101 at the neph's office. Later that night it was up to 174/106. The meds seem to be working though - today it is back in the 140/90 range. The Drs do not know why my BP is going up. Anyone have issues with high blood pressure after WG diagnosis and been told a good reason? I am only on 10mg pred, bactrum, pepsid, and have done 5 Cytoxan infusions to date. I blame everything on pred, so I didn't know if prolonged use of steroids drove up the pressure.

Thanks again for all of your time and attention to these posts. It always makes me feel better to check in and see how everyone is doing.

[Dirty Don]

My BP has been up while on pred, but has sunk some as I've been weaning from it...who really knows?

[pwc51]

After I was diagnosed with WG / GPA and on high pred I was told I had high blood pressure. Unfortunately I had hardly been to the doctor for 10 years prior to that so had no idea what it was before all this started!

As the pred came down my blood pressure has come down to pretty good levels too but they did not want to reduce / stop the BP meds. Unfortunately a small flare has pushed the pred back up for while pending the first of my next 2 RTX infusions next week so I guess there is still no excuse for being able to reduce them for a while yet!

[RudiK]

Greenjeep, my BP was high also until the doc put me on 10mg Amlodipine plus 20mg/12.5mg Benicar/HCT. It is now down to 110/65 up to 120/75.
Rudi K

[Psyborg]

Congrats on getting off the meds Pete! I'm glad things are going so well for you I hope the side pain gets reduced.

[Pete]

Thanks, Bob. I've been very fortunate with this disease. I have great docs to look after me, and I tolerate most meds pretty well. That allows me to keep active, and ward off (I hope) other problems.


Hope you get to full remission soon. Be well !!