Side effects of some common drugs
One of the reasons for the dramatic decline in deaths from heart disease is the wide array of cardiac medications that have been developed in the past several decades.
But as noted, drugs rarely come without side effects. And I am surprised how often cardiologists fail to tell patients about those side effects.
Here’s a rundown of the most common problems that can occur with six widely used medications.
1. ACE INHIBITORS
Angiotensin converting enzyme inhibitors (ACE inhibitors) are commonly prescribed to lower blood pressure and improve hearts weakened by congestive heart failure. They can also be used to treat diabetes and kidney failure.
Types of ACE inhibitors include benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), and lisinopril (Prinivil, Zestril).
It’s not uncommon for patients taking ACE inhibitors to develop a dry, persistent cough that
lasts for days or even weeks. Sneezing and nasal congestion can also develop. Sometimes, these symptoms are so severe that patients need to quit taking the drug.
If you are troubled by the cough caused by an ACE inhibitor, ask your doctor if you can take an angiotensin II receptor blocker (ARB inhibitor) instead.
ARBs do much the same thing as ACE inhibitors, and were developed as an alternative for people who could not tolerate the ACE side e ects.
ARBs cause a cough in only about 15 percent of those who take them — a far smaller number than those troubled by the ACE inhibitor coughs.
2. BETA BLOCKERS
Like ACE inhibitors, beta blockers are widely used to lower high blood pressure and treat congestive heart failure. They work by blocking the e ects of the hormone adrenaline, thereby slowing heart rate.
Examples of this class of drugs include propranolol (Inderal), carvedilol (Coreg), and metoprolol (Lopressor, Toprol XL).
One of the problems with beta blockers is that they can lower blood pressure and heart rate too much, especially in people who are elderly. For that increase blood pressure. The average rise is 3/2 mmHg, but it varies considerably.
In addition, NSAID use can reduce the e ect of high blood pressure medications, with the exception of calcium channel blockers.
Although aspirin is also an NSAID, it doesn’t carry these risks, so I generally recommend that my patients take aspirin for pain relief. But nondrug remedies are always safest, if available.
Aspirin is a safer choice than NSAIDs for people who are dealing with chronic pain. And, of course, millions of people take low-dose aspirin to prevent heart attacks and strokes.
But aspirin can cause problems for people who are on prescription blood thinners following stent insertion, those who have arti cial heart valves,
and those who use them to reduce the risk of the irregular heartbeat known as atrial brillation, which ups stroke risk.
One of the risks that aspirin carries is gastric bleeding. If taken with blood thinners, the risk increases.
So if you are taking both blood thinners and aspirin and notice any bruising, quit taking the aspirin. The same goes for sh oil tablets and vitamin E, which also thin the blood.
5. PROTON PUMP INHIBITORS
Long-term use of a popular type of medication taken to combat acid re ux — known commonly as heartburn — may slightly increase heart attack risk.
Proton pump inhibitors are a group of acid- suppressing drugs that include Prevacid, Prilosec, and Nexium. In a relatively short time, they’ve become the third most commonly used drug in the U.S.
These drugs, which suppress stomach acids, have been linked to de ciencies in magnesium, calcium, and vitamin B12. They have also been linked to bone density loss and fractures.
It’s also been suggested that they could interfere with the clot-buster clopidogrel (Plavix).
Researchers reviewed 300,000 patients with acid- re ux and found that those who used these drugs had a slightly higher heart attack risk.
There is no evidence yet for cause-and-e ect, but researchers noted that another class of heartburn drug, known as H2 blockers, did not appear to have this link.
The rst thing most people do when they get a cold or su er an allergy attack is head o to buy an over-the-counter medication.
Decongestants relieve nasal stu ness by narrowing blood vessels and reducing swelling in the nose. But the blood vessels in the nose aren’t the only ones a ected; so are other ones. Such narrowing makes your heart work harder, raising blood pressure.
That can lead to heartbeat irregularities,
including the dangerous arrhythmia known as atrial brillation, which hikes stroke risk by 50 percent.
The main culprits are pseudoephedrine, ephedrine, phenylephrine, naphazoline, and oxymetazoline.
Compounding the problem is that many of these preparations contain not only one of these decongestants but an NSAID as well. As noted, NSAIDs raise blood pressure in their own right.
These preparations are adrenalin analogs, which increases the heart rate and blood pressure.
So, if you’re sick with a cold, here are some alternatives:
• Choose a cold medication designed for people with high blood pressure, like Coricidin HBP. But read the label and follow the directions carefully because they contain other drugs.
• If you need a pain reliever, take one that is not an NSAID, like aspirin.
• Use saline nasal spray for congestion.
Drugs are not necessarily bad. Many medications are indeed lifesavers and OTC drugs can relieve symptoms and help people live better. The problem comes when people do not respect these medications and take them properly.
Don’t jeopardize your hard-won heart health. Learn the do’s and don’ts of drugs and take them according to the directions. That way, you’ll greatly cut down on any problems, while using them in your battle to maintain your heart health! more