Tuesday, May 26, 2015

drug conflicts: Spironolactone and Losartan

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Drug interactions between Aldactazide and Cozaar

Results for the following 2 drugs:
Aldactazide (hydrochlorothiazide/spironolactone)
Cozaar (losartan)

Interactions between your selected drugs


spironolactone ↔ losartan

Applies to:Aldactazide (hydrochlorothiazide/spironolactone) and Cozaar (losartan)
Using spironolactone together with losartan may increase potassium levels in the blood. High levels of potassium can develop into a condition known as hyperkalemia, which in severe cases can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. You may be more likely to develop hyperkalemia while using these medications if you are elderly, dehydrated, or have kidney disease, diabetes, or advanced heart failure. Regular or long-term use of nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen (Aleve) may also increase your risk. It is important that you maintain adequate fluid intake during treatment with these medications, especially if you are using them for prolonged periods. In addition, talk to your doctor to see if you should limit consumption of potassium-rich foods such as tomatoes, raisins, figs, potatoes, lima beans, bananas, plantains, papayas, pears, cantaloupes, mangoes, and potassium-containing salt substitutes. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should seek medical attention if you experience nausea, vomiting, weakness, confusion, tingling of the hands and feet, feelings of heaviness in the legs, a weak pulse, or a slow or irregular heartbeat, as these may be symptoms of hyperkalemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
end quote from:
http://www.drugs.com/drug-interactions/aldactazide-with-cozaar-1268-1371-1489-901.html

However, also just in regard to Losartan there are 474 drugs that have reactions to Losartan just so you are aware of it.

What happened to me is I went into the emergency room in a Portland Hospital and the emergency room doctor thought my cough might be caused by my taking lisinopril so he moved me to Losartan. However, I found out today through a conscientious pharmacist that losartan combined with Spironolactone can cause hyperkalemia in older patients. I wasn't very happy about this. And when I looked at potential symptoms I have no nausea or vomiting but weakness, confusion, tingling in the hands and feet, feelings at times of heaviness in the legs all are symptoms that I considered were a part of recovering from my operation caused by a burst appendix on March 27th. However, now I'm less certain that this is the reason.

Also, it makes even more suspicious my reaction to eating pasta last night and being confused as a result. This has never happened to me before either in my life. So, I'm very concerned about taking these two drugs together at this point. One possible solution since I'm not experiencing any swelling from edema is to back off the spironolactone because if I don't get enough heart medicine it can be a problem whether it is losartan or lisinopril or something else similar.

Another solution since my cough is now gone would be to return to lisinopril so I can keep taking spironolactone because it tends to prevents strokes and heart attacks in edema patients by reducing the stress on the heart from trying to deal with too many fluids in the extremities. In other words when you take spironolactone most of the time you have no edema symptoms at all.

My doctor thinks the chance of this conflict being fatal or injurious is small. However, I have taken lisinopril off and on since 1998 when I almost died of a heart virus and never had any problems with it. So, because of what I just read I think I will choose to go back to lisinopril and just wait and see if my cough returns. If it does then I'll have to try something else.

What I also learned is though I knew too many bananas would be bad for me while taking Spironolactone because of the potassium, I didn't know that papayas and Mangoes which I really love were rich in potassium too. This partly explains why I was having so much trouble while in Hawaii really having a lot of papayas and mangoes and POG and other tropical fruit juices there. It was really bad not only potassium wise because I was taking spironolactone but also bad because my body was so near to almost getting diabetes too. I still don't have diabetes but I have to be careful so I'm on a no carb no fruit juice diet which is also a quick weight loss diet. However, if you are a women over 40 don't expect to lose a lot of weight the first 3 weeks or so because over 40 women's bodies don't release weight very easily. I think it's partly about maintaining body warmth but likely there are many other factors as well.

As I have lost weight often I have felt cold as my body has had to adapt to less insulation from the cold. So, I'm at least 30 pounds lighter than I was in early March so I look and feel very different than I have in a long time. I sort of look more like I did when I returned from India in 1986 except older and grayer. So, often I need to wear jackets when others are just in shirt sleaves to compensate here on the northern California coast.

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