Managing Heart Medication Side Effects: Alternatives for Swelling and Discomfort

Hello, Dr. He. I would like to ask about a medication issue?

Hello, Doctor He.
My mother was previously prescribed Dronedarone 90 mg, but it became unavailable due to discontinuation.
The doctor recommended switching to Carvedilol 90 mg, but after using it, my mother experienced severe swelling in her legs, and there were even some rough cracks on the surface of her skin.
During this time, the doctor suggested changing her medication to Perindopril, but after taking it, she felt even worse, experiencing persistent vomiting, an inability to eat, extreme fatigue, and abdominal swelling.
Therefore, my mother switched back to Carvedilol.
I would like to know if there are any other medications that can treat the swelling side effect of Carvedilol or if there are alternative medications available.
Thank you, Doctor He!

Liu Ziwei, 30~39 year old female. Ask Date: 2016/03/30

Dr. He Dongjin reply Cardiology

Hello, the two medications should be the same, just from different manufacturers.
Theoretically, the side effects shouldn't differ that much.
Therefore, please ask your physician to issue an external prescription so you can pick up the medication at a pharmacy covered by health insurance.
Request the pharmacist to provide the same prescription with a different manufacturer's medication for you to try.
Changhua Hospital cares about you.

Reply Date: 2016/03/30

More Info

Managing heart medication side effects can be a complex issue, especially for patients with pre-existing conditions. In your mother's case, it seems she has experienced significant side effects from both the medications she has been prescribed: Kadycyn (likely a reference to a diuretic or heart medication) and Pedril (which may refer to a medication that can cause gastrointestinal issues).
Firstly, it’s important to understand that medications for heart conditions, particularly those that affect blood pressure and fluid retention, can have side effects such as swelling (edema), gastrointestinal discomfort, and fatigue. Kadycyn, if it is indeed a diuretic, can lead to fluid shifts in the body, which might explain the swelling in your mother's legs. This is a common side effect, especially if the body is not adjusting well to the medication.
When switching medications, it’s crucial to monitor how the patient responds to each new drug. In your mother's case, the transition from Kadycyn to Pedril seems to have exacerbated her symptoms, leading to nausea and abdominal swelling. These reactions can be distressing and may indicate that the medication is not suitable for her.

If Kadycyn is causing significant swelling, it may be beneficial to consider alternative medications that can help manage her heart condition without the same side effects. Some alternatives could include:
1. ACE Inhibitors or ARBs: These medications can help manage blood pressure and reduce the workload on the heart without causing significant fluid retention. They are often well-tolerated and can be effective in patients with heart conditions.

2. Beta-Blockers: If her heart condition involves arrhythmias or heart rate issues, beta-blockers can be a good option. They can help manage heart rate and reduce symptoms of anxiety related to heart conditions.

3. Calcium Channel Blockers: These can help with blood pressure and may have a different side effect profile that could be more tolerable for her.

4. Adjusting Diuretic Therapy: If diuretics are necessary, sometimes a lower dose or a different diuretic might be more effective without causing as much swelling.
5. Lifestyle Modifications: Alongside medication, lifestyle changes such as dietary adjustments (reducing salt intake), regular physical activity (as tolerated), and weight management can also help manage symptoms and improve overall heart health.

It’s essential for your mother to have a thorough discussion with her healthcare provider about her symptoms and the side effects she is experiencing. They may consider running additional tests to ensure that there are no underlying issues contributing to her symptoms.
In the meantime, if she is experiencing severe side effects such as persistent vomiting or extreme fatigue, it may be necessary to seek immediate medical attention. This could indicate that her body is reacting poorly to the medication, and adjustments may need to be made quickly.

In conclusion, managing heart medication side effects requires a collaborative approach between the patient and healthcare provider. It’s crucial to communicate openly about any adverse effects and to explore alternative medications or therapies that can help manage the heart condition while minimizing discomfort. Regular follow-ups and monitoring are key to ensuring that the treatment plan remains effective and safe for your mother.

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