Managing Medications for Hypertension and Diabetes: Key Questions Answered - Pharmacology

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Hello! I am a patient with hypertension and diabetes.
Below are the medications prescribed by my doctor: Tapal 100mg/tab (Aspirin) (to be taken in the morning), Plendil 5mg/tab (Felodipine) (to be taken in the morning), Tritace 10mg/tab (Ramipril) (to be taken in the morning), CTL XR 500mg/tab (Metformin) (to be taken in the morning), Kascoal 40mg/tab (Simethicone) (to be taken with meals), Harnalidge D 0.2mg/tab (to be taken at bedtime).

I have the following questions:
1.
Can Aspirin and Tritace be taken together? (My eGFR: 70)
2.
Metformin keeps my postprandial blood sugar around 140.
How should I adjust this medication if I have cold symptoms?
3.
How much can Tritace 10mg lower blood pressure per hour? I take the medication at 8:00 AM, and my blood pressure is around 130/80 with a heart rate of about 75.
By around 2:00 PM, it dropped to 98/53 with a heart rate of 80.
Is this dosage too high?
4.
Can Metformin be taken with Aspirin, Plendil, and Tritace?
5.
How long should I wait between taking antihypertensive medication and cold medication? Thank you very much.

Lao Wu, 70~79 year old female. Ask Date: 2009/07/22

Dr. Hou Fangmin reply Pharmacology


Hello: I apologize for the delayed response.

1.
It is fine to take Aspirin together with Tritace, as both are antihypertensive medications.

2.
Taking metformin while experiencing cold symptoms should not affect your medication schedule.

3.
How much can Tritace 10mg lower blood pressure per hour? Tritace is used to treat hypertension and post-myocardial infarction.
The initial dose is 2.5mg of Tritace once daily, with adjustments based on the patient's condition to a maintenance dose of 5mg to 10mg.
For patients with renal impairment or those taking diuretics, the initial dose should start at 1.25mg of Tritace once daily.
Regular monitoring of serum potassium levels is necessary, especially for patients with renal dysfunction.

4.
Metformin can be taken with Aspirin, Plendil, and Tritace without any issues.

5.
How long should antihypertensive medications be spaced from cold medications? Since I am not aware of the specific cold medication you are taking, it is advisable to wait at least 2 hours before taking them together if you are concerned.

That concludes my response.
Wishing you peace, good health, and well-being.

Reply Date: 2009/07/22

More Info


Managing medications for hypertension and diabetes can be complex, especially when multiple medications are involved. Based on the medications you are taking and the questions you have, let’s address each of your concerns in detail.

1. Can Aspirin and Tritace be taken together?
Yes, Aspirin (Tapal) and Tritace (ramipril) can generally be taken together. Aspirin is often used for its antiplatelet effects, which can be beneficial for patients with cardiovascular conditions, while Tritace is an ACE inhibitor used to manage high blood pressure and protect kidney function. Your eGFR of 70 indicates that your kidney function is within a normal range, so there should not be any significant interaction between these two medications. However, it is always advisable to monitor kidney function regularly, especially when on multiple medications.

2. How to adjust Metformin if experiencing cold symptoms?
If you are experiencing cold symptoms, it is important to continue taking Metformin as prescribed. Metformin does not need to be adjusted solely based on cold symptoms unless you are unable to eat or drink adequately, which could lead to dehydration or gastrointestinal issues. If you develop a fever or significant illness that affects your ability to manage your diabetes, consult your healthcare provider for specific advice on adjusting your diabetes medications.

3. How much does Tritace lower blood pressure per hour?
The exact amount by which Tritace lowers blood pressure can vary significantly from person to person. Typically, the effects of Tritace can be seen within hours after taking the medication, but the peak effect usually occurs within 4 to 6 hours. If your blood pressure dropped to 98/53 after taking Tritace, this could indicate that the dose may be too high for you, especially if you are experiencing symptoms of low blood pressure (like dizziness or fainting). It is crucial to discuss this with your doctor, who may consider adjusting your dosage or switching to a different medication.

4. Can Metformin be taken with Aspirin, Plendil, and Tritace?
Yes, Metformin can be safely taken with Aspirin, Plendil (felodipine), and Tritace. There are no known significant interactions between these medications. However, it is essential to monitor your blood sugar levels regularly, as changes in your health status or medications can affect your glucose control.

5. How long should you wait between taking hypertension medication and cold medication?
The timing between taking hypertension medications and cold medications can depend on the specific cold medication you are using. Generally, it is advisable to wait at least 2 hours between taking these medications to minimize any potential interactions. However, some cold medications can raise blood pressure, so it is crucial to choose cold medications that are safe for individuals with hypertension. Always consult your healthcare provider or pharmacist if you are unsure about the safety of a specific cold medication.

In summary, managing your medications for hypertension and diabetes requires careful monitoring and communication with your healthcare provider. Always report any unusual symptoms or side effects, and do not hesitate to seek medical advice if you have concerns about your medications or health status. Regular follow-ups and blood tests are essential to ensure that your treatment plan remains effective and safe.

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