Re: so much for clearing out my pill box

[Guest guest]

Pseudoephedrine is specifically the ingredient that people with high blood

pressure should avoid, without or without renal failure. It can

*potentially* raise the BP pretty dramatically, and more so in people with

renal failure who can't clear it. This ingredient is pretty much a synthetic

form of adrenaline. In addition to raising BP, it can make you pretty

jittery.

Antihistamines that don't have a decongestant in them (pseudoephedrine

usually) are Ok as far as blood pressure goes, but, many of them can still

accumulate to serum levels in renal patients, and so, they might have to be

taken at a smaller dose - for example, half or a quarter of the normal pill

might be enough. The full dose might make you a lot more drowsy than it

would the average person without renal failure.

So, Allegra is Ok, but Allegra-D is not. Anyone should check with their

doctor or pharmacist though!

BTW, on the links page www.igan.ca , there's a link to a drug dosing site

that gives the dosing information for most common drugs in renal patients.

It's a very useful site.

Pierre

Re: so much for clearing out my pill box

> Just checked the Allerga D website and it states on there:

> " Renally Impaired: In patients with mild (creatinine clearance 41-80

> mL/min) to severe (creatinine clearance 11-40 mL/min) renal impairment,

peak

> plasma levels of fexofenadine were 87% and 111% greater, respectively, and

> mean elimination half-lives were 59% and 72% longer, respectively, than

> observed in normal volunteers. Peak plasma levels in patients on dialysis

> (creatinine clearance <10 mL/min) were 82% greater and half-life was 31%

> longer than observed in normal volunteers.

>

> About 55-75% of an administered dose of pseudoephedrine hydrochloride is

> excreted unchanged in the urine; the remainder is apparently metabolized

in

> the liver. Therefore, pseudoephedrine may accumulate in patients with

renal

> insufficiency.

>

> Based on increases in bioavailability and half-life of fexofenadine

> hydrochloride and pseudoephedrine hydrochloride, a dose of one tablet once

> daily is recommended as the starting dose in patients with decreased renal

> function "

>

> Since I fall into the group they are talking about with a creatinine

> clearance of 48 I guess I should give my doctor a call tomorrow and see if

> he wants to reduce my dose down to 1 tablet a day rather than the 2 he has

> me on. I only took one today and it knocked me down quick....hate to see

> what would happen if the stuff built up in my system. Thanks again for

the

> warning Betsy!

>

> Amy

[Guest guest]

Pseudoephedrine is specifically the ingredient that people with high blood

pressure should avoid, without or without renal failure. It can

*potentially* raise the BP pretty dramatically, and more so in people with

renal failure who can't clear it. This ingredient is pretty much a synthetic

form of adrenaline. In addition to raising BP, it can make you pretty

jittery.

Antihistamines that don't have a decongestant in them (pseudoephedrine

usually) are Ok as far as blood pressure goes, but, many of them can still

accumulate to serum levels in renal patients, and so, they might have to be

taken at a smaller dose - for example, half or a quarter of the normal pill

might be enough. The full dose might make you a lot more drowsy than it

would the average person without renal failure.

So, Allegra is Ok, but Allegra-D is not. Anyone should check with their

doctor or pharmacist though!

BTW, on the links page www.igan.ca , there's a link to a drug dosing site

that gives the dosing information for most common drugs in renal patients.

It's a very useful site.

Pierre

Re: so much for clearing out my pill box

> Just checked the Allerga D website and it states on there:

> " Renally Impaired: In patients with mild (creatinine clearance 41-80

> mL/min) to severe (creatinine clearance 11-40 mL/min) renal impairment,

peak

> plasma levels of fexofenadine were 87% and 111% greater, respectively, and

> mean elimination half-lives were 59% and 72% longer, respectively, than

> observed in normal volunteers. Peak plasma levels in patients on dialysis

> (creatinine clearance <10 mL/min) were 82% greater and half-life was 31%

> longer than observed in normal volunteers.

>

> About 55-75% of an administered dose of pseudoephedrine hydrochloride is

> excreted unchanged in the urine; the remainder is apparently metabolized

in

> the liver. Therefore, pseudoephedrine may accumulate in patients with

renal

> insufficiency.

>

> Based on increases in bioavailability and half-life of fexofenadine

> hydrochloride and pseudoephedrine hydrochloride, a dose of one tablet once

> daily is recommended as the starting dose in patients with decreased renal

> function "

>

> Since I fall into the group they are talking about with a creatinine

> clearance of 48 I guess I should give my doctor a call tomorrow and see if

> he wants to reduce my dose down to 1 tablet a day rather than the 2 he has

> me on. I only took one today and it knocked me down quick....hate to see

> what would happen if the stuff built up in my system. Thanks again for

the

> warning Betsy!

>

> Amy

[Guest guest]

Pseudoephedrine is specifically the ingredient that people with high blood

pressure should avoid, without or without renal failure. It can

*potentially* raise the BP pretty dramatically, and more so in people with

renal failure who can't clear it. This ingredient is pretty much a synthetic

form of adrenaline. In addition to raising BP, it can make you pretty

jittery.

Antihistamines that don't have a decongestant in them (pseudoephedrine

usually) are Ok as far as blood pressure goes, but, many of them can still

accumulate to serum levels in renal patients, and so, they might have to be

taken at a smaller dose - for example, half or a quarter of the normal pill

might be enough. The full dose might make you a lot more drowsy than it

would the average person without renal failure.

So, Allegra is Ok, but Allegra-D is not. Anyone should check with their

doctor or pharmacist though!

BTW, on the links page www.igan.ca , there's a link to a drug dosing site

that gives the dosing information for most common drugs in renal patients.

It's a very useful site.

Pierre

Re: so much for clearing out my pill box

> Just checked the Allerga D website and it states on there:

> " Renally Impaired: In patients with mild (creatinine clearance 41-80

> mL/min) to severe (creatinine clearance 11-40 mL/min) renal impairment,

peak

> plasma levels of fexofenadine were 87% and 111% greater, respectively, and

> mean elimination half-lives were 59% and 72% longer, respectively, than

> observed in normal volunteers. Peak plasma levels in patients on dialysis

> (creatinine clearance <10 mL/min) were 82% greater and half-life was 31%

> longer than observed in normal volunteers.

>

> About 55-75% of an administered dose of pseudoephedrine hydrochloride is

> excreted unchanged in the urine; the remainder is apparently metabolized

in

> the liver. Therefore, pseudoephedrine may accumulate in patients with

renal

> insufficiency.

>

> Based on increases in bioavailability and half-life of fexofenadine

> hydrochloride and pseudoephedrine hydrochloride, a dose of one tablet once

> daily is recommended as the starting dose in patients with decreased renal

> function "

>

> Since I fall into the group they are talking about with a creatinine

> clearance of 48 I guess I should give my doctor a call tomorrow and see if

> he wants to reduce my dose down to 1 tablet a day rather than the 2 he has

> me on. I only took one today and it knocked me down quick....hate to see

> what would happen if the stuff built up in my system. Thanks again for

the

> warning Betsy!

>

> Amy

[Guest guest]

Thanks for the rundown Pierre. I called my GP today and said " hey I checked

online and the website says the renal dose is one tablet daily..just want to

make sure we have me on the right dosage. " He called back later saying he

hadn't checked my creatinine clearance when he gave me the Rx and that " I

shouldn't have any problems at two tablets daily but just to be safe lets

take it down to one. " Nice job of covering his butt ay?

I also checked again with my neph and he felt that the one tablet daily

for 7 days should be o.k. but wants me to closely monitor my b/p. If it

goes up rapidly we'll stop the Allegra D. He kind of felt it was one of

those situations where the infection is going to do more damage than the

drug so we'll take the drug and see how I do. At least I'm never alone in

the house and my daughter knows the 911 call rundown if she would ever need

it.

Still dizzy in Colorado...Amy

Re: so much for clearing out my pill box

>

>

> > Just checked the Allerga D website and it states on there:

> > " Renally Impaired: In patients with mild (creatinine clearance 41-80

> > mL/min) to severe (creatinine clearance 11-40 mL/min) renal impairment,

> peak

> > plasma levels of fexofenadine were 87% and 111% greater, respectively,

and

> > mean elimination half-lives were 59% and 72% longer, respectively, than

> > observed in normal volunteers. Peak plasma levels in patients on

dialysis

> > (creatinine clearance <10 mL/min) were 82% greater and half-life was 31%

> > longer than observed in normal volunteers.

> >

> > About 55-75% of an administered dose of pseudoephedrine hydrochloride is

> > excreted unchanged in the urine; the remainder is apparently metabolized

> in

> > the liver. Therefore, pseudoephedrine may accumulate in patients with

> renal

> > insufficiency.

> >

> > Based on increases in bioavailability and half-life of fexofenadine

> > hydrochloride and pseudoephedrine hydrochloride, a dose of one tablet

once

> > daily is recommended as the starting dose in patients with decreased

renal

> > function "

> >

> > Since I fall into the group they are talking about with a creatinine

> > clearance of 48 I guess I should give my doctor a call tomorrow and see

if

> > he wants to reduce my dose down to 1 tablet a day rather than the 2 he

has

> > me on. I only took one today and it knocked me down quick....hate to

see

> > what would happen if the stuff built up in my system. Thanks again for

> the

> > warning Betsy!

> >

> > Amy

>

>

>

>

> To edit your settings for the group, go to our Yahoo Group

> home page:

> http://groups.yahoo.com/group/iga-nephropathy/

>

> To unsubcribe via email,

> iga-nephropathy-unsubscribe

> Visit our companion website at www.igan.ca. The site is entirely supported

by donations. If you would like to help, go to:

> http://www.igan.ca/id62.htm

>

> Thank you

>

[Guest guest]

Thanks for the rundown Pierre. I called my GP today and said " hey I checked

online and the website says the renal dose is one tablet daily..just want to

make sure we have me on the right dosage. " He called back later saying he

hadn't checked my creatinine clearance when he gave me the Rx and that " I

shouldn't have any problems at two tablets daily but just to be safe lets

take it down to one. " Nice job of covering his butt ay?

I also checked again with my neph and he felt that the one tablet daily

for 7 days should be o.k. but wants me to closely monitor my b/p. If it

goes up rapidly we'll stop the Allegra D. He kind of felt it was one of

those situations where the infection is going to do more damage than the

drug so we'll take the drug and see how I do. At least I'm never alone in

the house and my daughter knows the 911 call rundown if she would ever need

it.

Still dizzy in Colorado...Amy

Re: so much for clearing out my pill box

>

>

> > Just checked the Allerga D website and it states on there:

> > " Renally Impaired: In patients with mild (creatinine clearance 41-80

> > mL/min) to severe (creatinine clearance 11-40 mL/min) renal impairment,

> peak

> > plasma levels of fexofenadine were 87% and 111% greater, respectively,

and

> > mean elimination half-lives were 59% and 72% longer, respectively, than

> > observed in normal volunteers. Peak plasma levels in patients on

dialysis

> > (creatinine clearance <10 mL/min) were 82% greater and half-life was 31%

> > longer than observed in normal volunteers.

> >

> > About 55-75% of an administered dose of pseudoephedrine hydrochloride is

> > excreted unchanged in the urine; the remainder is apparently metabolized

> in

> > the liver. Therefore, pseudoephedrine may accumulate in patients with

> renal

> > insufficiency.

> >

> > Based on increases in bioavailability and half-life of fexofenadine

> > hydrochloride and pseudoephedrine hydrochloride, a dose of one tablet

once

> > daily is recommended as the starting dose in patients with decreased

renal

> > function "

> >

> > Since I fall into the group they are talking about with a creatinine

> > clearance of 48 I guess I should give my doctor a call tomorrow and see

if

> > he wants to reduce my dose down to 1 tablet a day rather than the 2 he

has

> > me on. I only took one today and it knocked me down quick....hate to

see

> > what would happen if the stuff built up in my system. Thanks again for

> the

> > warning Betsy!

> >

> > Amy

>

>

>

>

> To edit your settings for the group, go to our Yahoo Group

> home page:

> http://groups.yahoo.com/group/iga-nephropathy/

>

> To unsubcribe via email,

> iga-nephropathy-unsubscribe

> Visit our companion website at www.igan.ca. The site is entirely supported

by donations. If you would like to help, go to:

> http://www.igan.ca/id62.htm

>

> Thank you

>

[Guest guest]

Wow, I'm sorry to hear that the nausea/dizziness still hasn't gone

away! I hope that things will work out, trying to tweak the meds is

always frustrating.

Sophia

> At least for the next ten days that is.... My b/p was still

running way low

> (97/78) for the better part of the day even after stopping the

Cardizem LA,

> so today my neph dropped my lisinopril dose down from 20mg twice a

day to

> 10mg twice a day. I get to give it another two weeks and see

where we go

> from here. He said we might have to tweak it a bit further if

things don't

> balance out. I also asked him about the pain I've been having in

my

> jaw...since he didn't see any connection with my recent med

changes he had

> me call my GP.

> So I get in to my GP this afternoon and they check me out.

The running

> theory is that the sinus infection I had back at the end of April

didn't

> clear up completely and settled into my inner ear/jawline area. I

had some

> blood work done to make sure it wasn't anything more nasty (like

Temporal

> Arteritis) than an infection and they started me on 4...yes count

them

> 4...more Rx's for the next 10 days to see if we can clear this

stuff up.

> Antibiotics, nasal spray, pain killer/anti-inflammatory, and

antihistamine.

> So I get to reduce one med and add four how fun. Although right

now I'm

> willing to do anything to get rid of the dizziness, nausea, and

major

> fatigue that I've been dealing with for the past 3 weeks. If this

round of

> meds doesn't clear up the pain my GP will send me to a DO for some

> manipulation treatments on my jaw. Let's hope it doesn't come to

that.

>

> I'm off to take a nap and hope that the room has stopped spinning

by the

> time I wake up. </whine>

>

> Amy

[Guest guest]

Wow, I'm sorry to hear that the nausea/dizziness still hasn't gone

away! I hope that things will work out, trying to tweak the meds is

always frustrating.

Sophia

> At least for the next ten days that is.... My b/p was still

running way low

> (97/78) for the better part of the day even after stopping the

Cardizem LA,

> so today my neph dropped my lisinopril dose down from 20mg twice a

day to

> 10mg twice a day. I get to give it another two weeks and see

where we go

> from here. He said we might have to tweak it a bit further if

things don't

> balance out. I also asked him about the pain I've been having in

my

> jaw...since he didn't see any connection with my recent med

changes he had

> me call my GP.

> So I get in to my GP this afternoon and they check me out.

The running

> theory is that the sinus infection I had back at the end of April

didn't

> clear up completely and settled into my inner ear/jawline area. I

had some

> blood work done to make sure it wasn't anything more nasty (like

Temporal

> Arteritis) than an infection and they started me on 4...yes count

them

> 4...more Rx's for the next 10 days to see if we can clear this

stuff up.

> Antibiotics, nasal spray, pain killer/anti-inflammatory, and

antihistamine.

> So I get to reduce one med and add four how fun. Although right

now I'm

> willing to do anything to get rid of the dizziness, nausea, and

major

> fatigue that I've been dealing with for the past 3 weeks. If this

round of

> meds doesn't clear up the pain my GP will send me to a DO for some

> manipulation treatments on my jaw. Let's hope it doesn't come to

that.

>

> I'm off to take a nap and hope that the room has stopped spinning

by the

> time I wake up. </whine>

>

> Amy

[Guest guest]

Amy - you have the most wonderful and responsble kids. What a

blessing! : )

Sophia

> >

> > > Thanks Cy...my daughter has been worried about me to the point

of not

> > > wanting to go to sleep until daddy is home at night. She now

is

> > > allowed to

> > > read in her bed until he gets home just to help cut her

anxiety.

> > >

> > > I did put a call into my neph today and gave him the rundown

of

> > > the

> > > drugs and dosages that were prescribed by my GP just to

confirm they

> > > were

> > > the correct renal dose. He was a bit concerned about me being

on the

> > > pain

> > > killers for the full 10 days but also wants my infection and

> > > inflammation to

> > > clear up so with a sigh he said continue with them. My

regular GP

> > > took a

> > > look at my medication reaction history and put me on an

antibiotic

> > > that I've

> > > been on in the past without problems. The only " unknown " in

the

> > > group was

> > > Allegra D...took my first dose of that today so we'll see how

I do.

> > >

> > > Fuzzy brained Amy

> > > Re: so much for clearing out my pill box

> > >

> > >

> > > > Oh Amy! This is not where it should be at. I know I haven't

been

> > > posting

> > > > in respose to your low bood pressure issues but I've been

very

> > > worried.

> > > > The floor coming up to your face and the incident in the

checkout

> > > line

> > > > sounded alarming. Hopefully dropping the lisinopril will do

the

> > > trick.

> > > >

> > > > I trust you trained your GP on the drill for an IgAN

patient taking

> > > all

> > > the

> > > > additional meds. I still remember the big scare we had when

Connie

> > > had

> > > that

> > > > scary, scary reaction to bactrim.

> > > >

> > > > Cy

> > > >

> > >

> > >

> > >

> > >

> > >

> > > To edit your settings for the group, go to our Yahoo Group

> > > home page:

> > > http://groups.yahoo.com/group/iga-nephropathy/

> > >

> > > To unsubcribe via email,

> > > iga-nephropathy-unsubscribe

> > > Visit our companion website at www.igan.ca. The site is

entirely

> > > supported by donations. If you would like to help, go to:

> > > http://www.igan.ca/id62.htm

> > >

> > > Thank you

> > >

> > >

> > >

> > >

> > >

[Guest guest]

Amy - you have the most wonderful and responsble kids. What a

blessing! : )

Sophia

> >

> > > Thanks Cy...my daughter has been worried about me to the point

of not

> > > wanting to go to sleep until daddy is home at night. She now

is

> > > allowed to

> > > read in her bed until he gets home just to help cut her

anxiety.

> > >

> > > I did put a call into my neph today and gave him the rundown

of

> > > the

> > > drugs and dosages that were prescribed by my GP just to

confirm they

> > > were

> > > the correct renal dose. He was a bit concerned about me being

on the

> > > pain

> > > killers for the full 10 days but also wants my infection and

> > > inflammation to

> > > clear up so with a sigh he said continue with them. My

regular GP

> > > took a

> > > look at my medication reaction history and put me on an

antibiotic

> > > that I've

> > > been on in the past without problems. The only " unknown " in

the

> > > group was

> > > Allegra D...took my first dose of that today so we'll see how

I do.

> > >

> > > Fuzzy brained Amy

> > > Re: so much for clearing out my pill box

> > >

> > >

> > > > Oh Amy! This is not where it should be at. I know I haven't

been

> > > posting

> > > > in respose to your low bood pressure issues but I've been

very

> > > worried.

> > > > The floor coming up to your face and the incident in the

checkout

> > > line

> > > > sounded alarming. Hopefully dropping the lisinopril will do

the

> > > trick.

> > > >

> > > > I trust you trained your GP on the drill for an IgAN

patient taking

> > > all

> > > the

> > > > additional meds. I still remember the big scare we had when

Connie

> > > had

> > > that

> > > > scary, scary reaction to bactrim.

> > > >

> > > > Cy

> > > >

> > >

> > >

> > >

> > >

> > >

> > > To edit your settings for the group, go to our Yahoo Group

> > > home page:

> > > http://groups.yahoo.com/group/iga-nephropathy/

> > >

> > > To unsubcribe via email,

> > > iga-nephropathy-unsubscribe

> > > Visit our companion website at www.igan.ca. The site is

entirely

> > > supported by donations. If you would like to help, go to:

> > > http://www.igan.ca/id62.htm

> > >

> > > Thank you

> > >

> > >

> > >

> > >

> > >

[Guest guest]

Hi Amy,

Good for you for calling your doctor on the dosage. Your expeience underscores

the importance to us of being our own health advocates.

I am sorry you are still so dizzy. I was hoping today would be a better day for

you.

[Guest guest]

Hi Amy,

Good for you for calling your doctor on the dosage. Your expeience underscores

the importance to us of being our own health advocates.

I am sorry you are still so dizzy. I was hoping today would be a better day for

you.

[Guest guest]

Hi Amy,

Good for you for calling your doctor on the dosage. Your expeience underscores

the importance to us of being our own health advocates.

I am sorry you are still so dizzy. I was hoping today would be a better day for

you.