Re: quick update - warning - Long!

April 7, 2005

Hi Cy,

In response to what kind of ACE inhibitor Elisabet was on, she took

Enalapril starting at 5mg and increasing over about a year until she

was at 30mg. At that point, she felt miserable, she was so tired.

Then she started with 80mg Diovan (the ARB) and has had much fewer

side effects. She's up to 240mg (I wrote 120 earlier, but I checked

and it's 240mg). Even though she's tired, she's still doing better

than she was on the Vasotec.

I'm glad to hear that is tolerating the ACE so well. I

recognize the lisinopril but not the norvasc or famotidine. Are they

different kinds of ACE inhibitors? I don't blame you for not wanting

to add another drug to the mix. Sounds like he's really been through

alot.

We see her neph in about 3 weeks, so we'll find out how the pred. is

working then. By the way, how old is ? Hope you don't mind all

my questions.

Thanks again for your reply,

B, Elisabet's mom (13)

> Hi ,

....

's neph has periodically threatened to put him on ARB's. I

> know we'll be there, but like I said, I'm in no hurry to throw a new

drug

> into the mix... and I hate to think of his exhausting the drug

possibilities

> at a young age.

>

> What kind of ACE inhibitor was Elisabeth on? What dose? I've

always been a

> little worried about the high dose that is on, but he seems to

> tolerate it well. I'm sorry to hear she wiped our on it. What is your

> experience with ARBs like?

>

> Sorry for running so long. Hope some of this was helpful. Please

let us

> know how Elizabet is getting on.

>

> Cy

April 7, 2005

Hi ,

Thanks for getting back to me re Elisabet's experiences with ACE inhibitors.

It's good to hear that she is tolerating the ARB better.

is 14 - just a wee bit older. Like Elisabet, fatigue has been a problem,

but that's been more due to the anemia from the virus 2 years ago than the meds.

Fortunately, that seems to be history. Currently, he's fatigued - but that is

more the product of a very, very full schedule.

Norvasc is a calcium channel blocker. This class of drugs works very

differently from ACE inhibitors and ARBs. Instead of affecting the angiotensin

system, they regulate intracellular calcium levels. This is important because

intracellular calcium levels affect contraction of cardiac and smooth muscle

(which in turn affects blood pressure). This was the first BP med was

ever on --- and it seems to be the least effective. Famotidine is just Pepcid.

Best wishes for good labs next time. Waiting for pred to kick in can be anxiety

producing.

Cy.

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