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Dr. Andrew Rynne

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Exp 18 years

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Feeling tired, drowsy, headache and swelling of hands and feet. What is the problem and treatment?

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Allergist and Immunologist
Practicing since : 1999
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upper lip is turning black, also tired and drowsiness. this has been happening for the last couple of days until it is affecting my driving. swelling of the hands and feet, sometimes headaches.
Mon, 17 Dec 2012 in General Health
Answered by Dr. Sujoy Khan 2 hours later
Welcome to Healthcare Magic and thank you for writing to us.

A recap: You are aged 42, male and on Exforge HCT (Amlodipine + Valsartan) for high blood pressure and for the last few days, having swelling attacks on lips, hands and feet with headaches.
The swelling attacks may be related to (1) blood pressure tablet, as amlodipine can cause feet swelling and rarely Valsartan can cause generalised swelling. This is more for people who are prone to swelling attacks and have previously been labelled as 'allergic reactions' when no allergy was found. If you have been prescribed with a blood pressure pill in the past such as enalapril, captopril, trandolapril etc and had a swelling attacks (and hence stopped), these attacks are similar and would be due to Valsartan, although a very different kind of tablet.
(2) idiopathic angioedema, i.e., you are prone to get swelling attacks; and the treatment is stat dose of Cetirizine 10mg x 2 tablets
(3) headaches, due to uncontrolled blood pressure or an eye problem (like refractive error) so you may want to get your eyes checked.
(4) You will need a complete hemogram, LFT, TSH, C3 C4 to ascertain the cause of these attacks. If C4 low, you would need additional tests to know why this is the case. If normal, then antihistamines is the treatment of choice.
But ensure your BP medications are reviewed.
(5) Allergic angioedema - do you have any allergies? say to dust, pets, pollens etc.
If yes, you will need allergy tests to determine if they have worsened. Antihistamines remain the treatment of choice.

Many thanks.
Best Wishes.
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