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Risks of combing Altace with Avapro?

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Internal Medicine Specialist
Practicing since : 1998
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What are the risks of combining Altace with Avapro? I am 60 years old a type one diabetic since the age of 14. I recently saw an interim Dr. to have prescriptions refilled, he said he was going to leave a note for my regular GP about the combination of the above two drugs. I asked why and he said they used to combine them but have since found that there are side effects to that and it is not generally done anymore. Can you explain the risks?
Posted Sun, 16 Jun 2013 in General Health
Answered by Dr. Jasvinder Singh 3 hours later
Thanks for posting your query.
I can understand your concern. Your doctor is right because there are moderate interactions between Avapro (irbesartan) and Altace (ramipril).

Combining these medications may increase the risk of side effects such as low blood pressure, kidney function impairment and sometimes may cause hyperkalemia (high blood potassium). In severe cases, hyperkalemia can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest.

Moreover the risk of hyperkalemia increases when you are elderly or diabetic. Both these risk factrs are there in your case.

When taking Avapro and Altace, take care f the following:

1)     Don't take any anti inflammatory pain killer without informing yur doctor as long-term use of nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen (Aleve) may also increase your risk of high blood potassium.

2)     Moreover maintain adequate fluid intake during treatment with either ramipril or irbesartan because dehydration may lead to hyperkalemia.

3)     Limit consumption of potassium-rich foods. Some of them are tomatoes, raisins, figs, potatoes, lima beans, bananas, plantains, papayas, pears, cantaloupes, mangoes, and potassium-containing salt substitutes.

4)     Keep an eye on certain symptoms like nausea, vomiting, weakness, confusion, tingling of the hands and feet, a weak pulse, or a slow or irregular heartbeat which are the symptoms of hyperkalemia. If you notice such symptoms, consult your doctor immediately.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

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