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Had Heart Attack. Prescribed Brilinta, Dilatren, Inspra And Nexium. Suggest

Posted on Mon, 19 Aug 2013

Question: About three weeks ago I was treated in Macau after i had a heart attack. The doctors may have prescribed a couple of medicines that I do not need. They prescribed Brilinta (ticagrelor as the blood thinner) and Dilatren (carvedilol as the beta blocker). They prescribed several other pills for me to take for more than 200 days. They are Tritace (ramipril to reduce hypertension), aspirin coated Cartia, Crestor (rosuvastatin to lower cholesterol), Inspra (eplerenone to reduce hypertension and prevent heart attacks) and Nexium (esomeprazole to reduce acid in the stomach). Do I need to take all of these that i listed above for nearly a year? Another one of your online doctors confirmed that Nexium or another acid blocker is a good idea to prevent possible ulcers. But he is not a cardiologist. Are there any of the listed prescribed medicines that the Macau doctors prescribed that are not necessary? I am now in mainland China where I work and cannot reach the doctors that treated me. Thanks ,

XXXXX

Answered by Dr. Anantharamakrishnan (11 hours later)

Hi friend,
Welcome to Health Care Magic

     Beta-blockers have a definite role in preventing/reducing future events – several studies have proved beyond doubt / at least for one after the episode, often longer.
     Blood thinners are a must for life time – usually dual anti-platelet therapy is given / a combination of aspirin and ticagrelor or equivalents...
     Angiotensin Converting Enzyme Inhibitors (ACEI) like ramipril have actions beyond blood pressure – typically help re-modelling of the damaged heart.
Aldosterone antagonists too have a role - in preventing muscle damage
Proton pump inhibitor (esomeperazole) is generally skipped – but with a history of ulcer, it is necessary and proper indeed
Cholesterol reducing drugs (Rosuvastatin) are given routinely even with normal levels – they have actions beyond cholesterol – antioxidant and plaque stabilisation...

Relax / You are in good hands...
The medicines are proper and state of the art...
You need follow up / need to check your electrolytes (especially potassium) and liver function...

Take care
Wishing speedy recovery
God bless
Good luck

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar