
On Avapro Have Cough And Urine Leakage. Was On BP Medicine. Have Headache With Neck And Eye Pain. Suggest?

1. After going through your history, it suggests you have severe hypertension (diastolic more than 105) and the side effect of drug as cough.
2. For severe hypertension with bad head ache, you need to be treated as inpatient to prevent any complications. Since you have no other problem you can start Tab Lasix which is a diuretic or Tab Amlodipine as a emergency measure to reduce BP now, but need to visit your doctor ASAP for further management.
3. Dry cough may be due to Avapro adverse effect. It is usually uncommon since avapro is ARB group drug unlike ACE inhibitor drugs. Since you have this intolerable side effect with uncontrolled BP and you are on higher dosage consult your doctor to change the drug.
4. Since even with the previous drug with 5 and 10 mg and with Avapro you are not relieved of hypertension, you need combination of 2 different group of drugs for management. Kindly get back with the previous drug. The drugs can be choosen based on your complete examination.
Hope I answered your question. Consult your doctor for further examination and management. Feel free to ask me if you have any further queries.
Wish you good health. Take care.
Regards


Cardiac evaluation, Stop Avopro, Regular followup
Detailed Answer:
Hi XXXXXXX
Apologies for the late reply.
I am happy at least some of your problems are reduced after the visit to your doctor. However since your blood pressure is not well controlled even with after trying 9 different BP medications, you need complete evaluation including ECG, Echocardiograph, Renal function test, liver function test and thyroid profile. I would encourage you to get the test done under the guidance of a cardiologist. With water pill and amlodepine I hope your BP should be controlled. If not we can add other drug with these and also can modify othe dose.
Avopro induced dry cough reduces with time once avopro is stopped. I would suggest you to wait a few days more. I think you should feel much better in 2-3 weeks.
I think there could be many reasons for disturbed sleep. Cough at night can be very disturbing. I am hopping that would get better in the next few weeks. I suggest my patients to sleep with head end of the cot elevated. It helps to an extent. Anxiety associated with blood pressure problems, too many medicines and may be undetected thyroid conditions may also keep you awake. I expect your doctors to detect those undetermined causes during your next visit.
As far as sleeping pills are concerned, I do not favour the use of sleeping pills in my patients because they do not help in the long run. But some pills can be tried briefly. I prescribe zolpidem, a benzodiazepine class of drugs to my patients. You can discuss about this drug with your doctor.
We can't tell which drug to chose only with the history, this need examination. Sleeping pill is also selected based on your examination. Now you can continue Zanax as prescribed by your doctor and there areother sleep medication like zolpedem etc which can be given but only your doctor need to prescribe this. So I advice to to consult any single board certified physician to manage you.
In brief don't take 9 BP medications all at a time. Follow only one doctor advice and have regular follow up with him to titer the dosage and drugs.
Hope this answered your query.
Wish you good health.
Regards

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