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What Causes Foul-smelling Urine While On Losartan?
Question: Hello. 2 yrs ago I was diagnosed with cardio microvascular disease with Prinzmetal's. I talke 60 mg diltiazem 3x/day (just switched from XR bc I can't handle feeling so sick everyday with nausea, malaise,etc). I also take 25mg Losarten. I have nitro patches I have to wear everyday and Ativan when chest pain gets too severe to relax everything. But, I spend the entire day & night going from hot/cold, flushing, feeling very overheated. It's truly awful. But what's worrying me is a very strong odor in my urine. I've had bloodwork & urine samples taken & everything looks ok. Could this be the Losarten? And, it feels like my kidneys hurt (or the vicinity where they're located is quite sore). Is this the drugs? This is the most awful disease. I went from being very healthy & fit to being disabled & hardly able to manage anything besides sitting in a recliner most the time. The pain, the discomfort, nausea has been going on for 2 yrs now and it's debilitating. Any ideas? My pcp doesn't seem to have any ideas & im feeling more & more desperate for answers.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello Debra!
I carefully passed through your medical history and would like to explain that it seems unlikely that bad urine odor to be caused by your current medications.
As long as Diltiazem and Losartan do not cause severe bradycardia and hypotension (low blood pressure), there is no reason why they would be responsible for chronic fatigue and weakness.
From the other hand, nausea, abdominal pain there exists also a possibility they could be an expression of medications adverse effects. The rational strategy to confirm/exclude it would be to temporarily withdraw the suspicious drugs one by one and see any symptomatic changes.
Regarding bad urine odor, I would mention several potential causes (besides urinary tract infection, which should have been excluded by the performed blood and urine tests) as follows:
- MSUD (maple syrup urine disease) which is a rare and inherited disease, caused by some missing or defective enzymes responsible for certain amino acids break down. When these happens amino acids leucine, isoleucine and valine are increased in urine leading to characteristic maple syrup odor.
As the above amino acids explains the odor, certain foods rich in protein should
be carefully consumed (meat, eggs, milk).
- Phenylketonuria (a mild form in your case) could be associated with bad urine odor. It is caused by defective hydroxylase responsible for accumulation of amino acid phenylalanine. It is a rare genetic disease.
- Dehydration and urine concentration could lead to bad urine odor. As there are several reasons for that, it is recommended to perform a comprehensive clinical investigation.
In addition, I would recommend evaluation of thyroid function status, blood cortisol level, blood electrolytes concentration and blood circulating catecholamines levels.
You have to discuss with your attending doctor on the above mentioned issues.
Hope to have been helpful to you!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello Debra!
I carefully passed through your medical history and would like to explain that it seems unlikely that bad urine odor to be caused by your current medications.
As long as Diltiazem and Losartan do not cause severe bradycardia and hypotension (low blood pressure), there is no reason why they would be responsible for chronic fatigue and weakness.
From the other hand, nausea, abdominal pain there exists also a possibility they could be an expression of medications adverse effects. The rational strategy to confirm/exclude it would be to temporarily withdraw the suspicious drugs one by one and see any symptomatic changes.
Regarding bad urine odor, I would mention several potential causes (besides urinary tract infection, which should have been excluded by the performed blood and urine tests) as follows:
- MSUD (maple syrup urine disease) which is a rare and inherited disease, caused by some missing or defective enzymes responsible for certain amino acids break down. When these happens amino acids leucine, isoleucine and valine are increased in urine leading to characteristic maple syrup odor.
As the above amino acids explains the odor, certain foods rich in protein should
be carefully consumed (meat, eggs, milk).
- Phenylketonuria (a mild form in your case) could be associated with bad urine odor. It is caused by defective hydroxylase responsible for accumulation of amino acid phenylalanine. It is a rare genetic disease.
- Dehydration and urine concentration could lead to bad urine odor. As there are several reasons for that, it is recommended to perform a comprehensive clinical investigation.
In addition, I would recommend evaluation of thyroid function status, blood cortisol level, blood electrolytes concentration and blood circulating catecholamines levels.
You have to discuss with your attending doctor on the above mentioned issues.
Hope to have been helpful to you!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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