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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have HCV, High Viral Load. Taken Peg Interferon Treatment, Metoprolol, Cilazapril, Clopidogrel. Suggest?

I have HCV , probably for 35 years, with a reasonably high viral load but with good liver function. Relapsed from Peg Interferon treatment five years ago after initially clearing the Virus. Had MI six weeks ago, treated with drug eluding stent. Prompt treatment and now normal ejection fraction with normal range echo sound results. However, post mi treatment with low dose metoprolol, cilazapril, clopidogrel and SRA has resulted in episodes of rate related low blood pressure after falling asleep, waking with extreme dizziness and discomfort. ECG shows no abnormal wave problems and low Troponin. Metoprolol has been discontinued which has improved the situation. However, heart rate and blood pressure still a bit low at rest and while asleep, plus headaches and feeling of extreme weakness. My question is whether HCV contraindicates cilazapril in this situation of slight hypotension and in the absence of diminished EF and T wave irregularities.
Mon, 4 Mar 2013
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General & Family Physician 's  Response
Hello,
CILAZAPRIL is an ACE inhibitor and is used to control hypertension.
CONCOMITANT HCV infection is not a contraindication for CILAZAPRIL use.However if you have cirrhosis,then it should be used with caution as it may induce hypotension.
If it is very important to use CILAZAPRIL in patients suffering from liver cirrhosis,then the dose given is half to specially avoid hypotension.
If you feel that you are uncofortable using CILAZAPRIL,you may ask your doctor for revision of prescription.
Thanks
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Have HCV, High Viral Load. Taken Peg Interferon Treatment, Metoprolol, Cilazapril, Clopidogrel. Suggest?

Hello, CILAZAPRIL is an ACE inhibitor and is used to control hypertension. CONCOMITANT HCV infection is not a contraindication for CILAZAPRIL use.However if you have cirrhosis,then it should be used with caution as it may induce hypotension. If it is very important to use CILAZAPRIL in patients suffering from liver cirrhosis,then the dose given is half to specially avoid hypotension. If you feel that you are uncofortable using CILAZAPRIL,you may ask your doctor for revision of prescription. Thanks