Doctors' Answers to "Frequently Asked Questions" - Prinivil

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Possible Prinivil Reaction in Lupus Patient [posted 1/14/99]
Question: I am a 46-year old lupus patient currently on prednisone, zocor and prinivil. For the past 5 months I have been plagued with an itchy red rash that does not respond very well to antihistamines, topical creams and the like. I went to a dermatologist who felt that the rash was either lupus or a drug reaction to possibly prinivil. He did a skin biopsy and I am awaiting the results. Are you aware of any such reaction to this drug. It is unbearably itchy and uncomfortable and has managed to cover most of my entire body.

Answer: Haven't seen one, but it's listed in the PDR as a possible problem.

Prinivil and Breast Feeding [posted 1/6/99]
Question: I would like to know if it is okay to take Prinivil while nursing a baby? My doctor says it's fine to take it while nursing, but I am not sure. Can you let me know if there is any possible side effects for my baby if I take this drug. I have not begun taking the drug yet because I have concerns.

Answer:Would potentially affect the blood pressure. Probably not a big risk, but not zero.

Prinivil
Question: I am a 31 year old male with an uneventful medical history (only in hospital overnight for my birth, no broken bones, etc.). While undertaking a medical so I could scuba dive, my doctor noted a slightly raised blood pressure, which he checked a few times over eight weeks or so. Based on this and a kidney test, he placed me on 10 mg of Prinivil daily. I also have had (and passed) a kidney IVP, hear ultrasound and stress ECG. He has suggested I have mild familial hypertension. I trust my doctor but like to stay informed. Considering my age and my doctor's desire for me to stay on Prinivil indefinitely, is there anything I should be aware of? I am not the medical equivalent of a Luddite, but don't like the idea of taking drugs over the long term.

Answer: First, did your blood pressure ever get checked at home? Two thirds of patients have elevated blood pressure at the physician's office. Check it at home off the medication to see if it really is elevated. Secondly, did you try weight loss? Five to ten pounds will usually suffice for young men. Thirdly, try stopping alcohol. About 2 of 5 Caucasian men will have a prolonged elevation of blood pressure after only one or two drinks. This commonly lasts for 1-3 days following ingestion. Fourthly, a low salt, high fiber diet can occasionally lower blood pressure sufficiently to avoid medications. I usually give patients six months to try the above prior to starting low term medications.

Prinivil and Aspirin
Question: Just started taking Prinivil for high BP. 10mg. Occasionally I get headaches that only Extra Strength Excedrin can cure. Can I take the Excedrin with Prinivil? Also, taking .10mg Synthroid daily and occasionally Seldane-D. Tylenol does nothing for my headaches.

Answer: There should be no problem taking prinivil and any aspirin product. Be aware that aspirin can be toxic in doses above 8-10 regular Aspirins/day. Signs of aspirin toxicity are usually ringing in the ears,and occasionally vertigo. Seldane-D has an ingredient that can increase your blood pressure-I'd discuss this with your physician.

Prinivil Side Effects
Question: What are the benefits, and negative affects of the drug PRINIVIL? Of what value is 5mg/day?

Answer: Prinivil belongs to a class of drugs called Angiotensin Converting Enzyme Inhibitors(ACE). This class of drugs inhibits the enzyme in the lung(and some tissues) that converts the hormone Renin to Angiotensin. Renin is made in the kidney-goes to the lung where it is converted by an enzyme and emerges as Angiotensin(a potent vasoconstrictor). We use this class of drugs in several applications. First is hypertension, second treatment of diabetics to avoid or minimize long term kidney damage from diabetes, third treatment of congestive heart failure(regardless of the blood pressure). There are other uses; but, these are the main ones. Side effects are usually minimal-one of their main advantages. Cough is common and can be prevented by using one of the newer selective ACE inhibitors like Cozier. Rash is occasionally seen. After that there are occasional problems which require blood tests; but, are less common.


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