# High BP, Ramipril, kidney pain



## Phil42 (Apr 4, 2006)

I've recently posted about hypertension. I have high blood pressure and was started on 2.5 mg Ramipril. There was some improvement but it wasn't consistent.

A blood test after 10 days showed no kidney problem (which occurs in a small number of cases). When the month's supply was finished, the dose was raised to 5 mg.

I don't really know what it's doing for my blood pressure as I decided to stop self-monitoring for a while. It's great when you get a low reading but I found that if I got a high one I got quite stressed and then, despite trying to relax, it was hard to lower it by much.

I believe I am, though, experiencing a number of side-effects. Won't bore you with them now though I'd be really interested to hear of other people's experiences.

Last Saturday night was very disturbing. I had pain/discomfort in the area of my left kidney, accompanied by tingly pins and needles on the skin directly over the pain.

Went to the doc on Monday a.m. I asked if this could be a side-effect. He poo-pooed the idea, as he tends to. He though a kidney infection was the most likely explanation and I had to give a urine sample. The results were back next day: no infection but a trace of blood in the urine.

I thought this was pretty scary, but he immediately said that this plus kidney pain was a classic symptom of kidney stones. I went for an xray that p.m. - results expected in about a week, though he did say that an x-ray doesn't always spot them and it might need ultra sound or a CT scan.

Meanwhile the discomfort has subsided but I'm still aware of it particularly at night.

So, I'd be very grateful for any experiences re ramipril - it seems to me a strange coincidence that, never having had any kidney problem, as far as I know, this should happen when I'm on this drug.

And any relevant experiences with kidney stones would be helpful.

To finish on a positive note, I started my recent statins thread because the doc and the pharmacist I spoke to said that anyone of my age with high BP should probably be on them. But I've now been tested and the very much younger doc says that he is very envious.  

Thanks if you've read this far (I'm not really a hypochondriac, honest!)

Phil


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## Spacerunner (Mar 18, 2006)

I've been taking ramipril for many years now on a daily 10mg dose.
Never had any side effects at all.


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## rayc (Jun 3, 2008)

"no infection but a trace of urine in the blood"

Is that the correct way round?


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## Phil42 (Apr 4, 2006)

Thanks Ray. I've just corrected it.

You see hoe it's a;; getting to me.  

Phil


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## rayc (Jun 3, 2008)

Phil, You are still at a relatively low dose of Ramipril so it is unrealistic to expect your blood pressure to come back into accepted levels in such a short time. I suggest you just monitor for now without getting uptight about it. Wait and see what it is like 3 months after a 10mg doseage.

I was at the docs getting my flu jab last week and they were handing out a leaflet regarding blood pressure. It said that to see them if a test showed 150/90 or above. It would appear that realism is coming back and trying to get everyone down to 120/80 is now seen as unrealistic or unattainable.

It never ceases to amaze me that when taking a drug, where there is an expected side effect of 1 in 10 people getting it, that doctors discount them when a patient reports one of them.


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## rugbyken (Jan 16, 2006)

Had the same side effect from rampiril felt like I'd been punched in both kidneys couldn't straighten up etc this came within two days of starting on it , stopped taking them pain went away , took them again back in two days , told doc changed them to amo something or other no probs.


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## Phil42 (Apr 4, 2006)

rayc said:


> Phil, You are still at a relatively low dose of Ramipril so it is unrealistic to expect your blood pressure to come back into accepted levels in such a short time. I suggest you just monitor for now without getting uptight about it. Wait and see what it is like 3 months after a 10mg doseage.
> 
> I was at the docs getting my flu jab last week and they were handing out a leaflet regarding blood pressure. It said that to see them if a test showed 150/90 or above. It would appear that realism is coming back and trying to get everyone down to 120/80 is now seen as unrealistic or unattainable.
> 
> It never ceases to amaze me that when taking a drug, where there is an expected side effect of 1 in 10 people getting it, that doctors discount them when a patient reports one of them.


Thanks Ray, good advice if I can do it.

Interesting point re the borderline. Some US sites read as if 120/80 is barely acceptable. I agree there may be a move back towards more realism

A positive for me is that the large majority of reading I've taken have shown the diastolic at 90 or below. It's the systolic that has been up and down.

As for side-effects, I couldn't agree more. Seems to me the 1 in 10 stuff is unlikely to be accurate as doctors probably decide not pass on many patient reports because they discount them.

Phil


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## sideways (Jun 2, 2008)

my mate took ramipril until one day a guy said to him " that constant dry cough you have is caused by ramipril", he was a stranger and didnt know my mate from Adam, he had been coughing and had a tickle in his throat for years, he stopped taking it and hasnt coughed since.


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## Phil42 (Apr 4, 2006)

sideways said:


> my mate took ramipril until one day a guy said to him " that constant dry cough you have is caused by ramipril", he was a stranger and didnt know my mate from Adam, he had been coughing and had a tickle in his throat for years, he stopped taking it and hasnt coughed since.


Yes, this is the one side-effect that seems to be generally accepted, even by the medics. Mine's a bit of a tickle and I seldom have to cough. I also get a very dry mouth at night.

Phil


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## gavinskii (Dec 31, 2012)

I've been on Ramapril for about 5 months. Started on 2.5mg for first month and then increased to 5mg. 

I am happy to report zero side effects. My BP has dropped right into the correct zone within 6 weeks of starting.

I was warned about the tickly cough thing, but it never materialised for me.

My belief is you know your own body best, so if the Doc is not supportive of your side effects, go and see a different one.

Good luck

G


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## rayc (Jun 3, 2008)

Phil42 said:


> sideways said:
> 
> 
> > my mate took ramipril until one day a guy said to him " that constant dry cough you have is caused by ramipril", he was a stranger and didnt know my mate from Adam, he had been coughing and had a tickle in his throat for years, he stopped taking it and hasnt coughed since.
> ...


The dry cough side effect is common with ACE inhibitors i.e.those ending in 'ipril'.


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## trevd01 (Oct 26, 2007)

Your GP will probably always try Ramipril first, because it is probably the cheapest of the modern hypertension drugs.

Have a look at third page of this report:

http://www.nhsbsa.nhs.uk/Documents/July_-_Sept_09_ACE_Inhibitors_and_AIIRAs.pdf

There are lots of similar alternatives, but they are all dearer than Ramipril. There are cheaper drugs such as diuretics - 'water tablets', which can be used for treating hypertension, but the latest guidance is for Ramipril or one of the similar dearer alternatives.

If you want to understand the pros and cons of each type of treatment, have a look on NHS Choices:

http://www.nhs.uk/Conditions/Blood-pressure-(high)/pages/TreatmentOptions.aspx]NHS Choices BP treatment - options

(Link feature in forum not working for that URL, so copy and paste it up to the end of the word options into your browser, or try the tiny url link below)

http://preview.tinyurl.com/nv98fdy


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## cliffhanger (Jun 27, 2008)

trevd01 said:


> Your GP will probably always try Ramipril first, because it is probably the cheapest of the modern hypertension drugs.
> 
> Have a look at third page of this report:
> 
> ...


Yes that's right Ramipril is old hat, it's cheap. I was on it for four years with the occasional cough until eventually I'd had enough and got switched to 50mg Losartan. No probs now. You have to make a fuss and embroider sometimes.

MAC 8)


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## rayc (Jun 3, 2008)

trevd01 said:


> Have a look at third page of this report:
> 
> http://www.nhsbsa.nhs.uk/Documents/July_-_Sept_09_ACE_Inhibitors_and_AIIRAs.pdf


The sheer number and cost of the tablets being taken for high blood pressure is amazing. No wonder the Government are considering raising the prescription charge to £10 although of course a lot of those taking the tablets will be exempt from charges due to age. Paying for a prescription for Ramipril appears false economy for the payer as it appears the cost is approx £3 for 2 months supply. I wonder how much the tablets are costing throughout the western world, no wonder drug companies are pushing the benefits so much.


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## Phil42 (Apr 4, 2006)

Yes, these links that Trevor posted are very helpful - and interesting.

Phil


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## trevd01 (Oct 26, 2007)

Re the price of Ramipril etc. 

You are not going to buy at the same price the NHS does! Even if it were not prescription only...


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## stu7771 (Jul 22, 2011)

*kidney pain*

Hi Phil

Has your GP been watching the adverts on TV by the NHS regarding blood in urine. This may be the only symptom of kidney or bladder cancer.

You have 2 other symptoms that could be this as well. HBP and kidney pain. I had all three and my cancer did not show up on an x-ray taken by A&E. I had an ultra sound 4 weeks later and had a 10cm x 8cm tumour.

These symptoms can be lots of things and nothing could well be the Ramipril.

You should be sent to a one stop urology clinic with the symptoms you are presenting with to rule things out. I only had one bout of haematuria and my back pain went after a couple of months.

My bloods were always normal.

I do not wish to scare anyone just going by my own experience.

Sue


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## Phil42 (Apr 4, 2006)

Thanks Sue. I know you're not scaremongering.

I have considered these possibilities and I'm trying not to think about them at present. I do trust my GP and I don't think he would need to see TV ads to be aware.

But I've read that two thirds of kidney stones are found after blood in urine. Often people go to their GP because they see blood in their urine. Mine certainly wasn't visible. Also, I'm not feeling pain in that area at present though the skin above is still slightly tingly.

So keeping my fingers crossed.

Phil


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## Phil42 (Apr 4, 2006)

I wish I hadn't picked up Sue's post before going to bed though.

I just found this NHS site which I found somewhat reassuring:

NHS page

I also remember the GP saying, of the urine sample 'no infection, no growth' which at the time I thought sounded good.

These thoughts will have to do me for the present.

Phil


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## Phil42 (Apr 4, 2006)

Thought I should finish the story, if only for the benefit of members who might have similar problems in the future and find this thread.

Nearly two months after this saga began, I got the all-clear. First a cystoscopy revealed that there were no problems with the bladder and a prostate palpation found that the prostate was enlarged but 'felt O.K. from the outside'.

The next step was a CT scan, which came a mere four days later. I was told that the consultant would get the results 'within two weeks'. Christmas and New Year came and went and after three weeks I finally phoned the department. A specialist urology nurse was able to tell me that an appointment had been made for 8th May! She said it was probably safe to assume that there was no serious or urgent problem. She phoned me back next day to say that I should have received a letter telling me that everything - CT scan, PSA test and kidney function test - was completely normal. A great relief, obviously.

During the two months my GP first of all prescribed Tamsulosin which immediately helped and then, following the cystoscopy when the symptoms flared again, suggested I might have an infection. I left a urine sample which was somehow 'lost' and so, as it was nearly Christmas he prescribed a broad spectrum anti-biotic. Within two days I started to feel normal again and symptoms subsided or disappeared.

Thinking about the whole experience, I believe I must have had an infection all along and that the initial urine sample, which produced a negative result within a suspiciously short time (there wasn't time to 'culture it'), must have been inadequately tested.

So, along with a great deal of stress and anxiety, made much worse by the fact that I am the sole carer for my wife who has Alzheimer's and is totally dependent on me, I do at least know that I don't have bladder, prostate or kidney cancer and that nothing else showed up on the CT scan.

Starting to look forward to more motorhome trips....

And the GP took me off Ramipril and I'm now on Losartan which is doing the job without any side-effects.


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## stu7771 (Jul 22, 2011)

Hi Phil

Pleased to hear you that you were checked out fully and that you have been given the all clear.

Sue


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## mrbricolage (Jun 30, 2008)

Pleased to hear that your OK Phil. I have started HBP treatment 3 months ago and they put me on a very low dose of ramilpril and then a slightly higher dose of 2.5mg which had absolutely no effect on my blood pressure, not a jot. 
Plus I am a very keen cyclist and I started to notice that I was really suffering on rides where I would normally have no problem, with excessive tiredness, back pain, higher heart rate and generally being a lot slower than previously. I had no other side effects.
So I came off the ramilpril and immediately I noticed a vast difference in my performance and physical state. It seems ridiculous that you take a drug that is supposed to help your heart and actually it makes your heart work harder in order to achieve the same thing. 
I went to see my GP and she recommended Lisinopril which has a slightly wider side effect footprint. I started this and my blood pressure has dropped to normal levels but I developed the cough that you get within the first few days. I understand this is a normal reaction as the body's ability to remove toxins is slightly affected by the ACE inhibitor. The toxins from the tablets called kinnins lodge themselves in the lungs and it is the bodies natural response to expel them by coughing. However this side effect seems to have passed and i upped my water intake which has helped.
Plus my bike riding seems to have returned to normal


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## rayc (Jun 3, 2008)

mrbricolage said:


> It seems ridiculous that you take a drug that is supposed to help your heart and actually it makes your heart work harder in order to achieve the same thing.


The acknowledged possible side effects of these drugs is well documented. It surprises me that Doctors do not appear to monitor users closely enough especially when first prescribing or changing the dosage. I wonder if in 50 years or so that this drive for lower blood pressure and the drugs that were prescribed will be acknowledges to be a worthy aim.


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## Mike48 (May 1, 2005)

rayc said:


> mrbricolage said:
> 
> 
> > It seems ridiculous that you take a drug that is supposed to help your heart and actually it makes your heart work harder in order to achieve the same thing.
> ...


My blood pressure is 143 over 82 with a resting heart rate of 68. My doctor has suggested I cut salt out of my diet, take more exercise and lose a bit of weight despite my BMI being within acceptable levels. I was told to return for another test in 3 months. I have a monitor at home.

Has anyone any idea of the blood pressure levels they were on before being prescribed with tablets and what level is acceptable for a 65 year old male?


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## rayc (Jun 3, 2008)

Mike48 said:


> rayc said:
> 
> 
> > mrbricolage said:
> ...


My doctor says 140 /90 are the aims for upper dis /sys levels if there are no other criteria such as diabetes where lower readings are desirable. 
[Readings in the range 120 -140 and 80-90 are now the prehypertension range.]

My 83 year old FIL had a short black out and was taken to A&E. He was found to have low blood pressure when standing up. The consultant told him to stop taking his high blood pressure tablets. Five days later he was feeling rough and had pins and needles in his left arm so his doctor was called. He found his blood pressure high and told him to start taking the tablets again. I thought the advise is always not to stop taking the tablets suddenly if you have been taking them long term. It shows you have to be careful out there.

http://www.bloodpressureuk.org/BloodPressureandyou/Thebasics/Bloodpressurechart


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## Phil42 (Apr 4, 2006)

mrbricolage said:


> Pleased to hear that your OK Phil. I have started HBP treatment 3 months ago and they put me on a very low dose of ramilpril and then a slightly higher dose of 2.5mg which had absolutely no effect on my blood pressure, not a jot.
> Plus I am a very keen cyclist and I started to notice that I was really suffering on rides where I would normally have no problem, with excessive tiredness, back pain, higher heart rate and generally being a lot slower than previously. I had no other side effects.
> So I came off the ramilpril and immediately I noticed a vast difference in my performance and physical state. It seems ridiculous that you take a drug that is supposed to help your heart and actually it makes your heart work harder in order to achieve the same thing.
> I went to see my GP and she recommended Lisinopril which has a slightly wider side effect footprint. I started this and my blood pressure has dropped to normal levels but I developed the cough that you get within the first few days. I understand this is a normal reaction as the body's ability to remove toxins is slightly affected by the ACE inhibitor. The toxins from the tablets called kinnins lodge themselves in the lungs and it is the bodies natural response to expel them by coughing. However this side effect seems to have passed and i upped my water intake which has helped.
> Plus my bike riding seems to have returned to normal


Thanks. Interesting point about heart rate. I've been using exercise bikes regukarly for at least 25 years and know my normal heart resting pulse rate and two minute recovery %age very well. Soon after starting on the Ramipril 5mg it became impossible to get my resting pulse below 70 and my recovery rate was also affected. Despite switching to Losartan, these things only got back to normal after the antibiotics dealt with the infection.


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