High BP Meds.....

[Navara]

...and possible effects....

This could be a bit of a long shot or I might just be way off base.

Back ground:-
I started taking medication for high blood pressure a couple of years ago.I take Ramipril 2.5mg once daily.It works and brought my BP under control.No issues or side effects.I take it alongside two other meds so 4 tablets in all first thing in the morning.

Problem:-
A couple of days ago I was out riding a regular loop.It felt strange from the off.I felt a distinct lack of energy but thought it was just muscle warm up etc.About 5 miles in there's a short,sharp little climb maxing out at 10% and to say I struggled is an understatement.I quickly ran out of gears and when I got to the top I had to stop and get off.Here is where the worrying started.I felt dizzy,was seeing stars and my legs just went.I had to physically lie down and felt sick.After a few minutes I sat up but still felt strange.I was in two minds whether or not to dial 999!
After roughly 10 minutes I felt OK so decided to get home a safely as I could.By the time I got home I'd done just under 13 miles but felt tired.It wasn't until yesterday that it dawned on me that I had quite possibly taken 3 Ramipril capsules instead of 1.I get a supply of 28 per month but appear to be 2 short!

So the question is could taking 2 extra that day have had such an effect so quickly?
My wife has jokingly said I should get one of those weekly pill dispensers that you fill up with your daily doses to stop confusion.She has never been one for sympathy!

[Jdsk]

Dizziness is a very well-known adverse effect. I don't know the usual time course but it has other effects within a few hours and the precautions on eg operating machinery are advised for a few hours after administration, so it sounds highly plausible.

NHS on ramipril:
https://www.nhs.uk/medicines/ramipril/

Wikipedia on ramipril:
https://en.wikipedia.org/wiki/Ramipril

Jonathan

[nickp]

I take Rampiril too, and I'm finding the current dose is enough to drop my BP considerably after exercise. So a triple dose plus exercise leading to low BP would not be too much of a surprise. On one occasion I missed two days worth then as soon as I started again, BP through the floor in a couple of hours - most alarming. Highly recommend the daily box for keeping track of consumption!

[NATURAL ANKLING]

Hi,
Nothing unusual to see drop in BP post exercise when on that stuff.
I think the warnings say contact you r GP and seek help if you overdose. but that the advice for every med.
I keep a close eye on my BP daily as I have been on all the stuff over the last 30 years or so.
None of its good news, even if you can stabilise your bp so you don't get migraines or a tight head, post exercise especially the day after can see BP drop through the floor, mine ended up at 50 / 90.
Have you got a BP home monitor? about £20 or so, useful to have one.
In the past I wanted to get off after 50 minutes and a few times have and sat on the side of the road wondering...............................
Its a juggling game I am afraid.
When I thought I was getting off all BP meds down from three types at once to a low dose of one, I would take one every other day when riding bike.
Suggest you talk to your Gp before self medicating.

Overdose well that would explain it, good luck.

[Navara]

I have a BP monitor I'm wishing I'd taken my BP on return now!
I shall be more careful as it was not an experience I want to endure again.I usually feel the effects of climbing but never to the point of feeling ill,dizzy and having to lie down!

[Navara]

I've just had a thought so checked my Smart watch for a rough guide to Heart rate average.
My resting HR is usually around 50-55bpm which is apparently very good for someone my age.
Looking at my last few rides my HR average is 120-130bpm with a high of 163bpm when doing an average 14-15mph over 30 miles.On this ride it was 143bpm average with a high 181bpm despite averaging only 12.5mph!Bearing in mind that it was a very short ride and the fact that the strange episode happened within 5 miles I'm convinced I took 3 Ramipril instead of 1 Ramipril and 2 Loperomide!!!
What an idiot

[thirdcrank]

I've been on a range of meds for sixteen years. The diagnosis of heart disease came as a shock and initially I was desperate for information about everything, including buying a blood pressure monitor and querying everything. It dawned on me that worrying is one of the biggest causes of high blood pressure, so I stopped worrying, as far as possible. That included opting out of the regular appointments to see the cardiologist which just wound me up even more. Was that a wise decision? Who knows, but if I drop dead tomorrow I've had sixteen years not worrying about my heart.

Normally, I don't bother with the news of dramatic medical breakthroughs in newspapers, but fairly recently I read something which suggested it may be better to take BP meds in the evening, rather than morning. IIRC and if I understood it correctly, it said that there had never been any research into the best time to take these meds but it had generally been assumed that morning was best as daytime activities were most likely to raise BP. The report suggested that the danger from BP remaining high overnight, ie not falling during sleep, was greater than the natural increase in BP from exercise. I switched to taking my BP meds in the evening but I don't know if that contributed to my being here today.

Over those years I've tried everything to prompt me to take medication. I'm sure that it's not a question of forgetfulness, it's just that when you've done things countless times, you don't know if you are remembering an earlier occasion when you did it. I've a couple of cheap dosset boxes from Wilko's which have been the best for me, but they are discontinued. They don't prompt you but are easy to check if you cannot remember if you have taken it. Various similar gadgets available.

[Cyril Haearn]

What an idiot, taking the wrong pills? No no, you have learned your lesson much better that way, better than reading about it or being lectured by a doc

[RH20]

Hello, if you did take too much Ramipril it could have been the cause of your problem, however. There is possibly another explanation. You might have had a nasty hypo, low blood sugar. I have a problem with hypos, What you have described sounds very similar to my own experience. Only last week I was out riding and felt a hypo coming on, low energy, feeling sick, eyes going blurred. I had to stop and take in some fast acting glucose. I waited a couple of minutes for this to get into my system, then carried on home. I get this out of the blue, no warning. Luckily I was only about half a mile from home.
The down side of this was feeling exhausted for a few days after. It might be worth considering keeping some fast acting glucose on you just in case of any future episodes. Hopefully you are now alright and will not have any similar experience of this again. This is just a suggestion to ponder.

[Navara]

I now own a little row of pill boxes from Home Bargains.
I have put numbers on top to correspond with how many of each I should take.I can't see me making the same mistake again but you never know.
I must've subconsciously done it whilst making a coffee/breakfast etc.

[NATURAL ANKLING]

Hi,
I have been on meds of one another for nearly 40 years.
How do I remember......I take them with my breakfast, standing.
I never look at the foil they come in........but at the end of dose when I run out its not always synchronized, that is to say that If I am one short in a foil and I run out of all 4, when I take them again when I have been to the chemist then In theory I should run out of all next time.
But NO I still run out some times on one or still have one of four
Some times they drop out of the foil into a container in the drawer then you find it later
I also have to take tablets twice a day, but I pretty reliable take them at dinner.
So normally I underdose, forget very seldom till later in day or and I know I do it, miss just one tablet, you start to lose count when you also take non critical stuff at the same time like anti pain / inflammatory stuff.
Now I just have to work out how I can reliably take meds before eating and after eating

Underdosing is no so critical as the meds stay in your body for some time and take a while when starting to build up.
Er indoors puts her vitamin tablets on her tray and normally I pick them up off the kitchen floor or the lounge
I take sometimes ten tablets in one go with a drink whilst waiting for the toast......straight down, so many years of practice, er struggles on one so needs to sit with a pint mug of tea

[NATURAL ANKLING]

Hi,

I now own a little row of pill boxes from Home Bargains.
I have put numbers on top to correspond with how many of each I should take.I can't see me making the same mistake again but you never know.
I must've subconsciously done it whilst making a coffee/breakfast etc.

One tablet I take 2 off twice a day, I normally take them before food so while I am making breaky / dinner, worst dinner I take them and then put the bottle on its side, that way I don't retake them.
Start dinner , put bottle on table top, take tablets and put bottle on its side, If I go to retake them which I have done (these are non critical so overdosing wont harm, low dose antibiotics) the bottle is in wrong orientation.
Reason tablets are in bottle is because I decant from the foil when I start new batch, otherwise you are forever picking them up off the floor as they ping all over the place, sometimes the plastic is impossible to break even with strong hands, workers hands with just going to split skin...ouch.
All 224 of them.

If you are just taking one tablet then I see its easy to miss the things / forget if you have taken it.............then a container marked is probably useful.

Me I just take them and count to six or whatever and down em

[drossall]

I use Ramilpril and various other medications after a double bypass last year. I've always had some dizzy spells, probably everyone does, just when getting up suddenly and so on. Not too much on the bike, though I think I'm more variable in energy levels now.

I use an app on my phone to nag me over tablets and to keep count. There are various ones around.

[Mick F]

I was on BP meds and then found out that I didn't have a BP issue, but a stress issue.
Take my BP at the health centre, and it's way too high.

White Coat syndrome?
No, not me.
It's being tested that sends my stress level up ............ and my BP ............ and it doesn't matter who is doing it, and me DIY included.

If you have your own BP monitor, do it on one arm, then do it on the other arm.
Quite a big difference.
Swap arms back and forth, and note the figures.
Do it over a whole evening relaxing and quiet.
Sit down at home in your armchair, relax, do it again and again, relax some more, get the pulse-rate down, and do it again ................

At no time will you have any figure that is consistent. Not one!
Which is correct?
Take an average?

Mine generally is fine.
Go to the doctor's and it's sky-high .............. hence the meds, which I was given, got side effects, and have since give up on them.

[Jdsk]

I have a BP monitor I'm wishing I'd taken my BP on return now!
I shall be more careful as it was not an experience I want to endure again.I usually feel the effects of climbing but never to the point of feeling ill,dizzy and having to lie down!

Yes, recording your blood pressure AND heart rate would be a smart move if you ever experience anything like that again.

There is possibly another explanation. You might have had a nasty hypo, low blood sugar.

Could be, but Navara didn't describe any of the other symptoms of neuroglycopaenia, and there's already a plausible explanation.

Could be lots of other things as well.

Jonathan