WebMD Ask the Pharmacist

Blood Pressure & Cholesterol: Ask the Pharmacist

Pharmacist Maria Marzella Sulli, PharmD, answers questions about blood pressure and cholesterol.

Question:

Can lisinopril cause bursitis?

Answer:

There is no significant evidence linking lisinopril with bursitis. If you are experiencing pain or any other new symptoms, you should consult your health care professional for an evaluation.

Question:

I take Bystolic and Uroxatral -- both at the same time. I accidently took a second pill of each, 4 hours after the first set. What can be the effects of taking a double dose of these medicines within 4 hours?

Answer:

Whenever more than the recommended dose of medication is taken, the most probable thing to expect is more of the intended action of the medication, or more pronounced side effects. With Bystolic and Uroxatral, since they both can lower blood pressure, you might feel dizzy and notice your blood pressure to be extra low. Since it was only one extra pill of the medications, it is unlikely to cause any significant harm.
In the future, I would suggest you come up with a system that reminds you to take your medication and that helps prevent you from taking extras. Talk to your pharmacist. He or she can suggest some strategies for you.

Question:

What is propranolol for?

Answer:

Propranolol is in a class of medications called beta-blockers. It can be used for a variety of conditions, like high blood pressure, rapid heartbeat, migraine headache prevention, and even stage fright. You should talk to your doctor or pharmacist, who can help you decipher why propranolol was prescribed for you.

Question:

I take enalapril for blood pressure. Is taking Viagra or another drug for erectile dysfunction something that I should avoid?

Answer:

The medications for erectile dysfunction, like Viagra, are safe to take with enalapril. There are no drug interactions to be concerned about. But you should take those medications only under the care and advice of a health care professional.

Question:

Why should I not drink grapefruit juice while taking simvastatin or other statin drugs?

Answer:

Grapefruit juice contains enzymes that can interact with certain medications like simvastatin by slowing down your body’s ability to metabolize them. This means it will take longer for your body to get rid of the simvastatin when you drink grapefruit juice, which can potentially lead to having too much simvastatin in your body. This can lead to more side effects, like muscle pains. This interaction does not happen with all the statins. For instance, there is no interaction between grapefruit juice and pravastatin, found in Pravachol.

Question:

I just recently lost 30 pounds. Should I contact my doctor to see if I need new blood work to adjust my cholesterol/triglyceride medications?

Answer:

That is great! Losing 30 pounds can affect your cholesterol. So you should see your doctor for some blood work. Some people lose enough weight so they no longer need blood pressure or cholesterol medications. But only your doctor can determine when it’s time to stop taking your medications.

Question:

Is there any OTC medication for water retention due to high blood pressure?

Answer:

No. There are no effective over-the-counter diuretics. If you are experiencing water retention, you should see your health care professional for an examination. Water retention could be a sign of other conditions that should be checked out by a doctor.

Question:

Can a statin drug cause higher blood sugar levels?

Answer:

While there is some evidence that statins can affect blood sugar, the benefits of the medications usually outweigh the risks. The effect on blood sugar is minimal. If you are concerned about your blood sugar or the medications you are taking, you should talk to your health care professional.

Question:

Should I be alarmed if I accidentally took my hypertension medication (lisinopril) twice today?

Answer:

No. It is unlikely to cause significant harm. You may notice some dizziness due to extra low blood pressure, though.

Question:

I’m taking the antibiotic Bactrim. I also take enalipril for high blood pressure. Will these two drugs interact or change in effectiveness when taken together?

Answer:

They should not affect the efficacy of each other. There are no significant interactions reported between these two medications, except that when taking Bactrim, you are more likely to experience high potassium levels, which is a side effect of enalapril. If you are concerned about drug interactions, you should talk to your doctor or pharmacist, who can help you sort through your concerns.

Question:

What time of day should you take Crestor?

Answer:

The best time of day to take Crestor is the time of day you are most likely to remember to take it. While some statin medications are best taken at night, Crestor -- since it has a long half-life -- can be taken any time of day.

Question:

What OTC pain medicines are safe to take with amlodipine besylate for high blood pressure?

Answer:

The three OTC pain relievers available are acetaminophen, ibuprofen, and naproxen. None of these interacts with amlodipine. So any of them would be considered safe to use for short-term management of pain or fever. Ibuprofen and naproxen, when taken chronically for pain, can raise blood pressure. In this case, acetaminophen would be best.
There is more to consider in finding the right pain reliever than just the other medications you take. I would suggest you talk to your pharmacist, who can evaluate your entire situation and help you find the best pain reliever for your needs.

Question:

Can I take Zyrtec with my blood pressure medicine?

Answer:

Zyrtec does not have any significant interactions with blood pressure medications. So it should be fine to take for managing your allergies. You should talk to your pharmacist, who can provide a full assessment of your situation and help determine if Zyrtec is best choice for you.

Question:

What are the differences between Trilipix and Lopid?

Answer:

Trilipix and Lopid are both in the class of fibric acid medications, which lower cholesterol and triglycerides. There are some differences in dosing and side effects. If you have concerns about which medication is best for you, you should talk to your health care professional.

Question:

Is it safe to take St. John’s wort while taking Lipitor?

Answer:

St. John’s wort has the potential to decrease the efficacy of Lipitor. So it is not suggested that you take St. John’s wort with Lipitor without consulting your health care professional. As a pharmacist, I generally steer my patients away from St. John’s wort. It is taken for depression, and depression is a condition that should not be self-treated. It requires a thorough evaluation and the help and advice of a professional.

Question:

My husband is taking medication for high blood pressure and he had his wisdom teeth taken out this week. His pain is not enough to keep taking the prescribed Percocet. Can he have ibuprofen, if he takes HCTZ and lisinopril?

Answer:

Yes, he can take ibuprofen for short-term pain while taking lisinopril and HCTZ. There are no significant interactions with this combination. The only concern would be that, in the first few days after surgery, some doctors suggest avoiding ibuprofen because of its potential to cause bleeding. But after the first day or two, it is usually fine. Talk to your dentist if you have concerns.

Question:

Please advise regarding renal toxicity potential while taking ramipril and Avalide.

Answer:

If you are concerned about your kidneys while taking ramipril and Avalide, you should talk to your health care professional. He or she will probably conduct routine blood tests to check your kidney function if there is a concern.

Question:

My doctor has prescribed Toprol XL for me. Are the active ingredients in metoprolol tartrate 50 mg the same exact ingredients in the prescription version, Toprol XL?

Answer:

Yes. The active ingredients are the same in the generic form of Toprol XL.

Question:

I would like to know if it is safe to take trazodone with Exforge blood pressure medicine.

Answer:

There are no significant interactions between these two medications. Your pharmacist should check all of your medications for drug interactions when you have your prescriptions filled. So as long as you have your prescriptions filled at the same pharmacy each time (which I suggest you do), they will be screened for dangerous interactions.

Question:

Is there any interaction between aspirin and lisinopril/ HCTZ? Are these safe to take together?

Answer:

Aspirin can be taken with lisinopril/HCTZ. There are no significant interactions to be concerned about. You should always talk to your pharmacist before taking any over-the-counter medications to make sure they are safe to take with any current medical conditions and medications.

Question:

Does it matter what time of day my husband takes his blood pressure medicine, cholesterol drug, and Niaspan? Currently he takes his blood pressure medicine in the morning and the rest in the evening. But his blood pressure medicine seems to make him sleepy. Can he take it all at night and at the same time?

Answer:

It really would depend on which medication he is using. Usually, if a medication causes sleepiness, it is fine to take it at bedtime. But I would need the names of the medications to be sure. His pharmacist should be able to help him decide when it is best to take each of his medications.

Question:

I started taking simvastatin several years ago. Now I am developing peripheral neuropathy. Any chance it is a side effect of the statin?

Answer:

Simvastatin is not associated with causing peripheral neuropathy. Have you seen your doctor about it? There are many causes of peripheral neuropathy. So it is important to have an examination and an evaluation by a health care professional.

Question:

Would it be dangerous for me to stop taking my Crestor for high cholesterol? I read that if you suddenly stop taking this medicine, cholesterol will start sticking together and cause blockage, which could result in stroke.

Answer:

If you stop taking Crestor on your own, the danger is that your cholesterol will rise. This puts you at increased risk for heart attacks and strokes. There is no immediate danger, but it would not be in your best interest if you are at risk for heart attacks and strokes. You should talk to your health care professional before stopping any prescription medication.

Question:

I take pravastatin, lisinopril, Singulair, fish oil, calcium, and vitamin D. Can I take them all together or should I not combine any of them?

Answer:

I do not see any medications on your list that should be separated from the others. So it appears you can take them all at the same time. Certain calcium supplements (carbonate) need to be taken with food. But other than that, they can all be taken at any time of day. Your pharmacist is the best person to talk to when you have medication questions -- they can help you come up with a schedule for all your medications.

Question:

Can lisinopril work with Ativan without any side effects?

Answer:

All medications cause side effects. But there are no significant interactions between Ativan and lisinopril. They can be taken together safely.

Question:

I am taking carvedilol (Coreg) for high blood pressure. I read that 32 deaths were attributed to this medicine in 2007. How does the FDA determine what medicines are a threat to the public? Should I be concerned that my medicine could harm me more than help me?

Answer:

If you are concerned about the medications you are taking, you should discuss it with your health care professional. Medications approved by the FDA are tested and considered safe and effective for the conditions they treat. All medications carry some risks of side effects, and some can be quite serious. But the benefits almost always outweigh the risks. Coreg treats serious conditions like high blood pressure and heart failure, which kills hundreds of thousands of people every year.
You should never stop a medication abruptly without talking to your doctor. If you have concerns, you should share them with your doctor, who can work with you to find a medication regimen to suit your needs and ease your concerns.

Question:

Does Lipitor increase your blood sugar?

Answer:

While there is some evidence that the statin medications can affect blood sugar, the benefits of the medications usually outweigh the risks. The effect on blood sugar is minimal. If you are concerned about your blood sugar or the medications you are taking, you should talk to your health care professional.

Question:

I am taking lisinopril HCTZ 20/12.5mg. Why do the directions say to stay out of the sun?

Answer:

The medication HCTZ can make your skin more sensitive to the sun and can cause you to get sunburn more easily. It is important to use a sunscreen whenever you go out into the sun to avoid sunburn.

Question:

Can metformin be taken two hours before taking simvastatin?

Answer:

Yes. Metformin can be taken two hours before simvastatin. There are no specific considerations that need to be made with those two medications, regarding the time of dosage. They can be taken at the same time or separately.

Question:

Does Hyzaar or lisinopril have snake venom in the ingredients?

Answer:

No. There is no snake venom in either of these medications.

Question:

Is it safe to take Cholest Factors with my medications? Cholest Factors is a natural herb for lowering cholesterol.

Answer:

According to its web site, Cholest Factors contains various natural ingredients that supposedly lower cholesterol, including red yeast rice. Without knowing what medications you take, I cannot really provide you with any advice on whether it is safe to use this supplement. It can interact with prescription medications. I suggest you talk to your pharmacist, who can review all of your medications and determine if it is safe for you to use this supplement.
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