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Super Advisor
ffmaya
Total Posts: 1,533
Registered on: ‎10-29-2011

Lisinopril and diabetes question

Hi everyone, I was just wondering about continuing my Lisinopril, it's been giving me this annoying dry cough.  It was prescribed for HBP shortly before my T2 diagnosis.  My BP has been in the normal range for some time now and I have started spreading the Lisinopril to every 2, 3, 4 days and now once a week, so far my BP has stayed normal, I am sure diet change and weight-loss has something to do with it as well.  Also, my BG is within the non-diabetic range at all times I do test.

 

The question I have is pertaining to Lisinopril being often prescribed for diabetics to protect their kidneys.  Being that my BG numbers are tightly controlled, what are the risks of getting off Lisinopril?  Can kidney damage still occur?

 

Thanks, Farida

Farida

" Remember, Google is your friend"

Dx'd Type II on Halloween 2011
Current 8/20/14 - A1c 5.8
Metformin 1000 mg twice daily
Flexeril 10mg for Fibromyalgia
Gabapentin 3200mg for Fibromyalgia
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Responder
drew219
Total Posts: 17
Registered on: ‎12-03-2010

Re: Lisinopril and diabetes question

Hey There

 

First off...I am not a Dr., so i would not be telling u to stop or keep taking ur meds.  I think this is something u should be discussing with ur Dr. I also suffor from the dry cough from taking the Lisinopril, I take 10mg per day, not for HB but for my kidneys. I get good and bad from this drug, the good is it slows the protein leak from my kidneys and the bad is i dont have HB. It tends to lower my BP to low sometimes. Last summer if I stood up too fast and started walking I would pass out, BP was too low. This went on for a while so they lowered my dose to 5mg per day. Its not working as good as the 10 mgs but oh well. I think that taking 10mg a week may be ok, something u should ask ur Dr.

alan_s
Total Posts: 15,272
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Registered on: ‎10-30-2009

Re: Lisinopril and diabetes question

I can't answer on the dangers of dropping the med, but your doctor can.

 

I recommend you discuss it with the doc as a matter of urgency; no side effect from a med should be ignored.


The question I have is pertaining to Lisinopril being often prescribed for diabetics to protect their kidneys.

Personally, I am not in favour of prophylactic medication to fix a problem that might, or might not, occur based on statistical studies. I will only take meds for real problems I have or am likely to get based on tests of my own body and blood.

Cheers, Alan, Type 2, d&e metformin 2000mg, Australia.
Everything in Moderation - Except Laughter.
There is nothing I could eat I like more than my eyes.
Type 2 Diabetes - A Personal Journey(latest: Catering For Different Tastes When Cooking)
Born Under a Wandering Star (Latest: Budapest, Hungary)
Valued Contributor
maplesyrup
Total Posts: 4,364
Registered on: ‎11-14-2009

Re: Lisinopril and diabetes question

Farida and Drew, There is a solution that your doctor can provide for you.

 

That dry cough that is caused by lisinopril and other ACE inhibitors which are in that family drove me crazy.

 

But even as my doctor prescribed AltAce (same family) he told me that it could cause an annoying dry cough and at the first sign of that side effect, I should come in to him and he had another med that also protected the kidneys and helped control blood pressure.

 

The drug I have take for 6 years now is an ARB, an angiotensen blocker, and it causes no dizzyness, no low BP in me. I think you will read that in the case of diabetes there are some prophylatic measures taken to protect us from complications.

 

My doctor knows that before the diabetes diagnosis that I had been on no meds whatsoever and he has taken great care to provide only what he thinks is necessary and in the lowest doses he feels will do the job.

 

Check with your doctor about an ARB. There is no cough and for me there have been no side effects at all.

 

Dianne

Dianne

Diagnosed as type 2 in 2005 with an A1c of 9.1

Started with metformin and a low dose of an ARB for blood pressure. Added a sulfonylurea (a med that helps my pancreas produce my own insulin) Also a low dose of Crestor to lower my cholesterol.
After 7 years I could no longer tolerate metformin so am doing my best to keep control with a max dose of the sulfonylurea and lots of walking, some swimming.
Advisor
TrevaC
Total Posts: 99
Registered on: ‎11-17-2011

Re: Lisinopril and diabetes question

Farida & Drew,

 

What time of day do you take your Lisinopril?  I have been a long time user of Lisinopril and when I first started taking it, I also developed the dry cough...quite irritating, isn't it?... When I contacted my doctor, his first response was to ask at what time of day I was taking the med.  At the time, I was taking it in the morning...thinking that was the best time of day to better control my bp.  He informed me to start taking it at night...within a day or two the cough had disappeared.  No problems with it ever since.

 

Hope this helps.

 



Treva
Diagnosed 11/1/11 - T2 - A1c 6.5
3/22/12 - A1c 6.2, lost 20 lbs. with low carb diet & exercise

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Super Advisor
ffmaya
Total Posts: 1,533
Registered on: ‎10-29-2011

Re: Lisinopril and diabetes question


TrevaC wrote:

Farida & Drew,

 

What time of day do you take your Lisinopril?  I have been a long time user of Lisinopril and when I first started taking it, I also developed the dry cough...quite irritating, isn't it?... When I contacted my doctor, his first response was to ask at what time of day I was taking the med.  At the time, I was taking it in the morning...thinking that was the best time of day to better control my bp.  He informed me to start taking it at night...within a day or two the cough had disappeared.  No problems with it ever since.

 

Hope this helps.

 


I take it in the evening.  Farida

Farida

" Remember, Google is your friend"

Dx'd Type II on Halloween 2011
Current 8/20/14 - A1c 5.8
Metformin 1000 mg twice daily
Flexeril 10mg for Fibromyalgia
Gabapentin 3200mg for Fibromyalgia
Clonazepam 1mg for Anxiety
Advisor
ronaka
Total Posts: 950
Registered on: ‎12-24-2011

Re: Lisinopril and diabetes question

[ Edited ]

Farida, as Dianne mentioned your best alternative to an ACE inhibitor like Lisinopril is an ARB. From the studies I've seen ARBs and ACE inhibitors are equally effective in treating progression of kidney disease in diabetics. The big plus that ACE inhibitors have had is from the HOPE study which showed a very significant reduction in the risk of cardiovascular disease, heart attacks, and stroke, and particularly in diabetics. The benefit was shown to be more than could be explained by the reduction in blood pressure alone. A more recent study that included an ARB was called NAVIGATOR. It was mainly to determine if the ARB could slow or reverse the development of diabetes. The study did show a benefit, but some suggest it was due to a flaw in the study. The control group taking a placebo were also taking drugs which were known to aggravate BG control. Another finding of the study was that the ARB did not reduce cardiovascular risk.

 

You may want to do a search on the HOPE and NAVIGATOR studies and come to your own conclusions. Then talk to your doctor and get advice. I've taken the ACE inhibitor (Ramipril) which was used in the HOPE study for about 10 years now. No issues with a cough, but that certainly is one of the most frequently reported side effects.

Ron

Not a doctor, only another T2 diabetic with, unfortunately 11 year experience. Be cautious about accepting advice, including mine, on medical conditions from the internet. It can be a good place to get ideas, but validate them with your doctor and other medical professionals first.
Trusted Contributor
morrisolder
Total Posts: 10,633
Registered on: ‎11-28-2009

Re: Lisinopril and diabetes question

As you know, kidney disease, like heart disease, is a not uncommon complication of diabetes.  That being the case, doctors look for other factors that can cause heart and kidney disease, namely cholesterol levels for the heart and blood pressure for  the kidneys, and set lower targets for those two markers for people with diabetes than for the general public. Since you are at higher risk, they want to lower the other risks leading in the same direction.

 

ACE inhibitors, like lisinopril, are generally considered to be the best blood pressure meds where potential kidney disease is being targeted because they actually help control blood pressure inside the kidneys, more than other types of blood pressure meds.  But coughing is the most common side effect of lisinopril, so they will usually prescribe some alternative to it to keep working on the blood pressure without causing the side effect.  So talk to your doctor about alternatives and about whether your current levels are low enough that you might no longer need a mediation for that...

Morris

Diagnosed Type 2, with an A1c of 11.4 in 2003; averaging a 5.0 A1c since then with diet, exercise and Glipizide XL + meds for blood pressure and cholesterol. 
A bit dated, but scroll down on this page if you want to know more ...


Advisor
Caloh
Total Posts: 641
Registered on: ‎11-02-2009

Re: Lisinopril and diabetes question

I am on an ACE inhibitor to protect my kidneys;  I've always had good blood pressure, so I do not take it for that.  When I first started on it, I coughed for a couple of months, and then the cough went away.  How long have you been on it?  I think the ACE is cheaper than the ARB, but if your insurance covers it, an ARB might be  better for you if you have been coughing for a long time.  Check with your doctor.

mollythed
Total Posts: 5,991
Topics: 75
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Registered on: ‎10-31-2009

Re: Lisinopril and diabetes question

I had a terrible time with a dry cough while using Lisinopril.  It was the doctor treating my sleep apnea, who had hard data from an overnight sleep study to show how much I was coughing who recognized that Lisinopril was the culprit. I stopped taking it, and the cough which had lasted for a couple of months was gone in just a couple of days.  When I went back to my primary care doctor a couple of weeks later, he prescribed a different kind of medication. 

 

Lisinopril is a member of the ACE family.  My doctor prescribed Diovan instead, a member of the ARB class of meds.  Since that time, my insurer changed its formulary, and now I am taking yet a different ARB med, losartan, which is the generic version of Cozaar.  Neither of the ARBs has given me any problem.


"Molly" (aka mollythed)
Type 2 diabetes diagnosed in 1995, now managed with Lantus, Humalog and Metformin; diet and exercise.
My husband and three adult sons also have type 2 diabetes.