Lispril / Zestril / Lisinopril BP med Supply Chain Nightmare

[dddave]

I'm curious.  I've been taking both Losartin (20mg/day) and HCTZ (20mg/day) for 6 years after bypass surgery.  Would they be considered redundant as both are primarily diuretics'?   Is this something I should review with my Dr.?

[Nickelbeer]

On 5/31/2022 at 12:43 AM, buick said:

interesting news.  my usual pharmacy guy in bkk appeared to imply the same about a month ago.  i tried getting the 10mg lispril (he's had it before) but he only had 20mg (i bought those) and he mumbled something but i wasn't sure what he was saying - i wondered, did he just say he isn't getting any more of this stuff.  i went in again to get some other meds and noticed the shelf still had only 20mg.  probably gone soon. 

Lisinopril has a number of unwanted side effects, such as arm and neck pain and a dry nagging cough. My doctor switched me to Losartan. I take 100 mg every morning and it seems to keep my blood pressure within the normal parameters until bedtime. Your mileage may vary. I have noticed no side effects from use of Losartan and I have been using it nearly seven years, now.

[Sheryl]

16 minutes ago, dddave said:

I'm curious.  I've been taking both Losartin (20mg/day) and HCTZ (20mg/day) for 6 years after bypass surgery.  Would they be considered redundant as both are primarily diuretics'?   Is this something I should review with my Dr.?

 

They are not both diuretics.

 

Losartan is an Angiotensin II receptor blocker (ARB).

HCTZ is a diuretic.

 

Fairly common to prescribe these in combination especially for people with underlying heart disease. In fact there are combined pills containing both, brand names Hyzaar and Fortzaar...but will be less expensive to buy local brands separately in Thailand

 

https://www.mayoclinic.org/drugs-supplements/losartan-and-hydrochlorothiazide-oral-route/description/drg-20062877

 

I think you have listed the dosages wrong, though. Losartan would usually be taken in dose of 50 - 100 mg and HCTZ (when combined with losartan) usually in dose 12.5 - 25 mg

[ukrules]

36 minutes ago, Nickelbeer said:

Lisinopril has a number of unwanted side effects

Not for everyone, many people take it all the time with zero zide effects.

 

[dddave]

16 hours ago, Sheryl said:

I think you have listed the dosages wrong, though. Losartan would usually be taken in dose of 50 - 100 mg and HCTZ (when combined with losartan) usually in dose 12.5 - 25 mg

Thanks for your comment regarding the Losartin dosage.  After bypass surgery 6 years ago, I was on VALSARTIN 50mg/day along with the 20mg HCTZ.  When Valsartin became unavailable in Thailand for a period, I was told to use Losartin but at only half the Valsartin dosage.  This was all by email with a physician who had replaced my primary care physician with the VA in the US.   

I will contact him and discuss the dosage. Perhaps return to Valsartin which is now available again though much more expensive than the Losartin.  

[Sheryl]

1 hour ago, dddave said:

Thanks for your comment regarding the Losartin dosage.  After bypass surgery 6 years ago, I was on VALSARTIN 50mg/day along with the 20mg HCTZ.  When Valsartin became unavailable in Thailand for a period, I was told to use Losartin but at only half the Valsartin dosage.  This was all by email with a physician who had replaced my primary care physician with the VA in the US.   

I will contact him and discuss the dosage. Perhaps return to Valsartin which is now available again though much more expensive than the Losartin.  

If your BP is OK on just 25mg Losartan (it could not be 20mg as it comes in tabs of 50mg..so 1/2 tab is 25mg) plus ?25 mg HCTZ (cannot be 20mg as it comes in tabs of 25 mg) then no reason to worry about the dosage.

 

I suspect you were on 40mg not 50 mg of Vlasdartan as it comes in 80 and 160 mg tablets.

 

25 mg of losartan is the equivalent of 40 mg of valsartan.

 

 As for changing  back to Valsartan, the main advantage to Valsartan is somewhat longer duration of action. Losartan  effects last less than 24 hrs at doses under 100 mg. But if your BP remains in normal range throughout then not an issue.

 

 

[dddave]

On 9/17/2022 at 10:54 AM, Sheryl said:

If your BP is OK on just 25mg Losartan (it could not be 20mg as it comes in tabs of 50mg..so 1/2 tab is 25mg) plus ?25 mg HCTZ (cannot be 20mg as it comes in tabs of 25 mg) then no reason to worry about the dosage.

 

I suspect you were on 40mg not 50 mg of Vlasdartan as it comes in 80 and 160 mg tablets.

 

25 mg of losartan is the equivalent of 40 mg of valsartan.

 

 As for changing  back to Valsartan, the main advantage to Valsartan is somewhat longer duration of action. Losartan  effects last less than 24 hrs at doses under 100 mg. But if your BP remains in normal range throughout then not an issue.

 

 

Thanks, Sheryl.  Yes, you are correct about the dosages.  As my BP has been staying consistently within acceptable range, I will leave well enough alone and change nothing.

[Sheryl]

56 minutes ago, dddave said:

Thanks, Sheryl.  Yes, you are correct about the dosages.  As my BP has been staying consistently within acceptable range, I will leave well enough alone and change nothing.

Are you also on a potassium supplement As the HCTZ can deplete potassium

[dddave]

6 hours ago, Sheryl said:

Are you also on a potassium supplement As the HCTZ can deplete potassium

Actually a concern.  When I was hospitalized in late April for a serious foot infection I was told my potassium levels were low and they gave me a liquid supplement several times but nothing prescribed on discharge.  What potassium supplement do you suggest? Would eating a banana or two a day be sufficient?

[Sheryl]

7 minutes ago, dddave said:

Actually a concern.  When I was hospitalized in late April for a serious foot infection I was told my potassium levels were low and they gave me a liquid supplement several times but nothing prescribed on discharge.  What potassium supplement do you suggest? Would eating a banana or two a day be sufficient?

Banana or two will help as would  drinking green coconut water also a good idea.  I also suggest you discuss with your cardiologist  whether to start a prescription supplement or whether you might be able to reduce or stop the HCTZ  and up the Losartan - but see what he advises as it depends on your overall cardiac status. Living in the tropics, where one is apt to sweat, increases the risk of electrolyte imbalance when on a diuretic. However if you have reduced cardiac function, diuretic might be unavoidable.

[buick]

i experienced the dry cough side effect from lisinopril.  it went away after a few weeks.  but it was very annoying while it lasted.

 

thanks for the update on lispril.  i'll take a look at my bkk pharmacy very soon and report back if i am able to get it.

[Nickelbeer]

On 9/16/2022 at 3:47 PM, Jingthing said:

Thanks.

Which pharmacy?

Ocean Pharmacy has it, also the pharmacy next door to Chanya Clinic on Theppraya.

[buick]

my usual pharmacy on sukhumvit btwn soi 20 and 22 did not have lispril.  i tried one down soi 22 and they had several boxes of the 20 mg tablets.  i take 5 mgs so that box will last quite awhile.

[wondra]

Hi

Im in Chaiyaphum. My current supply of Zestril runs out next week. Yesterday went to the largest suppliers her in Chaiyaphum and "no have". My wifes friend is a doctor she checked it out for her and apparently none available here in Chaiyaphum.

My question... is the supply issue sorted in Pattaya? or are people just finding the odd Pharmacy with a box or 2?

I will go out later today and seek an alternative as a stop gap. Thank you for the suggestions in this thread.

Thanks.

[Jingthing]

46 minutes ago, wondra said:

Hi

Im in Chaiyaphum. My current supply of Zestril runs out next week. Yesterday went to the largest suppliers her in Chaiyaphum and "no have". My wifes friend is a doctor she checked it out for her and apparently none available here in Chaiyaphum.

My question... is the supply issue sorted in Pattaya? or are people just finding the odd Pharmacy with a box or 2?

I will go out later today and seek an alternative as a stop gap. Thank you for the suggestions in this thread.

Thanks.

In Pattaya Fascino still doesn't have it.

 

I found a pharmacy in Jomtien  that has 5 and 20 mg but not 10.

 

They can order all you want.

 

It's located on Jomtien 2nd road across from Rompho Market 

[Sheryl]

5, 10 and 20 mg tabs (locally made brand) can be bought online here https://medtide.com/my-account/customer-logout/?_wpnonce=8a941bdbb7

(have to register an account first then search)

 

And 10 and 20 mg boxes here https://bangkokdrugstore.com/?s=lisinopril

 

[wondra]

Thankyou very much