Visit the Microscopic Colitis Foundation Website
Tex wrote: Sorry I'm late with this, I had some health issues today, and wasn't able to take care of business very well.
Love,
Tex
Are you feeling better?Gloria
Tex-
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
Tex-
Are you feeling better?Gloria
You never know what you can do until you have to do it.
Hi Gloria,
Well, actually, I never did feel bad, the only symptom I had was dry mouth, but that's what tipped me off, and caused me to check my blood pressure. Actually, this started yesterday, after lunch, and that's when I started monitoring my BP. I don't recall ever having that dry mouth problem before, except on one occasion, (unless, of course, I'm actually dehydrated, and simply need to drink water). That occasion was when I had the TIA, last July. Even though all sorts of thoughts were running through my mind on that morning, I kept noticing that I had dry-mouth. As you may recall, when I arrived at the ER that day, my systolic blood pressure was a little over 180.
It slowly receded later in the day, but the next day, when I went by my GP to discuss the TIA thing, my BP was back up to 180 again. My right arm, and the right side of my face, (right down to the right side of my tongue), was numb. My right leg seemed to be spared. The ER crew couldn't find anything wrong, but since they couldn't rule it out, they called it a TIA, by default. Over the next day or two, most of the symptoms slowly went away, except that it took over a week for the right side of my face to return almost to normal. The corner of my mouth never did quite return to normal. I have normal muscle control, but it always feels slightly numb.
Yesterday afternoon, when I checked it, I discovered that my systolic BP was running from a minimum of 165 to a maximum of 179, and my diastolic pressure was running from about 94 to 100. One time my diastolic reading was 102, and I almost caved in and went to the ER, but it slowly backed off a little so I toughed it out, all the while searching for an explanation. Naturally, I suspected the rasagiline, since there are all sorts of warnings about possible life-threatening BP excursions, if foods high in tyramine, (dried meat, dried fruits, aged cheeses, etc.), are ingested while taking rasagiline. The neuro even warned me about that possibility, however, he didn't mention any other risks. I checked PubMed, and found research that demonstrated that there was no increased risk of an adverse BP event, due to eating an unrestricted diet, so I kind of relaxed, and decided that rasagiline was a relatively safe drug. I hadn't eaten any of those foods recently, though, so I didn't see any reason to suspect food.
http://hyper.ahajournals.org/cgi/conten ... t/52/3/587
To shorten a long story, after running down all sorts of possibilities, yesterday, and finding nothing significant, I decided to check out the antihistamine that I took yesterday morning, (and the day before), to prevent hay fever symptoms from the extremely high level of cedar pollen that we've been having for the past few days. Bingo! Drugs.com shows a list of 625 drugs which are contraindicated with rasagaline, (Azilect). (Are there any that aren't on the list?) 
http://www.drugs.com/drug-interactions/rasagiline.html
Why didn't my neuro doc mention this? I'm not surprised that my GP wasn't aware of the risk, because he candidly admitted right off the bat, that he was completely unfamiliar with rasagiline. I wondered why I had never searched for that possibility, before, but, of course, Parkinson's adversely affects memory, also.
A page from the University of Michigan Health System even has this specific warning against the use of acetaminophen, chlorpheniramine, and dextromethorphan:
Acetaminophen, of course is used in Tylenol, and many other combination painkillers. Chlorpheniramine was in the antihistamine that I took, (Chlor-Tripolon), and dextromethorphan is a decongestant, commonly used in OTC cough syrups, and similar meds, (though I haven't used any of that lately, thankfully). All antihistamines are on the list, and virtually all anti-depression meds. What am I doing taking this stuff? Of course, I'm not taking it any longer, but according to the references, it will take 14 days to completely clear my system. I'm not taking any more antihistamines, either, at least not for 13 more days - I'll just put up with the watery eyes, runny nose, and throat congestion, until the rasagiline is completely depleated.
This morning, when I checked my BP, it was 148 over 88, much better than it had been when I went to bed, so I breathed a sigh of relief and drank a Dr. Pepper, in place of a cup of coffee. 30 minutes later, I checked my BP, and it was 158 over 94. I checked the drug list, and sure enough, caffeine is on there, (but only as a moderate interaction). 30 minutes later, the reading was 169 over 112. That's when I headed to the ER, since I've read where a diastolic BP reading of 100, is suggested as a threshold for deciding when to go to the ER. It took me 30 minutes to get there, and about 15 minutes later, when they got me hooked up to the monitors, and checked my BP, it was 225 over 121. It slowly came down, and within about an hour, the systolic reading was down to 160, and the diastolic reading was 90-something, but then it began to go up again, and when I checked out, if I recall correctly, the last reading showed 177 or 178 over 102. It's been up and down, since I got home. A few hours ago, it was down to 151 over 94. Then it went back up to 176 over 102. Right now it's 172/104.
When I first started taking the Azilect, my BP was mostly in the range of 120 to 130 over 70-something. A couple of weeks later, it was in the 110 to 120 over 60-something range. A month or so later, it was back up into the 120 to 130 range, with occasional 140s, (probably when I started occasionally taking an antihistamine, because of ragweed pollen, but I didn't take careful notes, unfortunately). There were also occasional readings below 120, so I decided it was doing OK, and I pretty much stopped checking it regularly.
Of course, I wasn't taking Azalect when I had the TIA, but my pressures were not as high, then, and they settled down much faster. To add insult to injury, Parkinson's disease messes with your blood pressure, too, but usually it causes hypotension, not hypertension. I have a feeling that it's the combination of drugs that's causing the worst part of the problem right now, but who knows? Whatever is going on seems to be serious stuff.
All my electrolytes, EKG, etc., checked out fine, at the ER. In view of the rather high pressure readings, the ER doc couldn't believe that the only symptom I had was dry-mouth. As far as resolving the problem is concerned, he was no help at all, and played down the possibility of drug interaction. He tried to convince me that I simply have chronic high blood pressure. I guess I'll see what happens over the next 13 days, as the rasagiline slowly exits my body.
I reckon I'll check with my GP tomorrow, but I'm pretty sure that he'll just prescribe another drug - for lowering blood pressure, since he doesn't know anything about rasagiline.
Anyway, that's the story as best I can tell.
Tex
P. S. Yes, Rosie, I remember you trying to talk me out of taking this stuff. I just wish that one of us would have come across some of these red flags, at the time.
Well, actually, I never did feel bad, the only symptom I had was dry mouth, but that's what tipped me off, and caused me to check my blood pressure. Actually, this started yesterday, after lunch, and that's when I started monitoring my BP. I don't recall ever having that dry mouth problem before, except on one occasion, (unless, of course, I'm actually dehydrated, and simply need to drink water). That occasion was when I had the TIA, last July. Even though all sorts of thoughts were running through my mind on that morning, I kept noticing that I had dry-mouth. As you may recall, when I arrived at the ER that day, my systolic blood pressure was a little over 180.
It slowly receded later in the day, but the next day, when I went by my GP to discuss the TIA thing, my BP was back up to 180 again. My right arm, and the right side of my face, (right down to the right side of my tongue), was numb. My right leg seemed to be spared. The ER crew couldn't find anything wrong, but since they couldn't rule it out, they called it a TIA, by default. Over the next day or two, most of the symptoms slowly went away, except that it took over a week for the right side of my face to return almost to normal. The corner of my mouth never did quite return to normal. I have normal muscle control, but it always feels slightly numb.Yesterday afternoon, when I checked it, I discovered that my systolic BP was running from a minimum of 165 to a maximum of 179, and my diastolic pressure was running from about 94 to 100. One time my diastolic reading was 102, and I almost caved in and went to the ER, but it slowly backed off a little so I toughed it out, all the while searching for an explanation. Naturally, I suspected the rasagiline, since there are all sorts of warnings about possible life-threatening BP excursions, if foods high in tyramine, (dried meat, dried fruits, aged cheeses, etc.), are ingested while taking rasagiline. The neuro even warned me about that possibility, however, he didn't mention any other risks. I checked PubMed, and found research that demonstrated that there was no increased risk of an adverse BP event, due to eating an unrestricted diet, so I kind of relaxed, and decided that rasagiline was a relatively safe drug. I hadn't eaten any of those foods recently, though, so I didn't see any reason to suspect food.
http://hyper.ahajournals.org/cgi/conten ... t/52/3/587
To shorten a long story, after running down all sorts of possibilities, yesterday, and finding nothing significant, I decided to check out the antihistamine that I took yesterday morning, (and the day before), to prevent hay fever symptoms from the extremely high level of cedar pollen that we've been having for the past few days. Bingo! Drugs.com shows a list of 625 drugs which are contraindicated with rasagaline, (Azilect).
(Are there any that aren't on the list?) http://www.drugs.com/drug-interactions/rasagiline.html
Why didn't my neuro doc mention this? I'm not surprised that my GP wasn't aware of the risk, because he candidly admitted right off the bat, that he was completely unfamiliar with rasagiline. I wondered why I had never searched for that possibility, before, but, of course, Parkinson's adversely affects memory, also.
A page from the University of Michigan Health System even has this specific warning against the use of acetaminophen, chlorpheniramine, and dextromethorphan:
http://health.med.umich.edu/healthconte ... ype=MultumDo not take this medication if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take dextromethorphan before the MAO inhibitor has cleared from your body.
Acetaminophen, of course is used in Tylenol, and many other combination painkillers. Chlorpheniramine was in the antihistamine that I took, (Chlor-Tripolon), and dextromethorphan is a decongestant, commonly used in OTC cough syrups, and similar meds, (though I haven't used any of that lately, thankfully). All antihistamines are on the list, and virtually all anti-depression meds. What am I doing taking this stuff? Of course, I'm not taking it any longer, but according to the references, it will take 14 days to completely clear my system. I'm not taking any more antihistamines, either, at least not for 13 more days - I'll just put up with the watery eyes, runny nose, and throat congestion, until the rasagiline is completely depleated.
This morning, when I checked my BP, it was 148 over 88, much better than it had been when I went to bed, so I breathed a sigh of relief and drank a Dr. Pepper, in place of a cup of coffee. 30 minutes later, I checked my BP, and it was 158 over 94. I checked the drug list, and sure enough, caffeine is on there, (but only as a moderate interaction). 30 minutes later, the reading was 169 over 112. That's when I headed to the ER, since I've read where a diastolic BP reading of 100, is suggested as a threshold for deciding when to go to the ER. It took me 30 minutes to get there, and about 15 minutes later, when they got me hooked up to the monitors, and checked my BP, it was 225 over 121. It slowly came down, and within about an hour, the systolic reading was down to 160, and the diastolic reading was 90-something, but then it began to go up again, and when I checked out, if I recall correctly, the last reading showed 177 or 178 over 102. It's been up and down, since I got home. A few hours ago, it was down to 151 over 94. Then it went back up to 176 over 102. Right now it's 172/104.
When I first started taking the Azilect, my BP was mostly in the range of 120 to 130 over 70-something. A couple of weeks later, it was in the 110 to 120 over 60-something range. A month or so later, it was back up into the 120 to 130 range, with occasional 140s, (probably when I started occasionally taking an antihistamine, because of ragweed pollen, but I didn't take careful notes, unfortunately). There were also occasional readings below 120, so I decided it was doing OK, and I pretty much stopped checking it regularly.
Of course, I wasn't taking Azalect when I had the TIA, but my pressures were not as high, then, and they settled down much faster. To add insult to injury, Parkinson's disease messes with your blood pressure, too, but usually it causes hypotension, not hypertension. I have a feeling that it's the combination of drugs that's causing the worst part of the problem right now, but who knows? Whatever is going on seems to be serious stuff.
All my electrolytes, EKG, etc., checked out fine, at the ER. In view of the rather high pressure readings, the ER doc couldn't believe that the only symptom I had was dry-mouth. As far as resolving the problem is concerned, he was no help at all, and played down the possibility of drug interaction. He tried to convince me that I simply have chronic high blood pressure. I guess I'll see what happens over the next 13 days, as the rasagiline slowly exits my body.
I reckon I'll check with my GP tomorrow, but I'm pretty sure that he'll just prescribe another drug - for lowering blood pressure, since he doesn't know anything about rasagiline.
Anyway, that's the story as best I can tell.
Tex
P. S. Yes, Rosie, I remember you trying to talk me out of taking this stuff. I just wish that one of us would have come across some of these red flags, at the time.
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
-
Gabes-Apg
- Emperor Penguin
- Posts: 8367
- Joined: Mon Dec 21, 2009 3:12 pm
- Location: Hunter Valley NSW Australia
Gabes-Apg wrote:Why didn't my neuro doc mention this? I'm not surprised that my GP wasn't aware of the risk, because he candidly admitted right off the bat, that he was completely unfamiliar with rasagiline
There in lies majority of our issues............ if we dont double and triple check everything ourselves we pay the price and then like me the other day with my GI specialist, when i do mention some of the details of my research and reading (most of which was links from this beautiful place, he frowned at me and then questioned why i had done so much research!!!
Hope you feel better soon....... it is a constant variable!
Gabes Ryan
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
Hi Tex, I hope you feel much better today and your bp is back to normal and stays there. Sorry to hear about the side effects of your allergy medications.
For what it is worth, I use daily allergy medication, it is called Zyzal brand name and active compound levocetirizine dihydrochlorid. I am taking them for years for a nonspefic nose allergy and they work very well for me and I have no side effect at all.
Hope you will be fine soon again
harma
For what it is worth, I use daily allergy medication, it is called Zyzal brand name and active compound levocetirizine dihydrochlorid. I am taking them for years for a nonspefic nose allergy and they work very well for me and I have no side effect at all.
Hope you will be fine soon again
harma
Hi All,
My pressure was 176/106 this morning. Surprisingly, when I got to my doctor's office, (where blood pressure test results are almost always higher, due to the "white coat" syndrome, I believe it's called), my BP measured 152/102. Another surprise came when he was willing to consider my opinion that I may be experiencing a drug interaction. Rather than reaching for a prescription pad, he suggested that I monitor the pressure for two weeks, and then show him the results, and we'll talk about our options, then. I measured it a few minutes ago, and it was 158/94, so things are looking better.
Of course, last night, I developed a headache, (presumably from the elevated BP), and since I'm unable to take anything for it, (everything is on the "avoid" list for Azilect), today it has turned into a migraine, (complete with nausea), so that kinda sucks. Otherwise, I'm doing better, I think.
Thanks for your concern.
Love,
Tex
My pressure was 176/106 this morning. Surprisingly, when I got to my doctor's office, (where blood pressure test results are almost always higher, due to the "white coat" syndrome, I believe it's called), my BP measured 152/102. Another surprise came when he was willing to consider my opinion that I may be experiencing a drug interaction. Rather than reaching for a prescription pad, he suggested that I monitor the pressure for two weeks, and then show him the results, and we'll talk about our options, then. I measured it a few minutes ago, and it was 158/94, so things are looking better.
Of course, last night, I developed a headache, (presumably from the elevated BP), and since I'm unable to take anything for it, (everything is on the "avoid" list for Azilect), today it has turned into a migraine, (complete with nausea), so that kinda sucks. Otherwise, I'm doing better, I think.
Thanks for your concern.
Love,
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Tex, I'm so sorry to hear that you have been going through this scary crisis with your BP. And yes, I was a bit skeptical about resagiline, but that was on the basis of its mechanism of action, and I never thought to look up drug/food interactions. I now wish that I had thought to do it. To be honest, part of my skepticism was due to the Israeli scientist who was making it look like the fountain of youth! I have had personal experience with Israeli scientists who were very aggressive in promoting themselves and trying to make money off their research than in being entirely truthful. Of course this sort of attitude seems to be widespread in the pharmaceutical business........
Hopefully as the resagiline decreases in your body your BP will get back to normal. Just something to be aware of....... you are suddenly withdrawing the resagiline after taking it for a number of months. Your brain has gotten used to having it, and suddenly stopping might result in some withdrawal effects. The brain seems to be especially sensitive. I say this based on personal experience. I was prescribed clonazepam for restless leg syndrome and took it for several years. It's a benzodiazepine affecting the GABA receptors in the brain and elsewhere. It seemed to stop working after a while, so I decided to go off it. Fortunately I did some web work, and was appalled to discover that it is very difficult to withdraw from because the brain cells adapt in a number of ways to its presence, and getting the brain back to normal is a slow process, even after low doses.
I found a great Forum populated by members that had gotten into trouble because their doctors weren't aware of the effects of benzodiazepines and the importance of slow withdrawal. I spent about 5 months slowly tapering, and it went very smoothly. So if you notice some odd, troubling symptoms, it might be due to your withdrawal.
Take care, Tex, and hopefully you will be able to put all this behind you soon!
Rosie
Hopefully as the resagiline decreases in your body your BP will get back to normal. Just something to be aware of....... you are suddenly withdrawing the resagiline after taking it for a number of months. Your brain has gotten used to having it, and suddenly stopping might result in some withdrawal effects. The brain seems to be especially sensitive. I say this based on personal experience. I was prescribed clonazepam for restless leg syndrome and took it for several years. It's a benzodiazepine affecting the GABA receptors in the brain and elsewhere. It seemed to stop working after a while, so I decided to go off it. Fortunately I did some web work, and was appalled to discover that it is very difficult to withdraw from because the brain cells adapt in a number of ways to its presence, and getting the brain back to normal is a slow process, even after low doses.
Withdrawal symptoms experienced by the chronic therapeutic low-dose benzodiazepine subjects can include dizziness, blurred vision, heart pounding, feelings of unreality, pins and needles, nausea, sweatiness, noises louder than usual, jitteriness, things moving, sensitivity to touch.
I found a great Forum populated by members that had gotten into trouble because their doctors weren't aware of the effects of benzodiazepines and the importance of slow withdrawal. I spent about 5 months slowly tapering, and it went very smoothly. So if you notice some odd, troubling symptoms, it might be due to your withdrawal.
Take care, Tex, and hopefully you will be able to put all this behind you soon!
Rosie
Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time………Thomas Edison
Tex, more on resagiline withdrawal. I found this on wikipedia under MOA inhibitors...........
RosieAntidepressants including MAOIs have some dependence producing effects, most notably a withdrawal syndrome, which may be severe especially if MAOIs are discontinued abruptly or over-rapidly. However, the dependence producing potential of MAOIs or antidepressants in general is not as significant as benzodiazepines. For example, antidepressants have significantly less abuse potential than benzodiazepines. Withdrawal symptoms can be managed by a gradual reduction in dosage over a period of weeks or months to minimize or prevent withdrawal symptoms.
Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time………Thomas Edison
Rosie,
Thanks for that information. Inspired by that, I found some more information along that line:
http://www.rxlist.com/azilect-drug.htm#
Thanks,
Tex
Thanks for that information. Inspired by that, I found some more information along that line:
It may take a long, long time to get all of this stuff out of my system, at that rate. I also found this:After oral administration of 14C-labeled rasagiline, elimination occurred primarily via urine and secondarily via feces (62% o f total dose in urine and 7% of total dose in feces over 7 days), with a total calculated recovery of 84% of the dose over a period of 38 days. Less than 1% of rasagiline was excreted as unchanged drug in urine.
The source for both these quotes is:Withdrawal-Emergent Hyperpyrexia and Confusion
A symptom complex resembling neuroleptic malignant syndrome (characterized by elevated temperature, muscular rigidity, altered consciousness, and autonomic instability), with no other obvious etiology, has been reported in association with rapid dose reduction, withdrawal of, or changes in drugs that increase central dopaminergic tone. [see DOSAGE AND ADMINISTRATION].
Withdrawal emergent hyperpyrexia was not reported in the AZILECT clinical development program.
http://www.rxlist.com/azilect-drug.htm#
Thanks,
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Tex,
Wow, what an ordeal you've been through! Once again, you've been able to determine the cause on your own. I'm very impressed, but not surprised.
It's scary to think that we could unknowingly be taking a dangerous combination of drugs. Even scarier to realize that our doctors don't have a clue.
I hope that you are on the mend and will continue to see your blood pressure approach normal. Whew!
Gloria
Wow, what an ordeal you've been through! Once again, you've been able to determine the cause on your own. I'm very impressed, but not surprised.
It's scary to think that we could unknowingly be taking a dangerous combination of drugs. Even scarier to realize that our doctors don't have a clue.
I hope that you are on the mend and will continue to see your blood pressure approach normal. Whew!
Gloria
You never know what you can do until you have to do it.
So sorry to hear that you're dealing with this and that you get this out of your system soon. We can never be too careful and I'm sure you are more careful than most already. Medication of any kind scares me the more I learn.
Resolved MC symptoms successfully w/L-Glutamine, Probiotics and Vitamins, GF since 8/'09. DX w/MC 10/'09.
Tex, it does sound like withdrawal won't be much of an issue, from what you found out. I did a bit more looking too (inquiring minds want to know), and resagaline is an irreversable enzyme inhibitor, which means that it isn't eliminated from the body until there is turnover of the cells that make it. So basically your body is doing a slow taper on its own, and that's why it takes several weeks to get rid of it. And that's why there hasn't been a withdrawal syndrome observed with it. Most of the newer MAO inhibitors are reversible inhibitors with a much shorter half life, and a resultant much greater risk of withdrawal symptoms. So at least you shouldn't have that to worry about. It sounds like your BP is coming back down, so that's a relief, and further indication that the hypertension is drug related as you think.
Rosie
Rosie
Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time………Thomas Edison