There is no going back. Damage to your nerves by neuropathy is a one way street. Start treating your diabetes while you still can prevent the worst of it.
The journey into becoming a diabetic is one that most of us join without knowing the consequences of what we’re doing. There are a lot opinions out there, even among doctors, as to what actually “causes” diabetes, but pretty much everyone I read knows that diabetes is highly related to obesity and carbohydrate overconsumption. And when I was diagnosed, more than twenty years ago, the information I was given was faulty and at the very least incomplete.
What no one ever said was that if I continued to eat what I thought of as a “normal” amount of carbohydrates and sugar every day, by the time I retired my life would be severely circumscribed, with many symptoms of diabetes and other metabolic syndrome related diseases causing continuing pain, physical exhaustion and emotional distress. I also suffer from chronic fatigue and despite having lost some weight, am still fighting the good fight doing intermittent fasting three days a week for 36 hours.
So what should I have been taught as a younger person, that might have protected me from getting full blown diabetes and other metabolic syndrome diseases.
Eat less carbohydrates. A lot less. On my current low carb high fat diet I keep my carbs below 150 grams a day. Eat even less added sugar. I try not to eat anything with added sugars, and when I do offend I eat very small portions of any sweet at all. Mind you, my appetite for sweet things has pretty much disappeared since I started avoiding them. Stay away from booze. Period. Lots of doctors and dieticians say that a one or two drinks a day is okay. I don’t believe them. Alcohol does similar things to the liver as carbohydrates, without the redeeming quality of providing me with any energy.
Always seek to reduce the amount of starch and sugar, and fill up on natural food if you are going to eat carbs. Eat fruit in season, in your area, and don’t overindulge even in fruit and vegetables.
Try not to get depressed because you can’t have any “real” food. Try to redefine what constitutes a meal, and understand that the meat and vegetables are really enough.
Rain Coast Review Blog author
It turns out that the best advice anyone can give anyone about diabetes is really simple – eat less carbs, fast intermittently, and exercise moderately as much as possible.
Starting today, January 6, 2020 It is my stated intention to achieve a BMI goal of 25% during the current calendar year.
Later in the afternoon
I started working on my blog earlier this afternoon, but was interrupted by a request from a family member for a ride from Burnaby, where I currently work, home to Langley. But I’m back at it now, and would like to upgrade my resolution to include a little more detail about this pledge, seemingly coming out of the blue.
I started doing intermittent fasting in July last summer, and promptly lost 35 pounds before the end of November, fasting for three days a week, 36 hours each on Monday, Wednesday and Friday. Pretty good results although most of the weight was lost in the first 60 days, and only a small amount during the last 60 days. In the last month I’ve pretty much given back ten pounds or so, depending on the time of day I weight myself.
Until Christmas holidays began I didn’t miss a single fasting day in my schedule, although I did start to cheat a little by eating Keto friendly pepperoni sticks and cheddar cheese sticks after a minimum of 24 hours into my fast. Checking my glucose levels shows me that the advisors are correct, and eating those two things, even combined, doesn’t raise my blood sugar at all, or not does having a handful of nuts. However, it does seem to have a negative effect on weight loss so I am going back to a more strict interpretation of fasting, which is eating nothing during the scheduled period.
During the holidays I broke the fast program only on two days, except for the cheating I’ve already mentioned, but my weight fluctuated from 209 back up to 222 and then down again to 216 and then back to 222. It’s amazing to think that I could regain basically 12 or 13 pounds, even attempting to keep my carbs down and no sugar to speak of at all, except for Christmas Dinner. Losing weight and keeping it off is a challenge, that’s for sure.
In addition, because I stalled quite a while before I started to cheat a little, I’m going to increase the length of my fasting period from a three day a week fast, alternative days during the week, to fasting for five days on and then four days off. My current plan, which I started implementing today with Day 1 of my first 5 Day Fast, is designed to kick start my weight loss again, so lose the next 25 to 35 pounds and get a lot closer to my goal of a BMI of 25, which as I said at the beginning of this blog, is my goal for 2020. I’m going to run with this schedule until my weight takes the next step down, past my previous barrier of about 209 pounds where I bounced back up to 222 over the Christmas holidays. .
My weight this morning when I weighed myself was 222.8 so a 25 pound weight loss would get my weight under 200 lbs, for the first time in a pretty long time. At 200 pounds my BMI will be about 31.2 instead of the current 34.8 (222 lbs) or 38.4 (245 lbs) when I started the program in July 2019.
Over the next few days I am going to re-read Dr. Jason Fung’s book the Diabetes Code, and also review his book on intermittent fasting. My own endocrinologist, Dr. Kang at VGH isn’t planning to see me again until about May so I hope my weight is down substantially by then, and my A1C levels at least down to 6.0, but we’ll see about that.
This plan to reduce my BMI to <25 and my weight to <160 is highly purposeful, in that I am attempting to do on my own what Dr, Fung achieves with his patients, a dramatic reduction in obesity and blood sugar levels. In the meantime I’ll continue to take my course in Pain Mastery from the Institute, and report back to my faithful readers my progress and challenges both in my fight against diabetes, and my battle to manage my chronic pain.
For the first time since I started this new lifestyle and intermittent fast, I am feeling a little discouraged. My weight has been fluctuating up and down between 215 and 225 pounds for a week. I thought once it got down to 215 it would stay there, but no. So I looked back at the week, and realize that I haven’t actually done anything inconsistent with my program.
So what is going on? I also notice that my blood readings have been running much higher all week, on fasting days as well as on eating days. What’s with that? Maybe I reduced my insulin too much too soon…. I don’t know but it’s discouraging. A bit. From what I read in the literature about fasting, it is seldom a straight line downwards in weight, and adjusting my insulin every day and every night is a little hit and miss.
Necessarily so, since the body isn’t actually just a machine, but is indeed an organic whole system, which I’ve been messing with for the last three months.
Today was my first day of fasting for this week. And I’m sticking to it, even on the bad days. Tomorrow with be a better day. Maybe not. But a tomorrow will be a better day if I stick to my guns and follow the program.
Hang in there with me, folks. The ride’s a little bumpy!
At the end of another week of three 36 hour fasts, I’m contemplating how much my life has already changed, and how much it may still change, as I continue my fasting and attack on diabetes.
Changing your lifestyle is the first key to beating diabetes
First of all, I currently weigh about 30 pounds less than when I started on the low carb high fat program. Fasting started about two weeks later, after I took the time to consult with my endocrinologist about how to manage my blood sugars during my fasting. We had already switched to two different types of insulin, long acting and fast acting, and I’m using the new meter that tests all day long, so he felt that the risk of a dangerous low could be managed.
Secondly, I now know that fasting isn’t really all that hard, for me. I suspect that motivation is a huge part of this, but fasting seems pretty straightforward to me now. Take care of my insulin and blood glucose levels, otherwise just don’t eat. Anything. Instead of it being hard, it’s been pretty easy, and the results so far are gratifying.
Weighing myself every day has become a lifetime habit. Getting my weight to a better levels is one of the keys to improving my diabetes, blood pressure, arthritis, and many other inflammatory problems and diseases.
I made the change to my lifestyle on July 10, and began fasting near the end of the month. It’s now the end of the first week of September so I’m approach two months into the program. My insulin levels are lower than ever as are my glucose readings. I take half of the prescribed dose of long acting insulin these days, and no fast acting insulin at all on my fasting days, and about three quarters of the previous prescibed dose on my non fasting days.
The biggest concern is keeping my blood sugars high enough not to end up in a coma from hypoglycemia from having too much insulin in my system and lowering my blood sugar too much. In more than 20 years of trying to manage my diabetes low blood sugar was never ever a remote possibility, even after being on insulin, as my blood sugars were always higher than desireable.
I recently made two new holes in my belt to keep my pants from falling down, after moving from the last belt hole at the other extreme. I didn’t measure my waist when I started because I was too embarrassed to admit how big I had become. Now I wish that I had because I’m shrinking fast.
When I started this fast, I told myself that I would stay the course for three months, and then re-evaluate where I’m at then, from a health perspective as well as general feeling perspective. I also said that I would be happy if I were to get my weight under 200 lbs or 90 KG by the end of the 90 days of fasting. Today I weigh 217 lbs, down from 244 lbs on July 10th. I believe that I will achieve both goals, at which time I will commit to the next phase of this program.
I wish I could say that there have been no negative effects of fasting. It’s a little early to make that statement. What I can say is that there haven’t been any, so far.
I’m reinventing myself again. My goal is to eliminate or radically reduce prescription medications for diabetes, and a whole host of inflammatory diseases caused by the same thing that causes diabetes.
Change doesn’t come easily when one is used to surrendering autonomy to the medical profession and simply being the obedient patient. It is NOT SAFE to simply trust that doctors know what is best for us. We already know this, but it is no surprise when we obediently follow their advice. Like everything else in life, you need to check the information out for yourself, and ask a lot of questions.
It seems that diabetes is actually caused by the thing that is supposed to cure it – insulin. In his book, The Diabetes Code, Dr. Jason Fung has coined the word diabesity – combining the words diabetes with obesity, to indicate that diabesity is caused by excess glucose in the body stored as fat, particularly in the internal organs, particularly the liver. There is a cycle in the body, controlled by the liver, that triggers the production of excessive blood sugar and results in insulin resistance.
Too much sugar and the body develops insulin resistance because the body simply can’t absorb any more sugar into the cells. To make matters worse, the medical profession prescribes increased insulin, or even just metformin, which helps the body to try to consume even more sugar.
Dr. Fung’s prescription for the elimination of diabetes is contained in a book called the Diabetes Code. Read it and weep, but understand that it calls for regular fasting to reset the diabetes cycle.
This week I’m seeing my endocrinologist, and am going to be seeking support to follow Dr. Fung’s program. I’m curious as to what he will say.
Will he continue to prescribe insulin, Janumet, and Invokana to address my extreme diabetes? Or will he support a major lifestyle readjustment along with a fasting program to eliminate the disease altogether, eventually? I have already started to substantially reduce my carbohydrates and sugars in preparation for the revised program, and have already lost over 10 lbs in just under ten days.
I started writing about my diabetes and this journey several months ago, when I decided to review the prescription medications and their side effects, as a result of finally getting fed up with being sick, and seeming to get worse and worse and the years roll by.
With the encouragement of my middle son, Don, I began to look at diet as a major issue in my illnesses, as well as my diabetes. Sure, I went to many diabetes dietician clinics years ago when I first became aware that I was a diabetic. They always talked about reducing carbohydrates and sugars, and using diet and exercise to control my weight, and therefore help control my blood sugars.
As noted by Dr. Fung in his book, diet and exercise programs have been a massive failure, all over the world, in controlling or preventing diabetes or obesity. There are many reasons for this failure, but the medical professional continues to support this old and tired cant, that doesn’t actually work. I think the real reason that nobody wanted to actually examine diabetes and obesity with new eyes is that the old views are very profitable, to the pharmaceutical industry, the vegetable oil industry, even the health and diet industry itself.
But you’d have thought that somebody would have noticed that it didn’t work. And finally somebody has.
Anyway. Wish me luck on this new direction in my journey to solve my diabetes, and eliminate the side effects of so many medications by eliminating my need for them at all.
Finally, my wife Katherine has been diagnosed with Type 2 Diabetes in the past month, and has begun the journey through this ugly territory as well. Hopefully we can solve the riddle of the disease for both of us, and she never has to go through the years of pain and agony I am experiencing as a result of having poorly controlled blood sugar for the past twenty five years.
There can be no time more suitable than the present to make
better choices for my future health and well-being. New choices mean reviewing and carefully
considering alternatives not previously pursued, or if previously pursued,
inadequately. In some respects, this
analysis reflects a continuing and necessary re-evaluation based of my current
state of health, not as a snapshot, as it were, but rather as a streaming and
changing set of conclusions and actions based on them. However, this analysis is specifically about
now and the immediate future, with a clear understanding that nothing is ever
completely settled in these issues, and there is new information available on
an ongoing basis.
More simply put – This self-analysis is about resetting how
I go about living my life with due consideration to what I have learned about the
conditions and diseases that currently plague me. How to do better and improve my health for
the future – this is my object.
Much of what will be expressed here rests on certain
persisting patterns of behavior which require significant modification. In other words, I must change if there is to
be any real improvement in my health reality. And based on what I know about
achieving anything of consequence in my life, it will need to be outlined in a
program of specific steps, which depend upon my own actions rather than on
others. My physicians can only provide
me with information and treatment within what I’m willing or able to do
myself. My partner, as supportive as she
has tried to be over the years, is not responsible for any part of this,
despite my tendency to try to lay responsibility at her door particularly for
my dietary habits and lack of blood sugar control.
Frequent urination – especially at night,
interrupting my sleep.
Poor sleep – several things wake me up at night,
variously including frequent urination, frequent cramps in my feet and calves, pain
my shoulders and hips, dry mouth and nasal congestion, sleep apnea, hay fever, and
difficulties breathing.
Chronic pain during waking hours – moderate to severe
pain in my feet, neuropathic pain as well as mechanical distress, including
pain caused by walking on supersensitive soles of my feet, as well as my
toes. Also… periodic moderate pain in my
back and shoulders, and more serious pain in my lower back and hips when
walking more that 1,000 to 2,000 steps.
Periodic breathing problems – mild to severe
asthma on a continuing basis, almost always somewhat symptomatic but much worse
when exercising or physically stressed.
Sometimes exacerbated by emotional stress or conflict.
Chronic physical exhaustion and fatigue – comes and
goes during the day but is worse during periods of relative inactivity (sense
of exhaustion) and during periods of exercise (weakness and muscle fatigue)
Dizziness upon standing – it is sometimes acute
and sometimes minor
Mental fatigue and a sense of a loss of acuity
and sharpness – I am finding it difficult to concentrate on mental tasks which
require the application of my intellectual skills and professional skills. I still feel capable of creative work for
relatively brief periods, but fatigue quickly overtakes me, and I must put
things aside, while I attempt to recover my energies and focus.
Forgetfulness and feelings of anxiety regarding
memory
Visual deficiencies – lately I can only read or
work on the computer for a certain period before my eyes begin to become less
effective, making it necessary for me to interrupt my work or reading, and brake
completely from work that require visual acuity. Eye fatigue contributes to my overall sense
of fatigue and exhaustion. Note: I probably need new glasses, something
I will discuss with my ophthalmologist on Friday when I next visit her.
Rain Coast Review Blog author
Conditions and/or diseases
Diabetes
Slightly elevated cholesterol
Sleep apnea
Asthma and bronchitis (borderline COPD)
Diabetic Neuropathy
Evidence of diabetic damage to my eyes
Fatty liver
Obese
Arthritis in hips, hands, shoulders, lower back
Tendonitis in hands and wrists
Eczema
High and low blood pressure
Allergies to a broad band of common allergens
including pollens, animal dander, dust and others. Anaphylactic reaction to Cipro and Penicillin
I have had recent visits with my family doctor, my Endocrinologist
and my Respirologist (Pulmonologist), plus an upcoming CT Scan in early June at
Burnaby General, and an eye exam this Friday.
I’m clearly a heavy draw on the medical system with all these frequent
appointments to deal with various ailments.
Clearly I’d like to see less of them, and they would like to see less of
me. All we have to do to accomplish this
feat is to improve my health sufficiently so that they wouldn’t need to see me
so often.
Diabetes blood sugar and neuropathy management
Endocrinologist
My most recent visit with my Endocrinologist, as usual, thorough,
with a significant discussion about changing my medications, in particularly,
moving to two different types of insulin every day, with a long acting insulin
injected in the morning with design purpose of bringing my premeal and fasting
insulin down to ideally 7.0mml or below and then having me take fast acting
insulin with each meal, dividing up the insulin between the meals, more or less
based on the prorated amount of food being ingesting at each meal.
In order to manage this much more intensive insulin regime,
it will be necessary for me to check my Blood sugar levels first thing each
morning, as well as 2 hours after each meal.
The goal of the fast-acting insulin is to return my blood sugars to
10mml or below within the two hours.
In order to maintain such a frequent reading of my blood
sugar levels, I need to have a new form of monitor with a patch blood reader
that sends the information to a monitoring device, either my iPhone or one that
comes with the patch. I submitted the
request to Blue Cross two weeks ago and am currently awaiting approval. Note: I
should follow up with them before Friday to make sure they are working on this.
The Endocrinologist wrote me prescriptions for the insulin
and the device, as well as had his assistant prepare the forms for Blue
Cross. Once I have approval, I will need
to deliver these forms to the Pharmacy for processing.
The Endocrinologist and I had a fairly long conversation
regarding various aspects of my diabetes including the need for me to have my
eyes re-examined, thus an appointment this Friday with Chui Luca, my Ophthalmologist. We also discussed my weight gain since being
diagnosed with diabetes with him expressing some thought that while weight loss
would be desirable many type two diabetics in my circumstances find it very
difficult to lose weight while taking insulin.
Not only does insulin contribute to weight gains, but so do Jentadueto
and Invokana my other diabetes treatment medications.
In addition, gabapentin, which has been prescribed for my
neuropathy due to diabetes, also leads to weight gain along with other symptoms
I am experiencing.
The more common side effects
of gabapentin include:
abnormal eye movements that are continuous,
uncontrolled, back-and-forth, or rolling
clumsiness or unsteadiness
constipation
diarrhea
difficulty speaking
drowsiness or tiredness
dry mouth
nausea
vomiting
Talk with your doctor about
precautions you can take for side effects from gabapentin:
Ask your doctor for advice on diet and
exercise to help manage your weight if you are concerned about possible weight
gain from gabapentin.
Don’t drive or operate heavy machinery until
you know you can function normally while taking gabapentin.
Talk to your pharmacist about
over-the-counter medications that can help relieve some of the more common
digestive system side effects.
Gabapentin side effects may
make you want to stop taking the drug. However, don’t stop taking it without
first talking to your doctor.
Stopping gabapentin suddenly
can cause serious problems, such as withdrawal symptoms or the return of
seizures. Your doctor will help you stop taking the drug safely.
Medically reviewed by Lindsay Slowiczek, PharmD on December 20,
2016 — Written by University of Illinois-Chicago, Drug Information Group
Other diabetes
Medications
In addition to the two new forms of insulin, and the
gabapentin for treatment of the diabetic Neuropathy I also take two other
diabetes medicines.
Jentadueto
2.5/1,000 MGs – taken twice daily prior to morning and evenings
meals.
Medical Editor: John P.
Cunha, DO, FACOEP
Last reviewed on RxList
08/28/2017
Jentadueto (linagliptin and
metformin hydrochloride) is a combination of two 2 oral antihyperglycemic drugs
indicated as an adjunct to diet and exercise to improve glycemic control in
adults with type 2 diabetes mellitus when treatment with both linagliptin and
metformin is appropriate. Common side effects of Jentadueto are:
cough,
sore
throat,
sinus
pain,
stuffy
nose,
upset
stomach,
weight
gain,
pancreatitis,
diarrhea,
and
low blood
sugar (hypoglycemia).
Get medical help immediately
if you have severe side effects of lactic acidosis (symptoms include muscle
pain or weakness, numb or cold feeling in your arms and legs, trouble
breathing, dizziness, lightheadedness, tiredness, weakness, stomach pain,
nausea with vomiting, or slow or uneven heart rate.
Jenadueto is available in the
following strengths: tablets containing 2.5 mg linagliptin and 500 mg metformin
hydrochloride or 850 mg metformin hydrochloride or 1000 mg metformin
hydrochloride. The maximum recommended dose is 2.5 mg linagliptin/1000 mg
metformin twice daily. Jenadueto should be taken daily with meals, with gradual
dose escalation to reduce the gastrointestinal side effects due to metformin.
Invokana
300 MG – taken once daily prior to the morning meal.
Medical Editor: John P.
Cunha, DO, FACOEP
Last reviewed on RxList
11/12/2018
Invokana (canagliflozin) is a
sodium-glucose co-transporter 2 (SGLT2) inhibitor used to control blood sugar
in people with type 2 diabetes mellitus, in addition to diet and exercise.
Common side effects of Invokana include:
urinary
tract infections,
increased
urination,
yeast
infections,
vaginal
itching,
thirst,
constipation,
nausea,
fatigue,
weakness,
skin
sensitivity to sunlight,
hypersensitivity
reactions (including skin redness, rash, itching, hives, and swelling),
bone
fractures, and
kidney
problems.
The recommended starting dose
of Invokana is 100 mg once daily, taken before the first meal of the day. Doses
may be increased to 300 mg in patients who are able to tolerate Invokana at 100
mg doses. Invokana may interact with rifampin or digoxin. Tell your doctor all
medications you use.
Asthma and Bronchitis Medications and treatments
After spending 10 days in the hospital in 2016 with severe
pneumonia, when I was discharged my Respirologist at Centrio Medical Centre diagnosed
me with COPD and prescribed three different inhalers to treat the disease.
Spiriva 2.5 mg
Spiriva 2.5 mg – two puffs with morning medications
Medical Editor: John P.
Cunha, DO, FACOEP
Last reviewed on RxList 2/12/2018
Spiriva HandiHaler
(tiotropium bromide) Inhalation Powder is an anticholinergic drug used to
prevent bronchospasm (narrowing of the airways in the lungs) in people with
bronchitis, emphysema, or COPD (chronic obstructive pulmonary disease). Common side
effects of Spiriva HandiHaler include:
Tell your doctor if you have
any serious side effects of Spiriva HandiHaler including:
difficult
or painful urination, or
fast
heartbeat.
The recommended dose of
Spiriva HandiHaler is two inhalations of the powder contents of one Spiriva
capsule, ONCE DAILY, with the HandiHaler device. Spiriva may interact with
atropine, belladonna, cimetidine, clidinium, dicyclomine, glycopyrrolate,
hyoscyamine, mepenzolate, methantheline, methscopolamine, propantheline, or
scopolamine. Tell your doctor all medications you use. During pregnancy,
Spiriva should be used only when prescribed.
Symbicort
Symbicort 200 mg – two puffs with
morning medications and two puffs with dinner medications
Medical Editor: John P.
Cunha, DO, FACOEP
Last reviewed on RxList
1/22/2018
Symbicort (budesonide and
formoterol fumarate dihydrate) is a combination of a steroid and a long-acting
bronchodilator used to prevent bronchospasm in people with asthma or chronic
obstructive pulmonary disease (COPD). Common side effects of Symbicort include:
headache,
throat
irritation,
nausea,
vomiting,
stomach
upset,
diarrhea,
back pain,
stuffy
nose,
muscle or
joint pain, or
changes in
your voice.
Tell your doctor if you
experience unlikely but serious side effects of Symbicort including:
white
patches on tongue or in mouth,
signs of
infection (such as fever, persistent sore throat),
mental/mood
changes (such as nervousness),
trouble
sleeping,
vision
problems (such as blurred vision),
increased
thirst or urination,
muscle
cramps, or
shaking
(tremors).
For patients 12 years of age
and older, the dosage of Symbicort is 2 inhalations twice daily (morning and
evening, approximately 12 hours apart). Symbicort may interact with
antibiotics, antifungal medication, MAO inhibitor, antidepressants,
beta-blockers, or diuretics (water pills). Tell your doctor all medications you
are taking. During pregnancy, Symbicort should be used only when prescribed.
Budesonide passes into breast milk. It is unknown if formoterol passes into
breast milk. Consult your doctor before breastfeeding.
Salbutamol
Salbutamol 100ug – two puffs as required
Medical Editor: John P.
Cunha, DO, FACOEP
Last reviewed on RxList
2/7/2019
Ventolin HFA (albuterol
sulfate inhalation aerosol) is a bronchodilator used to treat or prevent
bronchospasm in people with reversible obstructive airway disease. Ventolin HFA
is also used to prevent exercise-induced bronchospasm. Ventolin HFA is
available in generic form. Common side effects of Ventolin HFA include:
nervousness,
shaking
(tremor),
palpitations,
headache,
mouth/throat
dryness or irritation,
cough,
hoarseness,
sore
throat,
runny or
stuffy nose,
nausea,
vomiting,
dizziness,
sleep
problems (insomnia),
muscle
pain,
changes in
taste, or
diarrhea.
Seek medical help immediately
if you have rare but serious side effects of Ventolin HFA, including:
chest pain
or
irregular
heartbeat.
The dose of Ventolin HFA for
adults and children for treatment of acute episodes of bronchospasm or
prevention of symptoms associated with bronchospasm is 2 inhalations repeated
every 4 to 6 hours. More frequent administration or a larger number of
inhalations is not recommended. For exercise-induced bronchospasm, the dose is
2 inhalations 15 to 30 minutes before exercise. Ventolin HFA may adversely
interact with diuretics (water pills), digoxin, beta-blockers, antidepressants,
MAO inhibitors, or other bronchodilators. Tell your doctor all medications you
are taking. During pregnancy, Ventolin HFA should be used only when clearly
needed. Discuss the risks and benefits with your doctor. It is unknown if this
medication passes into breast milk. Consult your doctor before breastfeeding.
Other Medications Prescribed or recommended
Tecta 40 MG
Medical Editor: John P.
Cunha, DO, FACOEP
Last reviewed on RxList
10/24/2018
Protonix Delayed-Release Oral
Suspension and Delayed-Release Tablets (pantoprazole sodium) is a proton pump
inhibitor (PPI) used for short-term treatment (less than 10 days) of
gastroesophageal reflux disease (GERD) and a history of erosive esophagitis in
adult patients.
Common side effects of
Protonix include
injection
site reactions (redness, pain, swelling),
headache,
nausea,
vomiting,
abdominal
or stomach pain,
diarrhea,
gas,
dizziness,
joint
pain,
weight
changes,
drowsiness,
tired
feeling, or
sleep
problems (insomnia).
The recommended adult dose of
Protonix is 40 mg once daily. Protonix may interact with atazanavir,
nelfinavir, ampicillin, blood thinners, digoxin, diuretics (water pills),
ketoconazole, iron, or methotrexate. Tell your doctor all medications and
supplements you use. Protonix is not expected to be harmful to a fetus. Tell
your doctor if you are pregnant or plan to become pregnant during treatment
with Protonix. Protonix passes into breast milk and may harm a nursing baby.
Consult your doctor before breastfeeding.
APO-atorvastatin 40 mg
Medical Editor: John P.
Cunha, DO, FACOEP
Last reviewed on RxList
4/23/2019
Lipitor (atorvastatin) is a
statin used for the treatment of elevated total cholesterol, LDL,
triglycerides, and to elevate HDL cholesterol. Side effects of Lipitor include:
constipation,
diarrhea,
nausea,
fatigue,
gas,
heartburn,
headache,
and
mild
muscle pain.
Contact your doctor if you
experience serious side effects of Lipitor including:
muscle
wasting and muscle breakdown (rhabdomyolysis),
confusion
or memory problems,
fever,
dark
urine,
increased
thirst or hunger,
drowsiness,
loss of
appetite, or
yellowing
of the skin or eyes (jaundice).
The recommended dose of
Lipitor is 10-80 mg daily. Erythromycin (E-Mycin), ketoconazole (Nizoral),
itraconazole (Sporanox), cyclosporine (Sandimmune), indinavir (Crixivan) and
ritonavir (Norvir) decrease elimination of Lipitor. Lipitor increases the
effect of warfarin (Coumadin) and cholestyramine (Questran) decreases the
absorption of Lipitor. Lipitor should not be taken during pregnancy because the
developing fetus requires cholesterol for development, and Lipitor reduces the
production of cholesterol. Lipitor passes into breast milk and could harm a
nursing baby. Breastfeeding while taking Lipitor is not recommended.
Ramapril 10 MG
Ramipril side effects
Ramipril oral capsule doesn’t
cause drowsiness. However, it can cause other side effects.
More common side effects
If these effects are mild,
they may go away within a few days or a couple of weeks. If they’re more severe
or don’t go away, talk to your doctor or pharmacist. The more common side
effects that occur with ramipril include:
dizziness
or faintness due to low blood pressure
cough
dizziness
chest pain
nausea
vomiting
diarrhea
weakness
or tiredness
Serious
side effects
Call your doctor right away if
you have any of these serious side effects. Call 911 if your symptoms feel
life-threatening or if you think you’re having a medical emergency. Serious
side effects and their symptoms can include the following:
low blood
pressure. This is more common when you’re starting the drug or increasing
doses. Symptoms include:
dizziness
lightheadedness
allergic
or hypersensitivity reaction (angioedema). Symptoms include:
swelling
of your face, lips, tongue, or throat
trouble
breathing
stomach
pain with or without nausea and vomiting
liver
problems (jaundice). Symptoms include:
yellowing
of your skin or the whites of your eyes
stomach
pain
fatigue
swelling
(edema). Symptoms include:
swelling
of your feet, legs, or hands
low white
blood cell count. Symptoms include:
sore
throat
fever
purple
spot on your skin caused by internal bleeding (purpura)
fast or
abnormal heart rate or palpitations. Symptoms include:
feeling
like your heart is fluttering
high
potassium levels. Symptoms include:
weakness
arrhythmia
(irregular heart rate)
worse
kidney function. Symptoms include:
nausea and
vomiting
decreased
urine output when urinating
fatigue
loss of
appetite
Disclaimer: Our goal is to
provide you with the most relevant and current information. However, because
drugs affect each person differently, we cannot guarantee that this information
includes all possible side effects. This information is not a substitute for
medical advice. Always discuss possible side effects with a healthcare provider
who knows your medical history.
Senior dosage (ages 65 years
and older)
As you age, your kidneys may
not work as well as they used to. This can cause your body to process drugs
more slowly. As a result, more of this drug may stay in your body for a longer
time. This increases your risk of side effects. Your doctor may start you on a
lowered dose or a different schedule. This can help keep levels of this drug
from building up too much in your body.
Special considerations
Kidney problems: 1.25 mg once
per day. Your doctor may increase your dose to 5 mg taken once per day if
needed for blood pressure control.
Renal artery stenosis or
dehydration: The starting dose is 1.25 mg taken by mouth once per day. Your
doctor may change your dose as needed.
Dosage to reduce the risk of
heart attack, stroke, or death
Adult dosage (ages 18–64
years)
2.5 mg taken by mouth once
per day for 1 week. Then 5 mg taken once per day for 3 weeks. Your doctor will
increase your dose as tolerated to 10 mg taken once per day.
Rain Coast Review 