Millions of adults in the United Kingdom taking common blood pressure medications, ramipril and amlodipine, could be experiencing persistent dry coughs and swollen ankles that are often mistaken for other conditions, warned Dr. Amir Khan, an NHS GP and medical expert for ITV.
These two drugs, which work by widening blood vessels to facilitate blood flow, are among the most frequently prescribed for hypertension, with seven to nine million adults in the UK taking medication for high blood pressure. Dr. Khan suggests that some patients may suffer in silence or discontinue their treatment due to these side effects.
According to Dr. Khan, ramipril can lead to the release of bradykinin, a substance that may irritate the airways and cause a dry cough. This symptom can lead to misdiagnosis and unnecessary prescriptions of antibiotics or further medical investigations that yield no results. Similarly, amlodipine can cause fluid leakage into the ankles, a known side effect known as edema, due to its effect on blood vessels.
"If you're suffering with swollen ankles and a dry, irritating cough, it could be your blood pressure tablets. Speak to your doctor. [There are] plenty of alternatives," Dr. Khan advised. Despite these potential side effects, he also acknowledged the life-saving benefits of these medications. The NHS notes that ramipril can help prevent future strokes, heart attacks, and kidney problems, while amlodipine can reduce the risk of worsening angina.
Beyond the dry cough and swollen ankles, ramipril can cause other side effects in approximately one in 100 users. These include dizziness, headaches, diarrhea, vomiting, and skin rash. More serious, though less common, side effects can include yellowing of the eyes or skin, appearing paler than usual, increased bruising or bleeding, frequent infections, and severe stomach pain. Swollen ankles or blood in the urine while taking ramipril may also indicate kidney issues. In rare instances, ramipril can trigger anaphylaxis, a life-threatening allergic reaction.
The NHS states that while side effects can occur, many individuals experience none or only minor ones, and these often improve as the body adjusts to the medication. It was also noted that ramipril has experienced supply shortages, leading to a temporary limit of one month's supply per patient until October 30.
Individuals taking amlodipine should also be aware of potential side effects such as palpitations and facial or neck flushing. Dizziness or tiredness while on these medications may affect a person's ability to drive or operate machinery. More serious complications associated with amlodipine include anaphylaxis, acute pancreatitis (inflammation of the pancreas), and Stevens-Johnson Syndrome, a severe skin reaction. In very rare cases, amlodipine has been linked to heart attacks.
Patients experiencing any concerning symptoms while taking these medications are strongly encouraged to consult with a healthcare professional to discuss potential alternatives and management strategies.