People taking several widely prescribed drugs, such as ibuprofen for pain relief, ramipril to manage high blood pressure, and metformin to control blood sugar levels, have been advised to temporarily pause their medication if they develop particular symptoms. A pharmacist has outlined the essential guidance for patients using these medicines when encountering warning signs.
Ramipril, an ACE inhibitor prescribed primarily for treating high blood pressure, managing heart failure, and protecting the heart or kidneys after a heart attack, is widely used across the UK. Metformin is another commonly prescribed medication, mainly for controlling elevated blood sugar in individuals with type 2 diabetes.
Anil Sharma, a Committee Member and Regional Representative for the East of England at Community Pharmacy England, explained the NHS’s recommendations during an exclusive interview this week. He highlighted a “48-hour rule” advising patients to temporarily halt certain medications if they experience a stomach bug that causes three key symptoms: severe vomiting, diarrhoea, or a high fever.
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As we enter the colder months, the risk of contracting stomach bugs such as norovirus increases. These illnesses can cause dehydration through symptoms including vomiting, diarrhoea, and fever, which may lead to sweating, shivering, and reduced fluid intake.
Certain medications place additional strain on the kidneys, particularly when the body is dehydrated. Temporarily suspending these drugs during illness may help prevent serious kidney complications.
The NHS advises that while pausing some medicines during a dehydrating illness can be beneficial, patients should always seek professional advice from their GP, pharmacist, or NHS 111 before stopping any prescribed medication. Abruptly discontinuing certain treatments can worsen underlying health conditions.
According to the health service, taking some medications when dehydrated or very unwell increases the risk of severe side effects affecting the kidneys. To reduce this risk, the NHS recommends temporarily stopping the following medications during periods of illness that cause dehydration:
- ACE inhibitors and ARBs: drugs ending in “-pril” or “-sartan”, such as Lisinopril, Ramipril, Candesartan, and Losartan. Used for high blood pressure and heart conditions.
- Entresto (Sacubitril/Valsartan): combines an ACE inhibitor and ARB, prescribed for heart conditions.
- Diuretics (water tablets): including Furosemide, Spironolactone, Eplerenone, Bendroflumethiazide, used for fluid retention, high blood pressure, and heart issues.
- SGLT2 inhibitors: medications ending in “-flozin”, for example Dapagliflozin, Empagliflozin, and Canagliflozin, used for diabetes and kidney or heart disease.
- Metformin: a diabetes medication.
- Sulfonylureas: such as Gliclazide, Glimepiride, Glipizide, for diabetes.
- GLP-1 agonists: including Tirzepatide, Semaglutide, Liraglutide, used for diabetes and weight loss.
- NSAIDs: anti-inflammatory painkillers like Ibuprofen, Naproxen, and Diclofenac.
Patients are advised to drink plenty of clear fluids in small, frequent sips while unwell. Medication can typically be resumed after 24 to 48 hours of normal eating and drinking.
If illness persists beyond 48 hours or medication has been stopped for more than five days, patients should seek advice from their GP or pharmacist. It is crucial to verify medication management with a healthcare professional to prevent complications.
For any uncertainties or concerns, contacting a GP surgery or NHS 111 will provide guidance related to symptoms and medication use.
Urgent medical attention should be sought if the following symptoms occur:
[Note: The original article ends here without listing these symptoms.]