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Raised BUN, CREATININE on LISINOPRIL, GLUCOSAMINE SULPHATE, OMEGA-3.

Resolved Question:

I have been on the following medication and supplements for 3 weeks:
Lisinopril 10mg/day for blood pressure, omega-3 supplements 4g/day to lower my high triglycerides, and glucosamine sulfate 1500mg/day for knee joint pain.
I did a blood work before and after taking medication and supplements (3 weeks). The BUN and creatinine changed for the worse but triglycerides improved a lot. Here are the numbers before and after:

BEFORE taking Lisinopril 10mg/day and omega-3 supplements 4g/day
Triglycerides - 590
BUN - 13
Creatinine - 1.07
BUN/Creatinine ratio – 12

AFTER (3 weeks period)
Triglycerides - 170
BUN - 9
Creatinine - 1.16
BUN/Creatinine ratio – 8 (low)

I have been asked to double Lisinopril dosage to 20mg/day because my BP, though decreased, was still higher than normal. It was between 140/85 to 150/95 before. With Lisinopril 10mg/day, it went down to between 130/80 to 140/90.

I am concerned about BUN and creatinine because they both changed from the initial blood work. BUN and creatinine were within the normal level during the initial blood work and they changed after taking Lisinopril (10mg/day) and omega-3 supplements (4g/day).

Shall I stop Lisinopril although it did seem to work for BP but I am concerned about BUN and creatinine results. I am 50 years old patientold and weigh 190lbs.

Category: Cardiologist

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Category: Internal Medicine Specialist
 26 Doctors Online

Thank you for your query at DoctorSpring.com

I have gone through your case file, your blood pressure and serum triglycerides are well under control , I would suggest you can continue with tab lisinopril 10 mg and omega 3 supplements.
As far as your s.creatinine is concerned it is still within normal limits and lisinopril is a very good drug for kidney, but you should periodically monitor blood urea and serum creatinine.
Maintain your lifestyle modifications and reduce junk foods.
walk for atleast 4 to 5 kms per day for atleast 5 days in a week.
Eat healthy foods like more of green vegetables and fruits.
Monitor your blood pressure periodically .

Regards
Dr Satish


Patient replied :

Thank you for responding to my initial consultation. I have a couple of questions.
How often should I monitor serum creatinine and blood urea?
And the second question
The second blood work indicated an increase in s. creatinine and a decrease in blood urea after taking 10mg of lisinopril for three weeks. But now, I have been asked to double the dosage to 20mg per day because my blood pressure is still a bit higher that normal (between 130/85 to 140/90). Do you think I should continue with 10mg/day or go to 20mg/day? I am sure 20mg/day will have worse effect on creatinine and blood urea than 10mg. What do you think?
Thank you in advance.


As your blood pressure (< 140/90 )is controlled with 10 mg lisinopril , i would suggest to continue the same and periodically monitor blood pressure and B.Urea and S.Creatinine once in 2 months .In case you are require to the increase the dose in future for the control of blood pressure , then you have to monitor after 2 weeks and if no change ,then once in 2 months.In case you taking and other drugs which may interact with Tab Lisiniopril ,then you check it after 2 weeks.
Maintain low salt diet .
Regards
Dr Satish


Dr. E. Satish Kumar
Category: Internal Medicine Specialist
Experience: 
Fellowship, Cardiology - Tamil Nadu Doctor M.G.R. Medical University - DNB, Cardiology, 2002 – 2005Training in Germany in Complicated AngioplastiesMedical School - Maharaja Krushna Chandra Gajapati Medical college, MBBBS MD, Int Medicine, 1989 – 1999.
Trained in Rota Abalation for treating Calcific coronary artery disease in Japan
Dr. E. Satish Kumar and 4 other Medical Specialists are ready to help you

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