Dear Dr. Roach: About four months ago, my doctor switched me from a combination of 5 mg of amlodipine and 100 mg of Losartan daily (which I’d been taking for several years) to 10 mg of amlodipine only. Things went just fine until very recently, when I started developing some annoying skin problems. I’ve noticed wart-like growths and itchy, small white things that look like skin tags. They bleed when I scratch them, and my whole torso and neck are itchy.
I don’t tolerate antihistamines, so I’m using hydrocortisone cream, which is helpful. Would switching back to my old dosage of 100 mg of losartan and 5 mg of amlodipine help for the time being?
— J.B.
Dear J.B.: Amlodipine is a very commonly used blood pressure medicine. It’s potent and effective for most people. The most common side effect that my patients notice is swelling in their feet and ankles. Although many people worry that this represents organ damage, it’s a pharmacological effect of the blood vessels being so relaxed that they get a bit leaky. It’s due to excess water and salt, and treatment with diuretics is neither necessary nor effective.
I did read of reports of a chronic eczema that was associated with the use of amlodipine, especially in older people. The pictures that I’ve seen published show a symmetrical, usually red and sometimes scaly rash. I can’t speculate on the itchy, small white things, but I did find a few case reports of a psoriasis-like rash in people who take this type of medication.
While it’s possible that these skin changes are due to the medication and were stimulated by the higher dose, my experience with skin changes due to medicine suggests that any dose is likely to cause them, and they don’t tend to be dependent on the dose that you’re taking. A dermatologist has way more experience than I do and the added benefit of being able to examine you, so I recommend seeing one.In the meantime, changing back to your previous medication regimen might help, but if this really is a reaction to the medication, choosing an entirely different alternative to amlodipine will probably be necessary.
Dear Dr. Roach: I read with interest your recent column on the possible pros and definite cons of beer/light beer and sugary/sugar-free soft drinks. I used to drink up to 6 cans of diet cola a day; though, over the past couple of years, I’ve cut back to 1 can per day, sometimes none. I now mostly drink water or tea. However, I very much prefer carbonated drinks, so I wonder if there’s a decreased benefit to carbonated water (which is what I drink) compared to still water.
— S.G.
Dear S.G.: Water, unsweetened tea and coffee are the healthiest choices for beverages. (I’ve recently read that plastic tea bags can release a large number of microplastics into the tea, so I recommend loose tea or paper tea bags.)
As far as carbonated water, the main health risk is to your teeth. The body quickly buffers the acid in carbonated water, so your body’s overall acid-base status stays normal. (Carbonated water is mildly acidic with a pH of about 4.5. Fruit-flavored sparkling water will be even more acidic. Both of these are still less dangerous to your teeth than fruit juices and soft drinks, which have a pH around 3.) However, your teeth get exposed to the acid, which can demineralize the enamel of your teeth over time. Still water is best, especially in between meals.
Readers may email questions to ToYourGoodHealth@med.cornell.edu.
This article originally appeared on The Detroit News: Dr. Roach: Itchy skin tags appear after switching a medication’s dosage
Reporting by Dr. Keith Roach, To Your Health / The Detroit News
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By Dr. Keith Roach, To Your Health | USA TODAY Network
