Any GPs or Pharmacists who can advise on my DM's medication?

[MeMumsMedicine]

I would really appreciate any advice anyone appropriately qualified can offer. My DM, aged 76, has been on the following list of medication for the last few years.

Atenolol – 50mg
Bendroflumethiazide – 2.5mg
Ezetimibe – 10mg
Lercanidipine – 20mg
Ramipril – 10mg

It all started when she was diagnosed with borderline high cholesterol and prescribed medication about 10 years ago by a long since retired GP rather than him trying to get her to reduce it through a change of diet. She then developed side effects from that medication which showed she was borderline Type 2 diabetic despite a very healthy diet and being active, which has been recognised through studies, and was then put on medication for that. Another GP has said that she should never have been put on either medication but it's a bit late to do anything about that.

Since then she has been on all this medication and has developed incredibly painful arthritis in her feet and ankles. Some days she can't walk and ended up having a fall on Christmas Eve.

Her current GP won't presribe her any anti-inflammatories or pain killers due to the above list of medication that she's on. I've checked the NICE guidelines and I can't see any contraindications for pain medication. She tells her to take paracetamol which doesn't even touch the pain she's in. When I saw the same GP with an arthritic flare up with my knee I was given super strength co-codamol tablets.

Does this mix of medication look right? And is there any clinical reason why my DM's excrutiatingly painful arthritis can't be treated? She's close to becoming housebound which is both terrifying and depressing her. She's got a medication review with the GP in January, which I'll be attending, so I just want to be better informed as to what the best course of action might be, if anything.

Any help would be greatly appreciated.

Anti-inflammatories are relatively contraindicated with that combination of medication (esp in older folk) due to the risk of renal/cardiac failure.

There is probably more going on than your Mum has either understood/decided to tell you as that combination of tablets is treating more than just high cholesterol. If your mum is happy for you to attend it’s probably best to ask the GP for more details at her next review as they will have the benefit of the results of examination/bloods/anything else she’s had done rather than a bunch of us randoms on the internet attempting to interpret what may be quite a complicated bunch of risks/benefits.

Not a pharmacist or clinician, but my DH has recently been diagnosed with Type 2 diabetes and has also been put on statins for cholesterol as the GP said it can be high with diabetes. I don't think your mum is on a statin though, sorry to hear about her recent fall as well - it does knock your confidence.

Agree with the above poster that it's sometimes how the medicine is broken down by the body (liver/kidneys) that can cause an issue.

Does your mum know that you intend to attend her next medication review?

Thank you. I think it's more not listening, not understanding as she's very open about her appointments and conversations with the GP.

And I know it's more than high cholesterol. My DM has told me what all the medication is for and I've read all the relevant NICE guidance.
I'm just worried about her GP's reluctance to treat her current medical condition which is seriously affecting her quality of life. I honestly don't know which should come first. She is desperate to be able to walk again without pain and get out and about and cares less about her blood pressure and high cholesterol. I just want to keep her alive and well and happy.

And you're not randoms, you're professionally qualified people. I was just asking if anything looked a bit out of kilter. I do appreciate the advice though, thank you.

Hi Sass yes, she does. I wouldn't dare attend without her permission! The fall she had scared her though and by her own admission she hasn't been clear enough with the GP as to just how difficult she is finding it to walk and stand at the moment. She's of the 'just get on with it' generation which doesn't do them any favours.

She's not currently on a statin but she was for a few years before they changed it to Ezetimibe instead. It does much the same thing though.