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Ramipril

10 replies

Tryingtofindaway · 31/10/2025 14:11

I’m trying to understand something about my uncle’s treatment. He’s like a dad to me and it’s just me a sibling and our Aunt.

He is late 80s with heartfailure (diagnosed maybe 6/7 years ago and was told it was mild), he has mild Alzheimer’s and an enlarged prostate.He also has a pacemaker.

He’s not been doing too well recently. He was catheterised and he’s not taken too well to it.

My query is is about breathlessness that he has experienced for good number of years. Which we assume is to do with the hearfailure. In fact the doctors told us as much.

He has 1.25 of ramipril every day.
He also takes apixaban, Tamsulosin and furosemide. He takes something for Alzheimer’s too but I’m not sure what.

Can the rampiril not be increased to reduce the breathlessness?

Ive got no idea, but I just keep thinking in this day and age, surely there is something they can give him to help. So even if the rampiril doesn’t help it, isn’t there something else that can?

His O2 when monitored (they gave one of those finger machines at home) is always 96, 97, 98, 99. Even when he is short of breath.

He is overweight - he has a big stomach and always (last 25 years), has done. But he doesn’t move a lot because of the breathlessness.

I realise no one lives forever. And when the doctor came in a couple of weeks ago, they shared the Respect form with us to complete. (My uncle does not, under any circumstances, want to go into hospital). I’m not looking for s miracle, just for him to be comfortable.

He still, mostly, gets up, washes or showers with help and comes down stairs. Sometimes he does stay in bed. When down stairs, he mostly sits in a chair. He still chats about stuff on the tv and sometimes reads his newspaper. But he doesn’t go out (recent thing) and naps quite often. (He says he is shattered.) His eating and drinking is up and down.

Is there anything they can give for breathlessness? When we’ve mentioned it to GP, they haven’t suggested anything. More so looking at the whole person, iykwim, rather than treating a symptom. Cheers

OP posts:
zipadeedodah · 31/10/2025 14:14

He might be a suitable candidate for oxygen. as his physician

Tryingtofindaway · 31/10/2025 14:25

zipadeedodah · 31/10/2025 14:14

He might be a suitable candidate for oxygen. as his physician

Even though his oxygen is generally above 95/96 on the oxygen finger monitor?

OP posts:
ChocHotolate · 31/10/2025 14:28

What makes you think it is the ramapril which needs increasing?

zipadeedodah · 31/10/2025 14:43

Tryingtofindaway · 31/10/2025 14:25

Even though his oxygen is generally above 95/96 on the oxygen finger monitor?

yes because he's still breathless.

Have you tested that the oxygen finger monitor is working properly?

Musicaltheatremum · 31/10/2025 14:47

His oxygen levels are good so that wouldn't help as his breathlessness isn't causing low oxygen levels. Assuming the monitor is working
We don't know what his kidney function is like so this may prevent the ramipril from being increased.
If he's overweight and doesn't do much excersise then he will be deconditioned and no drugs will help.
The breathlessness is probably multifactorial and can be very difficult to treat.
Has he been seen by a care of the elderly specialist. They may shed some light but it's often a very difficult problem to treat.
Also, it was diagnosed 7 years ago and said to be mild but it will probably have progressed in that time. Would benefit from either care of the elderly or heart failure team review to optimise treatment. But sometimes it's just everything wearing out.

Greybeardy · 31/10/2025 14:49

Home oxygen is really unlikely to help - very occasionally it is used for palliative care for people with normal sats if there's nothing else to tweak, but am not sure there's great evidence for it working. Sometimes just an ordinary fan can help with the sensation of shortness of breath...may be worth trying if he has one and there's nothing medical to tweak. This really is bread-and-butter GP medicine and if they haven't managed to come up with any ideas there probably aren't any great solutions. Polypharmacy and multiple co-morbidities in older folk are really tricky. Ramipril is great, but comes with some really significant risks. Sometimes tweaking the diuretics can help a bit but not always. If he's on apixaban because of AF then it's worth making sure his heart rate is well controlled because if he's going fast that'll make him feel grotty. People in their late 80s with heart failure often have a degree of renal failure and that can limit what you can do with drugs. Being overweight (assuming it's fat rather than fluid) won't be helping (because he will be using more energy to do everything), but frankly going on a diet in you late 80s seems miserable for pretty limited benefits. There will also be a degree of deconditioning from being sedentary. Presumably he had some bloods done when the catheter went in, so it may be worth double checking there was nothing daft on those that could be improved. If he can still wash and dress himself and get up and down stairs he really is doing pretty well - there's an awful lot of folk his age who can't do anywhere near so much. Difficult situation...

Tryingtofindaway · 31/10/2025 14:50

ChocHotolate · 31/10/2025 14:28

What makes you think it is the ramapril which needs increasing?

I don’t, which is why I asked.

OP posts:
blackwhitepink · 31/10/2025 14:51

Why do you think Ramipril would help with breathlessness?

Tryingtofindaway · 31/10/2025 14:52

zipadeedodah · 31/10/2025 14:43

yes because he's still breathless.

Have you tested that the oxygen finger monitor is working properly?

I see. It appears to be working. Batteries were changed not long ago and we all “have a go” and it works on us too. I think!

OP posts:
Musicaltheatremum · 31/10/2025 14:52

Tryingtofindaway · 31/10/2025 14:50

I don’t, which is why I asked.

It's a very reasonable question as it's a heart failure drug but can't be increased if poor kidney function or if his BP drops with it. A poster up thread made some valid points @Greybeardyupthread

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