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Blood pressure medication comes with cautionary tale

Q: On Jan. 15, my brother experienced an allergic reaction that made his throat and tongue swell. He was rushed to the nearest emergency room, but shortly after he arrived, his airways closed up so the ER staff could not get a tube in for some time.

His wife had brought in his meds, and it was quickly determined that the culprit was the blood pressure pill lisinopril. He had been taking it for four years.

He went into cardiac arrest and was revived but suffered massive brain damage. He died Feb. 8. You might want to warn your readers.

A: We are so sorry to learn of your brother’s tragic death.

Lisinopril is the most commonly prescribed blood pressure medicine in the U.S. At last count, roughly 77 million prescriptions were filled annually.

Although many people do well on this medication, some suffer from a reaction rather similar to your brother’s. It is called angioedema and is characterized by rapid swelling of the face, throat, tongue and airways. Blood pressure drugs called ACE inhibitors (benazepril, captopril, enalapril, fosinopril, lisinopril, quinapril, ramipril) can trigger this reaction, sometimes even after years on the drug.

Anyone who experiences swelling while taking an ACE inhibitor should treat this as an emergency. If angioedema occurs, the drug should be discontinued.

Q: I’ve had a cold and been very stuffed up for several days. I’m in a quandary about treating it.

I’ve read that nasal sprays can cause “rebound congestion” when taken for too long. I’ve also heard concerns about pseudoephedrine pills.

I’d really prefer a natural remedy. Do you know of any that work?

A: A reader reports that Xlear Nasal Spray ( with xylitol has been helpful for nasal symptoms. A study in the journal Laryngoscope (November 2011) reported that nasal irrigation with a xylitol solution improved nasal congestion and sinus symptoms.

Ginger tea can help ease chest and nasal congestion temporarily. Natural supplements such as andrographis, astragalus, elderberry, vitamin D and zinc may help ease cold symptoms. We are sending you our Guide to Colds, Coughs and the Flu for more information about these treatments as well as tips on antiviral medications to treat the flu. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (65 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. Q-20, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: