Med Question

[Miraclex2]

Hi Dr Fett

I know that you prefer to use coreg as a BB in ppcm . Is there a diference in Ace inhibitors and in what they do for cardiac function in ppcm . Just curious . I am on Benazepril 5mg daily ,but I notice many peolpe on elanapril or lisinipril

[JAMESFETT]

Those ACE-inhibitors are equally effective. Titer up to max as needed and worked out with your cardiologist. Poverty in Haiti forced me to use captopril, the oldest and cheapest of the ACE-inhibitors; but captopril would not be my choice because it requires 2 to 3 times daily dosing, and has more side effects.

James

[Miraclex2]

Thanx for the quick response Dr Fett. What is the max that one can aim for with Benazepril. I have been on that dose since diagnosis . Do you think it is because of my low BP issues . Is it better in such circumstances to rather increase the coreg as high as tolereted . By the way I am so excited I have an appointment with Dr Felker next week . I read in one of your other responses that he was one with experience in ppcm

[JAMESFETT]

Good, glad you are going to see Dr. Felker. He has broad knowledge about the causes of dilated cardiomyopathies, including PPCM. I don't use benazepril so will let you work that out with your physician. The ACE-inhibitors I work with are: captopril 6.25 to 50 mg 3x/day max; enalopril 2.5 to 20 mg 2x/day max; ramipril 1.25 to 5 mg 2x/day max; lisinopril 2.5 to 40 mg daily max; quinapril 10 to 40 mg 2x/day max.

James