I was all set to submit a witty, incredibly well-written, and judgmental article when life went and got all serious on me. Yesterday, I ended up in the emergency room due to an allergic reaction to lisinopril called angioedema. Of course, I had no idea that it was related to lisinopril at that time, and like most people do in situations like this, I was reaching for anything I could think of as to why my right-side profile looked less like sexy AF Skip Hill and more like Rocky Dennis.
I am typically not the type of person that runs to the hospital for any little thing that happens to me. Basically, I’m a guy, and guys for the most part tend to for some reason wait until they are on their deathbed before going to the hospital. My situation is a little different in that I live roughly 40 minutes from the closest hospital, and with the situation I found myself in, I was concerned that the swelling might get to my tongue and/or throat. Though I’m not the sharpest tool in the shed, I knew the potential for this to turn serious was looming.
To give you an idea of what I was experiencing, I went to bed fine after an uneventful day. I had a normal workout and ate my normal foods that I always eat; nothing was out of the ordinary. Because I work very late at night, I went to bed about 5 AM and woke to use the bathroom around 9:30 AM and noticed that my right lip felt tight — much like if I was getting a cold sore. Because I have been under a bit of stress lately, I assumed that was what it was, gave it no more thought, and went back to bed. When I woke at 12:30 PM (I work very late so I sleep late as well), the entire right side of my face from the bottom of my eye, through my entire right cheek and both lips (only on the right side), were incredibly tight. When I looked in the mirror, I was horrified at what I saw and knew something was very wrong.
My wife was home—which is quite uncommon—and she didn’t help to soothe my concerns much when she responded that I looked like shit and needed to go to the hospital ASAP. Leave it to Mrs. Skip to keep me calm. At this point I was concerned that I had either had a reaction to something I ate or the Copenhagen had somehow caused a tumor in my mouth overnight. Listen, I can’t be the only one that reaches far and wide with absurd ideas to explain something that is out of the ordinary.
I agreed to go to the emergency room, took two outdated Benadryl tabs, and left the house in about 15 minutes.
The long and short of it is that the doctor thought it was from lisinopril and that I needed to stop taking it immediately. They wanted to give me IVs with a corticosteroid and Benadryl, but in this day and age, people who actually have good credit and pay their bills have to balance out whether staying in the ER for five more hours and being charged exorbitant fees for drugs administered intravenously is a better option than just getting a script for the oral versions and leaving in 30 minutes. It is a sad state of affairs when you have pretty good insurance and still have to make decisions like this, but I digress.
I got the hell out of there as fast as I could, due primarily to the swelling going down in response to the antihistamine that I was given.
I have learned a lot about the relationship between lisinopril and angioedema in the last 24 hours. Though an estimated six million people have used or use lisinopril, only a very small percentage of them have this reaction. Women are more likely to have this condition and African-Americans have an even higher risk of having this condition (cue jokes about my tan here).
Even though only a small percentage of people have this condition, it should be noted that approximately one third of all angioedema cases seen in the ER are related to lisinopril or other ACE inhibitors.
Bug bites or even food allergies can also cause angioedema, but I eat the same foods daily (like most of us do) and at 47-years old my doctor agreed that it would be unlikely for me at my age to have all of a sudden developed a reaction to the foods I eat. I also had no known insect bites, though they agreed this could not be ruled out entirely. It is difficult to pin down exactly what caused this reaction, but it did seem likely that it was caused by the lisinopril.
I am not writing this article for sympathy; I am writing this article because if I was unaware of the potential reaction, there are probably a lot of you that are unaware as well. Lisinopril is a very commonly used drug and I think most people are not aware of the potential life-threatening effect that this situation can create. Swelling of the lips and cheek is not life-threatening, but I could feel the swelling progressing to the left side of my lips and face, and had it gotten to my throat or tongue—which often happens when this situation goes untreated—it could have had dire consequences with my breathing slowly being cut off.
As much as the lisinopril was controlling my slightly high blood pressure (of which I have had almost all of my life), I have stopped using it and will be looking for an alternative. If you ever experience these symptoms and are using an ACE inhibitor, I implore you to not ride it out by taking an antihistamine and thinking it will go away, because sometimes this situation is non-responsive to antihistamines. Get to the hospital right away, because being intubated was not something I wanted to have done on a beautiful, Colorado Thursday afternoon. I was lucky that I responded to the antihistamine (and prednisone), and even luckier that it wasn’t related to Copenhagen. I couldn’t get to the car fast enough to put in my first rub of Cope for the day. We all have our vices. Just Sayin’.