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On call: Can two medications be worse than one?

February 01, 2006

On call

Can two medications be worse than one?

Q. I was diagnosed with congestive heart failure last month. By now, my breathing is back to normal, and I feel well. My doctor has prescribed several medications recommended for the condition, but he said that since I'm taking Vasotec, I should stop my aspirin. Do you agree?

A. It's a legitimate recommendation. The issue is a possible adverse interaction between angiotensin converting enzyme inhibitors (ACEIs), such as your Vasotec (enalapril), and aspirin. Both drugs have major cardiac benefits, but some studies suggest that aspirin may diminish the benefits of ACEIs in patients who have congestive heart failure. But other studies disagree, and many cardiologists continue to use both medications in heart failure patients.

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