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Can a heart patient take sleeping pills?

Answered by: Dr Chandra M Gulhati

Editor, MIMS, New Delhi

Q. I am a 57 years old diabetic man who had a heart attack 10 years back and had an angiogram done 2 years back. I am taking Glycomate 500 mg, Monotrate 20 mg, Betaloc 2.5 mg, Amxide, Autofit 40 mg, Aspirin 75 mg for the last 10 years. There are 5 blocks in the vessels; the main vessel had 80% block with other multiple blocks with a lower percentage. Nowadays I get chest pain during walks, while travelling long distances and while lifting heavy things. I am not getting good sleep so I take Trika 2 mg sleeping pills. Can a heart patient take such pills? Please advise.

A.  Since you are suffering from diabetes, drugs belonging to betablocker class such as Betaloc (metoprolol) should be avoided. It is known that such drugs precipitate diabetes or make it worse. The fact that you get chest pain during walking and angiogram showed blockade, there is definitely an element of angina for which Monotrate (isosorbide-5-monotrate) has been prescribed. Its effect is for short duration; hence you can take the same drug sold under the brand name of Monocontin Continus 25mg, which can be taken just once a day with long duration effect. Amixide is the brand name of a combination product that contains chlordiazepoxide and amitriptyline. Chlordiazepoxide is for short-term treatment of severe or disabling anxiety to be taken for very short duration, say 5-7 days. Amitriptyline is for major depression. You have made no mention of either suffering from severe anxiety or major depression. Hence I do not know the reasons of prescribing this product. Trika contains alprazolam and it is very similar to chlordiazepoxide. It is not rational to take Amixide and Trika concurrently. The risk of dependence (addiction) increases when you take two addiction prone drugs together. The two drugs should not be taken concurrently. Autofit is not an approved allopathic product since it does not appear on the databank of quality medicines.

A.  Since you are suffering from diabetes, drugs belonging to betablocker class such as Betaloc (metoprolol) should be avoided. It is known that such drugs precipitate diabetes or make it worse. The fact that you get chest pain during walking and angiogram showed blockade, there is definitely an element of angina for which Monotrate (isosorbide-5-monotrate) has been prescribed. Its effect is for short duration; hence you can take the same drug sold under the brand name of Monocontin Continus 25mg, which can be taken just once a day with long duration effect. Amixide is the brand name of a combination product that contains chlordiazepoxide and amitriptyline. Chlordiazepoxide is for short-term treatment of severe or disabling anxiety to be taken for very short duration, say 5-7 days. Amitriptyline is for major depression. You have made no mention of either suffering from severe anxiety or major depression. Hence I do not know the reasons of prescribing this product. Trika contains alprazolam and it is very similar to chlordiazepoxide. It is not rational to take Amixide and Trika concurrently. The risk of dependence (addiction) increases when you take two addiction prone drugs together. The two drugs should not be taken concurrently. Autofit is not an approved allopathic product since it does not appear on the databank of quality medicines.

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