Are you coughing?
Could Lisinopril be causing this cough?
This video will examine what’s causing the cough and how you can get rid of it.
Coming Up!
A persistent dry cough has been associated with ACE-Inhibitors.
Doctor I thought you are going to talk about Lisinopril and one of its most common and
annoying side effects.Well, Lisinopril is an ACE-Inhibitor.ACE-I stands for angiotensin
converting enzyme inhibitor.Here are examples of other ace inhibitors and
they have been associated with a cough as well.In studies the numbers range from 5-20%
and popping up on your screen are different studies looking at this ACE-inhibitor cough!
What are the characteristics of the ACE-inhibitor cough?
IT is dry.
It is hacking.
And often persistent, and annoyingly bothersome
What causes the Lisinopril (ACE-Inhibitor) cough?
Like I mentioned before Lisinopril is an ACE-Inhibitor. It blocks an enzyme
called a Angiotesin converting enzyme. In this way
it prevents the conversion from AT1( Angiotensin 1) to AT2(Angiotensin
2).Because of this ACE-inhibitors relax and widen your blood vessels. This lowers
your blood pressure and makes it easier for your heart to pump blood around your body.
Unfortunately, as this is happening because AT2 is being blocked by Lisinopril another substance
builds up in your body called bradykinin and a couple of other substances which I’m
going to list here( Substance P, thromboxane, prostaglandins). All of these substances can
build up in your airways causing an inflammatory reaction as well as a constriction of your smaller
airways(bronchoconstriction).This is what you are feeling right now.
That annoying, persistent and bothersome tickly feeling at the back of your throat
What are other features of this cough? Who is at risk?
It is more common amongst women than men. It can happen within a couple of weeks
after you start treatment with Lisinopril or other ACE-Inhibitors.
Sometimes this is delayed, and you may develop symptoms after a couple of months
or with some individuals after years. This study looked at a “ high prevalence
of this cough in Chinese.This study showed an unusually high percentage ( 44%) with a cough.
If you are an asthmatic, you might be more affected especially if Lisinopril
causes a narrowing of your smaller airways.
I have a cough. What can I do? These are the six tips!
1) You can be switched to another class of medication called an ARB.(Angiotensin receptor
blockers). An example of an ARB is Losartan. This group of medications are comparable
to ACE-inhibitors and have a lower rate of cough.
If you are interested in a video comparing Lisinopril and Losartan check this card out.
2) Your doctor or your health care provider can stop your medication and the symptoms should resolve within a couple of days.
Usually within a week your symptoms should start improving. Other individuals it might take longer
and with others the cough lingered on for up to 3 months.
3) Sometimes your doctor might want to rechallenge you with another ACE-inhibitor. However,
these have been associated with a high rate of re-occurrence of this cough.If you are finding
values in this video don’t forget to like, comment and subscribe.Back to the video.
4) There is some data to suggest that drugs such as Baclofen, Aspirin or even Indomethacin
may help suppress the cough. I am very hesitant about suggesting this.
One thing you are treating a side effect of a medication with yet another medication. Secondly
medications such as Indomethacin or other NSAIDs are associated with renal problems
and can contribute to higher potassium levels. 5) Depending on your constellation of
co-morbidities your health care provider might want to switch you to another class of blood
pressure medications. They usually would fall into one of the following categories: beta blockers,
thiazide diuretics or calcium channel blockers. 6) Another possibility would be to use a lower
dose of the ACE-inhibitor. This might be an alternative especially if your
health care provider believes the medication believes that the medication is helping manage
your co-morbidities such as hypertension or heart failure. Nonetheless, you still might
experience side effects as these side effects are not dose dependent.
If you are interested in other videos click right here, or here.