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Prospective trial on captopril-related cough
J Lefebvre1, L Poirier, Y Lacourcière
1Hypertension Research Unit, Research Center, Centre Hospitalier de l'Université Laval, Ste-Foy, Québec, Canada.
The Annals of Pharmacotherapy
|February 1, 1992
Summary
Captopril, a medication for hypertension, can cause a cough in about 7.1% of patients. This cough is usually mild to moderate and may be more common in women.
Area of Science:
- Pharmacology
- Clinical Medicine
- Adverse Drug Reactions
Background:
- Captopril is a widely used angiotensin-converting enzyme (ACE) inhibitor for hypertension.
- Cough is a known adverse effect of ACE inhibitors, but its incidence and characteristics with captopril require quantification.
Purpose of the Study:
- To quantify and characterize the incidence of cough as an adverse reaction to captopril.
- To identify potential predisposing factors for captopril-induced cough.
Main Methods:
- A six-month prospective cohort analytic study was conducted.
- 199 patients with mild to moderate hypertension received captopril 50 mg/d for five months.
- Data on cough were collected through self-questionnaires, interviews, and dechallenge/rechallenge periods, analyzed using Naranjo's algorithm.
Main Results:
- The cumulative incidence of captopril-induced cough over five months was 7.1% (95% CI, 6.8-7.4%).
- 1.0% of patients discontinued captopril due to severe cough.
- Cough was generally mild to moderate, persistent, and resistant to antitussives.
Conclusions:
- Captopril can induce cough in a significant percentage of patients, necessitating awareness among clinicians.
- While not statistically linked to sex, age, or smoking, female gender and concurrent common cold infections may predispose patients to captopril-induced cough.