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Summary
Persistent dry cough is an unusual side effect of captopril and enalapril. Five patients experienced severe cough, which resolved upon drug withdrawal and recurred upon re-challenge, suggesting a causal link.
Area of Science:
- Pharmacology
- Adverse Drug Reactions
- Respiratory Medicine
Context:
- Captopril and enalapril are angiotensin-converting enzyme (ACE) inhibitors.
- ACE inhibitors are commonly prescribed for hypertension and heart failure.
- A persistent dry cough is not a widely recognized adverse effect of these drugs.
Purpose:
- To report a series of patients experiencing persistent dry cough potentially linked to captopril and enalapril.
- To investigate the causality between ACE inhibitor use and severe dry cough.
- To explore potential mechanisms underlying this adverse reaction.
Summary:
- Five patients presented with severe, persistent dry cough attributed to captopril or enalapril.
- Discontinuation of the offending ACE inhibitor led to rapid and complete resolution of the cough.
- Re-challenge with the drug in some cases induced the recurrence of the cough, confirming the association.
Impact:
- Highlights a rare but significant adverse effect of captopril and enalapril.
- Suggests that clinicians should consider ACE inhibitors in the differential diagnosis of persistent dry cough.
- The findings may prompt further research into the specific mechanisms, possibly involving bradykinin and prostaglandins, contributing to this cough reflex.