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Cough associated with captopril and enalapril
British Medical Journal (Clinical Research Ed.)
|June 13, 1987
Summary
Cough is a common adverse reaction to captopril and enalapril, particularly in women. This severe side effect often necessitates drug withdrawal, though recovery is rapid and without long-term issues.
Area of Science:
- Pharmacology
- Adverse Drug Reactions
- Postmarketing Surveillance
Background:
- Cough is a known side effect of angiotensin-converting enzyme (ACE) inhibitors.
- The New Zealand Intensive Medicines Monitoring Programme collects data on adverse drug reactions.
Purpose of the Study:
- To review reports of cough associated with captopril and enalapril.
- To characterize the incidence, severity, and patient demographics of this adverse reaction.
Main Methods:
- Retrospective review of 33 captopril and 26 enalapril adverse event reports.
- Analysis of patient data, including sex, dosage, and treatment outcomes.
Main Results:
- Cough was confirmed as an adverse reaction, occurring even at low doses.
- Women predominated in reported cases, and the reaction was more frequent with enalapril.
- Drug withdrawal led to rapid symptom resolution without long-term sequelae.
Conclusions:
- Cough is a significant adverse effect of captopril and enalapril, necessitating careful monitoring.
- The reaction's pathogenesis remains unclear, with bradykinin and prostaglandins as potential mediators.
- Early identification and discontinuation of the offending drug ensure favorable patient outcomes.