1. Moreover, in a large pooled analysis of 27,492 patients randomized to receive perindopril, the incidence of ACEI-induced cough was 3.9%, and only 3.1% of patients discontinued treatment due to cough. Ann Pharmacother. The patient experienced cough 3 days following the initiation of losartan treatment.The cough continued in this patient for the 2-week dura atio on of lo osarta an treatm ment; however, 1 week after substitution of losartan with enalapril (22.5 mg/dd),the cough resolved completely. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. cough, elevated potassium levels, low blood pressure, muscle or bone pain, and ; rash. Introduction: Cough is an adverse event associated with the angiotensin-converting enzyme (AA inhibitor drugs. Case summary: A 23-yyear-oold, nonsmoking white woman, weighing 73.55 kg,ACE inhibitor naive (before admission),presented to the emergency department at Imam Referral Hospital,Tehran, Iran,with hypertension,proteinuria, and hyperlipidemia.The patient was admitted to the nephrology ward.She was prescribed hydrochlorothiazide 12.55 mg/dd, furosemide 20 mg BID,and simvasta atin 20 mg/dd. Cough induced by losartan with resolution after substitution with enalapril. 0000046856 00000 n The mechanism of ACE inhibitor-induced cough is not precisely known, although it may involve increases in bradykinin, prostaglandins, thromboxanes, and/or substance P [ 66,67 ]. 0000020199 00000 n ARBs cause cough less frequently than ACE inhibitors. startxref ACE inhibitor-induced cough is believed to be related to the accumulation of bradykinin,substance P,and prostaglandins resulting from the inhibition of ACE.Angiotensin-receptor blockers (AARBs) do not have any effect on ACE and theoretically might not cause cough. 0000044930 00000 n ACE inhibitor-induced cough is believed to be related to the accumulation of bradykinin,substance P,and prostaglandins resulting from the inhibition of ACE.Angiotensin-receptor blockers (AARBs) do not have any effect on ACE and theoretically might not cause … History of ACE inhibitor-induced cough was found to be an independent risk factor for developing ACE inhibitor-related angioedema in one retrospective cohort study . Therefore, a proposed option in patients suffering with ACE inhibitor -induced cough is to try an ARB.However,this report describes the reverse: a case of lo osarta an-iin nduced cough th hat co om mple etely resolved after it was substituted with an ACE inhibitor, enalapril. 0000020565 00000 n Therefore, they are often substituted for ACE inhibitors when patients complain of cough with ACE inhibitors. J˾�@o,��"K�"��$@�1���1�5�$���$�vtf�L�7����������g�sK,`'�ţݗ�Y��s� ������H�ߔ��"m� �X>@�8�G����� h�@�P�i��14'ى���K�v�E+BBw;Mx�i��ܹ���6���(� � q1���1N+#��wFE�� The most effective intervention for the ACEI-induced cough is stopping the offending agent and switching to an ARB. Alerts and Notices Synopsis A variety of medications can induce cough through different mechanisms. 0000003829 00000 n 0000046268 00000 n In other words, people who are sensitive to drug-induced cough can still experience this complication when switched to an ARB like valsartan (or presumably other ARBs). 28 0 obj <> endobj trailer Losartan is an antihypertensive drug that belongs to the class of angiotensin receptor blockers (ARB). 0000046190 00000 n 0000002320 00000 n Furthermore, an accumulating body of evidence supports the concept that the angiotensin receptor blockers (ARBs) do not cause cough, including in those patients with a history of ACE inhibitor-induced cough. ACE inhibitors like captopril, enalapril and ramipril can produce dry cough on long term use. 0000046389 00000 n 0000045934 00000 n 0000002006 00000 n ... Straight forward: Change to arb, such as olmesartan. 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