ACE Inhibitor--Coughing Fits

[Mich]

I thought I would post this because of a recent experience with an ACE inhibitor. I was given this med 20+ years ago before I even had high blood pressure. The study had just been released saying that it would help protect kidney function in diabetics.

The first week or so, I was dizzy now and then and had a bit of a mild cough. Both symptoms disappeared.

About two years ago when my blood pressure began to creep up, my endo sent me for a baseline evaluation by a heart specialist due to my longstanding diabetes. My heart was fine and my vessels and arteries are healthy also but he doubled the ACE inhibitor and added a beta blocker. General principles I guess. My endo agreed with it so I went with it. I couldn't function with the beta blocker (I felt like I was made of lead, I was so tired) until I got it down to ONE SIXTH of the dose prescribed (25 mg now.)

Over the two years since, I began to cough--more and more. Eventually it got to the point where I gagged and couldn't stop coughing. I gagged so badly, it nearly made me throw up. It never entered my mind that it was the ACE inhibitor because I had been taking it for 20 years.

Well it was.

About a month ago, my endo switched me to an angiotensin receptor inhibitor which does the same job as the ACE inhibitor but in a different way.

Magic. I haven't coughed since that day.

Sooo, if you are taking an ACE inhibitor and coughing, don't just "tough it out." Ask your doctor.

Mich

[princesslinda]

Glad you've gotten a medication that doesn't cause those side effects....odd that you'd have them suddenly after all those years. I've taken Accupril for about 10 years now...did notice a "tickle" at first, but this went away.

[kgm0612]

My mom experienced the "cough" on two different blood pressure medications. She's now on a third with no coughing symptoms at all.

Karen

[Scrabblechick]

I had that tickle too, the first couple of weeks I was on the Enalapril, but don't have it, now. I tolerate it pretty well, thank goodness.

[bluesgirl102]

While I didn't have the ACE cough, I did indeed experience severe vertigo while on Accupril. It was so bad I had to discontinue it. Just about 8 months ago my GP put me on Diovan which is an ARB due to my blood pressure creeping up and, of course, for the kidney protection. I was very hesitant to do go on the Diovan due to the problems I had years ago with the Accupril. Surprisingly, I have had no problems with the Diovan. Oh, like you Mich, I also take a beta blocker as well...

[Eddy]

2.5 mg enalapril made me cough, not to mention crazy tired. BP also was creeping up.

I'm now on 20 mg benicar (an ARB).

[Blue Dog]

I had that hacking cough when I was first put on ACE inhibitors. Some people are allergic is what I was told. After a few months, my doctor switched me. I'm on Hyzaar and Norvasc now, blood pressure under control.

[GretchO]

About a month ago, my endo switched me to an angiotensin receptor inhibitor which does the same job as the ACE inhibitor but in a different way.

Mich

Mich...which angiotensin receptor inhibitor did your doc put you on? I'm currently taking Lisinopril, have the cough, and have been unable to convince my endo it's ACE inhibitor related. He told me to wait until my next visit as he was pretty sure it was just a cold (yes, I've been coughing for like 3 years, must be a cold!). It's driving my husband (and me) crazy.

...Gretchen

[Mich]

Gretchen,

Lisinopril is the one I took for 20+ years. At first 20mg, then the heart doctor doubled me to 40mg which caused the cough/gagging after two months.

My endo switched me to Diovan 160 mg. I stopped coughing the very next day.

The only drawback and it isn't a big one is that it is not available in a generic.

Mich

[Norman_G]

Gretchen,

Lisinopril is the one I took for 20+ years. At first 20mg, then the heart doctor doubled me to 40mg which caused the cough/gagging after two months.

My endo switched me to Diovan 160 mg. I stopped coughing the very next day.

The only drawback and it isn't a big one is that it is not available in a generic.

Mich

Altace or ramipril is quite commonly used now - it is an ACE inhibitor with a low incidence of the coug hside effect. Also now available as a generic (in Canada any way) . I order out of India for the price advantage as no insurance

[notme]

I take Lotrel. It is part Ace Inhibitor and partly a calcium channel blocker.


Lotrel

Generic Name: amlodipine and benazepril


Amlodipine is in a group of drugs called calcium channel blockers. Amlodipine relaxes (widens) blood vessels and improves blood flow.

Benazepril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme. Benazepril also widens blood vessels and prevents the body from retaining water, which increases blood pressure.

Lotrel is used to treat high blood pressure (hypertension). It is usually given after other blood pressure medications have been tried without successful treatment.

Lotrel may also be used for purposes other than those listed in this medication guide.


Common side effects are dizziness and cough. So far, I don't suffer from either.

[Mich]

Thanks, Nancy.

I'll keep Lotrel in mind as I evaluate the effects of this Diovan. I seem to have an unidentified one minute headache now and then. I'm waiting to see if it's sinus related. It isn't in the usual sinus places though.

I hate to keep piling on pills. You never know what even one small change will add to the mix.

I do appreciate feedback from this group when trying to figure it all out.

Mich

[TeeJaxx]

My doc put me on Conversyl. He warned me that 1 in 10 people have a coughing reaction to it. We both hoped I wouldn't be the1 in 10.

Two or three days after I started it, I started coughing. Just a little at first, but by about a month, I was up nights coughing.
He wanted me to try it for a 3 month period. The last 2 months were pure he**. I'd cough so hard, I'd almost vomit. I work with immune compromised people, so they would freak out as I was coughing, and I had to explain to them that I wasn't contagious, this is a medication side effect.

Finally, 3 months ended and I went back and told him what I went through. So, he switched me to Avapro. I haven't had any problems with this so far....... touch wood.

[Cyborg]

I got the ACE Cough from ACE Inhibitors. I ended up switching to Cozaar (an angiotensin II receptor antagonist) and the problem has completely dissapeared.

[moorejames]

I took an ACE inhibitor for close to 3 years before my cough developed. Switched to something else and it was gone in days.

[Alene]

I've been on Ramipril for a couple of months and I hate it. I have fits of coughing day and night. (They don't last long, but they're still annoying.) I'm pretty good with my diabetes, but I always have trouble understanding why I need to be on blood-pressure medication. I got myself in trouble as a kid for not taking my bp pills and the tickle in my throat also makes me want to stop taking them now... they also make me dizzy and I am getting the feeling the pills give me mixed up with the feeling of low blood-sugar which I would like to remain aware of. I'm also not convinced that I have high blood-pressure... it's just easy for me to get nervous and I have a bad case of white coat syndrome. :P

[Noturningback]

I had that problem with Lisinopril.

Do you have a blood pressure monitor at home? I monitored my BP for a month or so before any diagnosis was made. When it was confirmed it was hypertension, my GP put me on lisinopril. After the coughing fits and tickle in the throat (aka: torture), he put me on micradis HCT and that has been fine for me.

If you purchase a BP monitor, I would advise against a wrist monitor. They don't seem acurate enough. Also, measure your arm for the proper cuff size. I'm a "plus size" woman and need a larger cuff which doesn't come with the monitor.

~Danielle

[RandallFlagg]

I took lisinopril the first week of my diagnosis. That was in Dec. 07. My doctor, who I've seen for the past 11 years, knows I currently don't have insurance. He prescribed what he said was the least expensive meds. I hacked for a solid week and went back to him. He said he told me the lisinopril and any of the "prils" had this side effect, but that only about half the people that took it had a problem. He said he would switch me to Cozaar, but that it was ten times the price. I figured the lisinopril was $5, so for $50 I don't have to cough. Well worth the investment every month. I've been on Cozaar since Jan and I've had no side effects:) I use a wrist bp monitor that I got at Long's. Your right in that it does seem a little inaccurate. If you read and reread the instruction and practice with it you'll find the sweet spot. I have to sit at the dining room table, feet planted, place my arm with the monitor across my chest and rest that wrist on my other fist. It places the monitor just about heart level, which will give you a pretty accurate read. I tested at the house and then drove around the corner to Long's and used their machine. It was just about the same within a couple of points.

[lisa821]

Mich, since you were on the ACE inhibitor for 20+ years, could the awful cough have come from the combination of the ACE inhibitor with the new beta blocker? I keep reading about problems with certain drug combinations, so even though you've resolved the problem by switching from the ACE inhibitor to another product, could the two drugs have been incompatible? I can't imagine your body suddenly not tolerating a drug you've been taking for that long. The beta blocker sounds like the bad guy here.
~Lisa

[REDLAN]

persistent cough is the most reported side effect for ACE inhibitors. About 1 in 10 taking an ACE inhibitor will report persistent cough as a side effect.

I can't imagine your body suddenly not tolerating a drug you've been taking for that long.The beta blocker sounds like the bad guy here.

This experience is not unusual. side effects from drugs can take many years to appear. Tardive dyskinesia is a very disturbing side effect of anti-psychotic medication and can take many years before it appears.

(tardive dyskinesia is characterised by repetitive purposeless movements. Typified by random movements of the tongue)

[Nita]

I am having a problem with finding the correct BP med for me right now.

BUT, I am here to testify that I am another one that took Lisinopril for over 20 years and don't remember how it affected me at first but certainly can relate to the chronic coughing....especially in the mornings which I attributed it to sinus and gerd problems. Since I have been off of it the coughing is rare and if so very light in the a.m. It was embarrassing at times. Most people get irritated hearing some one cough and clear their throat constantly. I did find it did the BP job for me though.

Different doctors are trying different ones on me and I seem to retain fluid on most so I went back to my PP and said let's start from the beginning. I am taking readings for a month with Verapamil and Triamterene but the numbers are not quite good enough yet.

I had just filled my Diovan for three months and have to pay full price :eek: for it as I am in the doughnut hole with my prescription coverage with AARP or is it Medicare?? That was a lot of money!! I didn't see any better numbers with it. Has anyone googled Diovan and tinnitis?? It is a side effect of Diovan HCT. Is that different than Diovan? I have developed tinnitis which revs up at different times of day.

I did use a beta blocker for a short while with my Diovan but got off of it when my derm said, "No beta blockers with psoriasis". Tried Exforge and Coreg.....swelling.

So I imagine with trial and error I will get there.

Nita

[Hummergal]

I've been on Lisinopril for years, as well as a beta blocker. I have the annoying, constant, dry cough too!! I'm hesitant to change to something else though because they both work very well for me.

[Mich]

Hummergal,

I took lisinopril for over 25 years. It was only when my dose was upped that I began the bad gagging. I switched to Diovan, an ARB.

Lisinopril and Diovan both work on angiotensin, the body chemical that causes your vessels to contsrict, causing high blood pressure. They just do it in different ways. Lisinopril and other ACE inhibitors work by inhibiting the Angiotensin Coverter Enzyme that makes Angiotensin. Diovan blocks the receptors that receive the antiotensin and allow it to constrict the vessels.

Both of these drugs have been shown in tests to preserve diabetic kidney function. There is lots available on the internet on the interchangability of these two drugs.