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ENALAPRIL-INDUCED COUGH.

The angiotensin-converting-enzyme inhibitor enalapril is increasingly advocated as the initial therapy of hypertension, in part because of its generally favorable side-effect profile. However, anecdotal reports and several small published series suggest that the incidence of troublesome enalapril-induced cough is not trivial.

Gibson reviewed the records of 209 patients in a general medical practice who were given enalapril and followed for at least three months. Twenty-two patients (10 percent) developed a cough requiring discontinuation of enalapril, and in 21 of the 22 patients, the cough disappeared within two weeks of stopping the drug. The cough was non- productive, was usually worse at night, and was not accompanied by dyspnea or wheezing.

Although the manufacturer's product information notes a 1 to 2 percent incidence of enalapril-induced cough, this may be an underestimate. However, because the cough is reversible and apparently is not associated with significant damage to the respiratory tract, the decision to stop the drug remains a matter of patient preference and clinical judgment.

— ASB

Published in Journal Watch General Medicine December 29, 1989

Citation(s):

Gibson JR. Enalapril-induced cough. Arch Intern Med 1989 Dec 149 2701-2703.

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