Does amlodipine cause coughing
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Does Amlodipine Cause Coughing?
Introduction to Amlodipine and Coughing
Amlodipine is a widely used calcium channel blocker prescribed for the treatment of hypertension and angina. While it is generally well-tolerated, there have been inquiries about whether it can cause coughing, a common side effect associated with some antihypertensive medications.
Amlodipine and ACE Inhibitor-Induced Cough
Research has shown that amlodipine may actually reduce cough induced by angiotensin-converting enzyme (ACE) inhibitors. A study comparing the effects of amlodipine, nifedipine, and indomethacin on ACE inhibitor-induced cough found that amlodipine reduced the incidence of cough, although not as effectively as indomethacin . This suggests that amlodipine might have a mitigating effect on cough caused by other medications rather than being a direct cause of cough itself.
Incidence of Cough in Clinical Trials
In a randomized, open-labeled, crossover trial involving patients with a history of ACE inhibitor-induced dry cough, only two out of sixty patients reported cough during treatment with amlodipine . This indicates a very low incidence of cough associated with amlodipine, especially when compared to the high recurrence of cough in patients treated with ACE inhibitors.
Case Studies and Observations
There are isolated case reports of patients experiencing cough while on amlodipine. For instance, a 56-year-old male patient on amlodipine for eight years presented with a history of dry cough and evening rise of temperature . Another case involved a 70-year-old woman with a chronic cough who was also on amlodipine . However, these cases do not establish a direct causal relationship between amlodipine and cough, as other factors could contribute to the symptom.
Comparative Studies on Antihypertensive Agents
A study comparing the antihypertensive effects and tolerability of losartan, amlodipine, and lisinopril found that coughing was a common side effect in the lisinopril group but not in the amlodipine group . This further supports the notion that amlodipine is less likely to cause cough compared to other antihypertensive agents, particularly ACE inhibitors.
Safety Evaluations
A safety evaluation of a combination of perindopril arginine and amlodipine besylate noted that cough was one of the common adverse effects, but it was not specifically attributed to amlodipine alone . This suggests that while cough can occur in patients taking amlodipine, it is not a predominant side effect.
Conclusion
The evidence suggests that amlodipine is unlikely to be a significant cause of coughing. In fact, it may reduce cough induced by ACE inhibitors. While there are isolated reports of cough in patients taking amlodipine, these instances are rare and not conclusively linked to the medication. Overall, amlodipine appears to be a well-tolerated antihypertensive agent with a low incidence of cough as a side effect.
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