How long does lisinopril cough last
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Duration of Lisinopril-Induced Cough: Insights from Research
Introduction to Lisinopril-Induced Cough
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is commonly prescribed for hypertension and heart failure. However, a notable side effect is a persistent, dry cough. Understanding the duration and management of this cough is crucial for patient care.
Onset and Duration of Lisinopril-Induced Cough
Onset of Cough
Research indicates that the onset of cough typically occurs within the first week of starting lisinopril therapy. This early onset is consistent across various studies, highlighting the need for close monitoring of patients soon after initiating treatment.
Duration of Cough
The duration of the cough is directly linked to the continuation of lisinopril therapy. The cough persists as long as the patient remains on the medication and generally resolves within a few days after discontinuation. This rapid resolution upon stopping the drug suggests a direct causal relationship between lisinopril and the cough.
Comparative Studies on Cough Incidence
Lisinopril vs. Other Antihypertensives
Several studies have compared the incidence of cough in patients treated with lisinopril to those treated with other antihypertensive agents. For instance, a study involving 129 patients found that 68.9% of those on lisinopril experienced a dry, persistent cough, significantly higher than the 19.5% in the valsartan group and 19.0% in the hydrochlorothiazide group. Another study with 135 patients reported a 72% incidence of cough with lisinopril, compared to 29% with losartan and 34% with hydrochlorothiazide.
Severity and Frequency of Cough
The severity and frequency of the cough are also higher in patients taking lisinopril. Visual analogue scale scores from multiple studies indicate that patients on lisinopril report more frequent and severe coughing episodes compared to those on losartan or hydrochlorothiazide .
Mechanism Behind Lisinopril-Induced Cough
The mechanism of lisinopril-induced cough is believed to involve the accumulation of bradykinin and substance P, which are normally degraded by ACE. This accumulation leads to the stimulation of lung afferent C fibers, resulting in a persistent cough. The role of prostaglandins has also been suggested, as nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported to alleviate the cough in some cases.
Conclusion
Lisinopril-induced cough typically begins within the first week of therapy and persists as long as the medication is continued, resolving within a few days after discontinuation. The incidence and severity of this cough are significantly higher compared to other antihypertensive agents like valsartan and losartan. Understanding these dynamics can help healthcare providers manage and mitigate this common side effect, improving patient adherence and outcomes.
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