Lisinopril-induced cough duration

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Lisinopril-Induced Cough: Incidence and Onset Duration

Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is well known for causing a persistent, dry cough in a significant number of patients. The cough is typically described as dry, nonproductive, and persistent, often accompanied by a tickling or irritating sensation in the throat 64. The onset of lisinopril-induced cough can vary, with reports indicating that it may begin within days of the first dose or may take several months to develop after starting therapy 46.

Duration of Lisinopril-Induced Cough After Discontinuation

The duration of the cough after stopping lisinopril is generally short. Most studies agree that the cough usually resolves within a few days to a few weeks after discontinuing the medication. Specifically, the cough typically remits within a few days, but in some cases, it may take up to 1 to 4 weeks for the cough to completely disappear after stopping lisinopril 46. This resolution period is consistent across different ACE inhibitors, including lisinopril.

Factors Influencing Cough Duration and Incidence

The likelihood and duration of cough can be influenced by several factors. Women and nonsmokers are more likely to report lisinopril-induced cough, and the incidence is higher in these groups compared to men and smokers . The cough persists as long as the drug is taken and resolves after discontinuation, with no evidence suggesting long-term persistence once the medication is stopped 46.

Comparison with Other Antihypertensive Agents

Studies comparing lisinopril with other antihypertensive agents, such as valsartan, losartan, and hydrochlorothiazide, show that the incidence of cough is significantly higher with lisinopril. However, the duration of cough after stopping lisinopril remains similar, with most patients experiencing resolution within a few weeks 15.

Conclusion

Lisinopril-induced cough is a common side effect that typically begins within days to months of starting therapy and resolves within 1 to 4 weeks after discontinuation. The risk is higher in women and nonsmokers, but the cough does not persist long-term after stopping the drug. Alternative antihypertensive agents may be considered for patients who develop this side effect.

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Most relevant research papers on this topic

Valsartan, a New Angiotensin II Receptor Antagonist: A Double‐Blind Study Comparing the Incidence of Cough with Lisinopril and Hydrochlorothiazide

Valsartan, a new angiotensin II receptor antagonist, offers therapeutic efficacy comparable to lisinopril but with significantly less cough in hypertensive patients with angiotensin-converting enzyme inhibitor-induced cough.

RCTHighly Cited

1997·

105citations

·J. Benz et al.

Female preponderance for lisinopril-induced cough in hypertension.

Lisinopril-induced cough is more common in women than men, and nonsmokers report increased cough more often than smokers.

RCTLarge Human TrialHighly Cited

1994·

80citations

·I. Os et al.

ACE INHIBITORS; COMPARISON OF ACE INHIBITORS (PERINDOPRIL, RAMIPRIL & LISINOPRIL) INDUCED COUGH

Chronic dry cough is a common side effect of ACE inhibitors, with lisinopril having the highest incidence, followed by perindopril and ramipril.

Observational Study

2016·

2citations

·A. Nazir et al.

Effects of modulators of the renin—angiotensin—aldosterone system on cough

Losartan has a significantly lower incidence of cough-related side effects compared to lisinopril and hydrochlorothiazide, making it a potential new treatment for hypertensive patients with ACE inhibitor-related cough.

RCTHighly Cited

1994·

238citations

·Y. Lacourciére et al.

The Positive Association of Cough with Angiotensin‐Converting Enzyme Inhibitors

Cough is a common side effect of ACE inhibitor therapy, with potential mechanisms including prostaglandin E2 stimulation and decreased substance P breakdown.

Highly Cited

1989·

72citations

·P. Just

The cough reflex is upregulated by lisinopril microinjected into the caudal nucleus tractus solitarii of the rabbit

Lisinopril microinjected into the caudal nucleus tractus solitarii of anesthetized rabbits increases the cough reflex, mediated by an accumulation of bradykinin and substance P.

Non-RCTAnimal Study

2015·

15citations

·E. Cinelli et al.

Use of losartan in the treatment of hypertensive patients with a history of cough induced by angiotensin-converting enzyme inhibitors.

Losartan significantly reduces the incidence, severity, and frequency of dry cough in hypertensive patients with a history of ACE inhibitor-induced dry cough compared to lisinopril and placebo.

RCT

1998·

35citations

·R. Z. Paster et al.

Angiotensin converting enzyme inhibitors and cough--a north Indian study.

Cough is a common side effect of ACEI therapy, with a higher incidence in females and no significant difference in age groups.

Observational Study

1998·

14citations

·N. Singh et al.

ACE Inhibitors for Prophylaxis of Migraine Headaches

ACE inhibitors show potential for prophylaxis of migraine headaches in a small group of patients, with minimal side effects and sustained benefit.

1995·

46citations

·William I. Bender

Zofenopril and incidence of cough: a review of published and unpublished data

Zofenopril has a relatively low incidence of induced cough, with mild to moderate intensity, occurring more frequently in the first 3-6 months of treatment and always improving upon discontinuing therapy.

Systematic Review

2011·

21citations

·Stefano Omboni et al.

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