Losartan side effects dry cough
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Summary
7 papers analyzed
Some studies suggest losartan significantly reduces the incidence of dry cough compared to ACE inhibitors, while other studies indicate it may cause dry cough in a small percentage of patients.
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Losartan and Dry Cough: Analyzing Side Effects
Introduction to Losartan and ACE Inhibitors
Losartan, an angiotensin II receptor antagonist, is commonly prescribed for hypertension. Unlike angiotensin-converting enzyme (ACE) inhibitors, which are also used to manage high blood pressure, losartan is less frequently associated with the side effect of dry cough. This article synthesizes research findings on the incidence of dry cough in patients treated with losartan compared to those treated with ACE inhibitors.
Incidence of Dry Cough with Losartan
Comparative Studies with ACE Inhibitors
Several studies have demonstrated that losartan has a significantly lower incidence of dry cough compared to ACE inhibitors. In a study involving hypertensive patients with a history of ACE inhibitor-induced cough, the incidence of dry cough was 87.5% in the lisinopril group, compared to 36.7% in the losartan group and 31.4% in the placebo group. Another study reported that 72% of patients treated with lisinopril experienced dry cough, whereas only 29% of those treated with losartan did. These findings suggest that losartan is a preferable option for patients who develop a cough with ACE inhibitors.
Mechanism of Action
The lower incidence of dry cough with losartan can be attributed to its mechanism of action. Losartan blocks the effects of angiotensin II at the receptor level without affecting the bradykinin system, which is implicated in the cough associated with ACE inhibitors. This distinction is crucial as it explains why losartan is less likely to cause this particular side effect.
Case Reports and Clinical Trials
Case Reports of Losartan-Induced Cough
While rare, there have been isolated reports of losartan-induced dry cough. One case involved a 49-year-old woman who developed a severe dry cough eight weeks after starting losartan therapy. The cough resolved after discontinuing the drug, suggesting a probable link between losartan and the cough in this patient. However, such cases are uncommon and do not significantly impact the overall safety profile of losartan.
Clinical Trial Data
In large-scale clinical trials, the incidence of dry cough in patients treated with losartan was comparable to that in patients receiving a placebo. For instance, in a study involving approximately 2,900 hypertensive patients, 3.1% of those treated with losartan reported a dry cough, similar to the 2.6% in the placebo group . This further supports the notion that losartan is well-tolerated and does not significantly increase the risk of dry cough.
Conclusion
Losartan is an effective antihypertensive agent with a lower incidence of dry cough compared to ACE inhibitors. While rare cases of losartan-induced cough have been reported, the overall evidence suggests that losartan is a safer alternative for patients who experience cough with ACE inhibitors. This makes losartan a valuable option in the management of hypertension, particularly for those sensitive to the side effects of ACE inhibitors.
Sources and full results
Most relevant research papers on this topic
2
Modulation of the renin-angiotensin-aldosterone system and cough.
2
18 Citations
1995
4
A case of losartan-induced dry irritating cough
4
0 Citations
2004