How To Stop ACE Induced Cough
Doctors often prescribe
Inhibitors of angiotensin-converting enzyme (ACE inhibitors; eg, captopril, ramipril, and
enalapril) for treatment of high blood pressure, heart failure, and diabetes-related kidney
disease. It has been seen that about 10% of these individuals develop a persistent dry cough,
whatever dose they receive, and the cough is relieved only by withdrawal of the treatment. Thogh
cough is not harmful in itself, but it is so annoying for some patients that they stop taking
medicine at all, that may lead to complications of hypertension.
What to do to stop ACE Induced Cough
There is not much data in this regard. You may
stop ACE inhibitors and switch to another group of medication called as ARBs after consultation
with your doctor. Their are however, some certain situations where ACE inhibitors are the only best
choice. For those cases, Dr. Pier Luigi Malini and colleagues from the S Orsola Hospital in
Bologna, Italy, report that picotamide (currently being researched and not available in the U.S.
yet) is a medicine that may relieve ACE induced cough when used along with ACE inhibitors.The basic
mechanism of this medicine is that it acts to prevent aggregation of platelets (an early step in
the formation of blood clots).
In that study, picotamide was given to nine
patients with ACE-inhibitor-induced cough, out of those nine, eight patients declared that cough
was completely stopped after few days of starting Picotamide. The investigators performed this
study by giving a placebo (inactive substance) for two weeks and picotamide for another two weeks
and the patients did not know which was the real drug, but the responses to picotamide were
remarkable. They noticed that unresponsive patient did not absorb picotamide properly. One thing
was very attractive, that picotamide did not show any kind of interaction with effects of ACE
Majority of doctors adopt another approach of
switching to another type of treatment like ARBs. However, for patients who have to continue to
take ACE inhibitors, picotamide may be the drug of choice. I have noticed in my patients that even
ARBs cause dry cough in some patients when use in high doses.
A Korean study reveals that Iron Supplementation
Inhibits Cough Associated With ACE Inhibitors. Dry cough induced by ACE inhibitors is thought to be
associated with the increase in nitric oxide (NO) generation. Bronchial epithelial cells have an
inflammatory effect due to nitric oxide(NO). This study was carried out by Dr. Hong and colleagues.
They embarked on their study, based on reports that iron supplementation decreases NO generation or
diminishes NO-related bronchial cell damage. According to this small study's findings, Iron
supplementation appears to treat ACE-inhibitor-induced cough effectively in the short term. Iron is
very attractive treatment option for many patients due to its safety and less cost. As with any
treatment, recommendations should be tailored to individual patients. Before taking any kind of
medicine please consult with your doctor.