A patient treated with an angiotensin converting enzyme (ACE) inhibitor may develop a chronic cough that will last as long as the person continues to take the drug and for several weeks after discontinuation.


Onset may be from hours to months after starting the ACE inhibitor.


The only way of positively diagnosing the condition is to discontinue the drug and see if the cough disappears within the next month. The cough often does not disappear immediately after stopping the drug. For a person with multiple reasons to cough then the cough should significantly improve and reflect features of the remaining causes for cough.


A person with the cough may obtain some relief if treated with:

(1) aspirin

(2) indomethacin

(3) inhaled cromolyn sodium

(4) nifedipine

(5) sulindac

However, the ultimate solution is to discontinue the drug.


While individual ACE inhibitors vary in the frequency of cough, a patient may develop a cough with any drug in the class. Because of this a person with an ACE inhibitor-induced cough should not be switched to another ACE inhibitor but rather to another class of drugs such as an angiotensin II receptor antagonist.


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