This Article Full Text (PDF) All Versions of this Article: 0897190009333358v1 22/5/508    most recent References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Herner, S. J. Articles by Billups, S. J. Social Bookmarking                         What's this?

Interventional Case Series: Angiotensin-Converting Enzyme Inhibitor (ACE-I)–Induced Cough: Is Rechallenge With a Second ACE-I Worthwhile?

From the Pharmacy Department, Kaiser Permanente of Colorado, and the University of Colorado at Denver School of Pharmacy, Denver, Colorado.

Correspondence: Sheryl J. Herner, Pharmacy Department, Kaiser Permanente of Colorado, 1835 Franklin Street, 5th Floor, Denver, CO 80218; e-mail: Sheri.J.Herner{at}kp.org.

Angiotensin-converting enzyme inhibitors (ACE-Is) are a cornerstone of therapy with proven morbidity and mortality benefit in many disease states. The unpredictable, bothersome cough that occurs in 15% to 41% of patients oftentimes leads to noncompliance or discontinuation. Management of ACE-I-induced cough remains controversial. The authors’ objective was to determine whether patients experiencing an ACE-I-induced cough could be successfully switched to a different ACE-I without recurrent cough. A total of 10 participants deemed to have ACE-I-induced cough were enrolled in an interventional case series to assess whether they could tolerate rechallenge with an alternative ACE-I. During phase 1, ACE-I therapy was stopped for up to 4 weeks to allow the cough to resolve. During phase 2, participants were rechallenged with an alternative ACE-I and followed for 4 months. Of the 10 participants who consented to enroll, 6 were rechallenged with a second ACE-I. Cough recurred in 4 of these within 1 week (5-7 days), whereas 2 participants continued ACE-I therapy cough-free. Results suggest that a small percentage of patients with ACE-I-induced cough tolerate an alternative ACE-I. For patients with a true ACE-I-induced cough who are motivated to continue an ACE-I, a trial of a second ACE-I may be worthwhile.

Key Words: angiotensin-converting enzyme inhibitor • cough • adverse effects

This version was published on October 1, 2009

Journal of Pharmacy Practice, Vol. 22, No. 5, 508-512 (2009)
DOI: 10.1177/0897190009333358


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?