Enalapril-Induced Cough

doi:10.1001/archinte.1989.00390120061012

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Vol. 149 No. 12, December 1989

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Enalapril-Induced Cough

Gary R. Gibson, MD

Arch Intern Med. 1989;149(12):2701-2703.

Abstract

• A retrospective analysis of records from an outpatientmedical practice was undertaken to determine the incidence andfeatures of cough resulting from the use of enalapril maleate.Of 209 patients taking enalapril, 22 (10.5%) required discontinuationof therapy because of an intractable, dry cough. Cough was morethan twice as common in women; 16 (14.6%) of 109 women and 6(6%) of 100 men stopped taking enalapril because of cough. Thecough resolved in 21 of 22 patients within 2 weeks of discontinuationof enalapril therapy. When the patients with cough were comparedwith the others, there was no significant difference in age,smoking status, creatinine levels, enalapril dosage, associatedcardiopulmonary disease, or concomitant administration of medications.Among the 187 study patients who did not discontinue takingenalapril because of cough, many developed a persistent, drycough that to date has not been severe enough to require discontinuationof therapy, after a mean follow-up period of 16 months. Theenalapril-induced cough is insidious, dry, persistent, benign,and reversible on discontinuation of therapy. It is importantto distinguish enalapril-induced cough from cough resultingfrom acute illness, reactive airway disease, and congestiveheart failure. Optimal clinical application of enalapril inthe treatment of hypertension and congestive heart failure willrequire increased awareness of this incessant cough, which requiresdiscontinuation of the therapy in about 10% of patients.

(Arch Intern Med. 1989;149:2701-2703)

Author Affiliations

From the Department of Medicine, Northeastern Ohio Universities College of Medicine, Rootstown.

Footnotes

Accepted for publication July 10, 1989.

Reprint requests to 1651 E Market St, Warren, OH 44483 (Dr Gibson).

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