Why does enalapril cause a cough

When the patients with cough were compared with the others, there was no significant difference in age, smoking status, creatinine levels, enalapril dosage, associated cardiopulmonary disease, or concomitant administration of medications. Among the study patients who did not discontinue taking enalapril because of cough, many developed a persistent, dry cough that to date has not been severe enough to require discontinuation of therapy, after a mean follow-up period of 16 months.

In this case, you may not feel any different when you take enalapril. This doesn't mean that the medicine isn't working and it's important to keep taking it. Usually, treatment with enalapril is long term and you may have to take it for the rest of your life. Enalapril is generally safe to take for a long time. In fact, it works best when you take it for a long time. Taking enalapril for a long time can sometimes cause your kidneys to not work as well as they should.

Your doctor will check how well your kidneys are working with regular blood tests. Stopping it may cause your blood pressure to rise - and this may increase your risk of heart attack and stroke. If you're bothered by side effects, your doctor may be able to prescribe you a different medicine.

Even if enalapril brings down your blood pressure successfully, it's best to carry on taking it. If you stop taking it, your blood pressure could go back up again. If you need medicines to lower your blood pressure, you'll probably need them for the rest of your life. Remember, by keeping your blood pressure low, you're protecting yourself against having a heart attack or stroke in the future.

Enalapril lowers your blood pressure and drinking alcohol can increase its effects. This can make you feel dizzy or lightheaded. During the first few days of taking enalapril or after a dose increase, it's best to stop drinking alcohol until you see how the medicine affects you.

If you find enalapril makes you feel dizzy, it's best to stop drinking alcohol. There are several other ACE inhibitor medicines which work in the same way as enalapril. They include ramipril , lisinopril and perindopril.

There are also lots of other types of blood pressure-lowering medicines:. If you can't take enalapril or other ACE inhibitor medicines because of side effects such as a dry cough, you may be able to switch to another blood pressure-lowering medicine. This will usually be a medicine called an angiotensin receptor blocker such as candesartan , irbesartan , losartan or valsartan.

Enalapril works as well as other ACE inhibitors when you take it to lower blood pressure and for heart failure. The side effects are also similar to those of other ACE inhibitors. Tell your doctor that you're taking enalapril if you're going to be put to sleep with a general anaesthetic for an operation or are going to have a major operation, such as a caesarean section, without a general anaesthetic.

Enalapril can reduce your blood pressure when it's used with an anaesthetic. Your doctor may advise you to stop taking enalapril 24 hours before surgery. However, some types of hormonal methods of contraception, such as the combined pill and contraceptive patch , aren't usually recommended for women with high blood pressure.

Talk to your doctor if you're taking a combined hormonal contraceptive. There's no firm evidence to suggest that taking enalapril will reduce fertility in either men or women. However, speak to a pharmacist or your doctor before taking it if you're trying to get pregnant. Do not use salt substitutes such as Lo-Salt. This is because they are high in potassium.

When mixed with enalapril they may make the level of potassium in your blood too high. There is nothing else you need to avoid while taking enalapril. Eating well can help if you have high blood pressure or heart failure. Enalapril can cause blurred vision and can make some people feel dizzy or weak.

If this happens to you, don't drive a car, ride a bike, or use tools or machines. Feeling dizzy is more likely to happen when you first start taking enalapril or after increasing your dose. It's best to stop driving, riding a bike and using tools or machines during these times. You can boost the health of your heart by making some key lifestyle changes.

These will also help if you have high blood pressure or heart failure. Page last reviewed: 13 December Next review due: 13 December Enalapril On this page About enalapril Key facts Who can and cannot take enalapril How and when to take it Side effects How to cope with side effects Pregnancy and breastfeeding Cautions with other medicines Common questions.

About enalapril Enalapril is a medicine used to reduce high blood pressure and to prevent or treat heart failure. NHS coronavirus advice If you have coronavirus, or think you might have it, keep taking your blood pressure medicines as usual.

Updated: 17 March Help us improve our website Can you answer a quick question about your visit today? Enalapril lowers your blood pressure and makes it easier for your heart to pump blood around your body. Your first dose of enalapril may make you feel dizzy, so it's best to take it at bedtime. After that, if you don't feel dizzy, you can take it at any time of day. Some people get a dry, irritating cough with enalapril. Physicians should be aware that a dry cough is the most common adverse effect of ACE inhibitors and that this symptom may occur not necessarily shortly after institution of therapy but months or even a year later.

Replacement by another ACE inhibitor should not be tried, since the cough will almost always recur on rechallenge with the same or another ACE inhibitor. Neel Jr. Any advice or information provided should not be followed in lieu of a personal consultation with a trained medical professional.

One of the telltale adverse effects of ACE inhibitors, including lisinopril, is a chronic, hacking cough — a potential side effect that patients often don't hear about. Studies suggest that up to a third of all patients taking an ACE inhibitor will develop this type of chronic dry cough, and the cough often doesn't go away when they stop taking the drug. This happens more with women than with men, and more with African Americans and Asians than others.

You might be wondering how a blood pressure drug could cause respiratory problems. ACE inhibitors affect the process of renal perfusion, which is how the kidneys filter impurities out of the blood.

As an older person loses kidney function, the change is reflected in his or her glomerular filtration rate GFR. The lower your GFR, the more difficult it is for your body to clear drugs from your kidneys and bloodstream, lowering their effectiveness and potentially causing them to accumulate at toxic levels in the body.

In this case, the insoluble by-products of the drugs, called kinins, are not filtered out of the blood. They then flow out of the kidneys and lodge themselves in the lungs' bronchial tubes. The coughing spells represent the body's attempt to expel the kinins from the lungs. Even after the drug is stopped, the cough can linger for months until all the kinins eventually find their way out of the lungs.

You can save on eye exams, prescription drugs, hearing aids and more. Many of the patients I see with this problem are being treated for sinusitis, bronchitis, sore throat, laryngitis, asthma and many other respiratory conditions that are all a result of the ACE-inhibitor therapy.

I recommend that you talk with your doctor or other health care provider about stopping the lisinopril.