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British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1987 Jun 13;294(6586):1521–1523. doi: 10.1136/bmj.294.6586.1521

Cough associated with captopril and enalapril.

D M Coulter, I R Edwards
PMCID: PMC1246673  PMID: 3038257

Abstract

Thirty three reports of cough associated with captopril and 26 associated with enalapril received by the New Zealand intensive medicines monitoring programme were reviewed. The programme is a specialised part of the New Zealand postmarketing surveillance system. Review of these reports showed that the cough was an adverse reaction to the drugs, occurred even with low dose treatment, and was severe enough to warrant withdrawal of the drugs in most of the cases reported. A significant sex difference was shown, with women predominating. The reaction seemed to be a greater problem with enalapril, and in seven patients it occurred with both captopril and enalapril. Withdrawal of treatment resulted in rapid recovery, and no long term effects were shown. The pathogenesis of the reaction is unknown, but possible mediators include bradykinin and prostaglandins.

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Selected References

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  1. Ball S. G., Robertson J. I. A need for new converting enzyme inhibitors? Br Med J (Clin Res Ed) 1985 Jan 19;290(6463):180–181. doi: 10.1136/bmj.290.6463.180. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Carruthers S. G. Severe coughing during captopril and enalapril therapy. CMAJ. 1986 Aug 1;135(3):217–218. [PMC free article] [PubMed] [Google Scholar]
  3. Cleland J. G., Dargie H. J., Ball S. G., Gillen G., Hodsman G. P., Morton J. J., East B. W., Robertson I., Ford I., Robertson J. I. Effects of enalapril in heart failure: a double blind study of effects on exercise performance, renal function, hormones, and metabolic state. Br Heart J. 1985 Sep;54(3):305–312. doi: 10.1136/hrt.54.3.305. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Crombie A., Manson P., McVey D., Smith M. W., Smeeton V. J., Somerton D. T. Once daily enalapril in general practice patients with mild to moderate essential hypertension. N Z Med J. 1986 Jul 9;99(805):503–504. [PubMed] [Google Scholar]
  5. Davies R. O., Irvin J. D., Kramsch D. K., Walker J. F., Moncloa F. Enalapril worldwide experience. Am J Med. 1984 Aug 20;77(2A):23–35. doi: 10.1016/s0002-9343(84)80055-8. [DOI] [PubMed] [Google Scholar]
  6. DiBianco R. Adverse reactions with angiotensin converting enzyme (ACE) inhibitors. Med Toxicol. 1986 Mar-Apr;1(2):122–141. doi: 10.1007/BF03259832. [DOI] [PubMed] [Google Scholar]
  7. Dollery C. T. Safety and efficacy of enalapril. Summing up the evidence. J Hypertens Suppl. 1983 Oct;1(1):155–157. [PubMed] [Google Scholar]
  8. Edwards C. R., Padfield P. L. Angiotensin-converting enzyme inhibitors: past, present, and bright future. Lancet. 1985 Jan 5;1(8419):30–34. doi: 10.1016/s0140-6736(85)90975-4. [DOI] [PubMed] [Google Scholar]
  9. Frohlich E. D., Cooper R. A., Lewis E. J. Review of the overall experience of captopril in hypertension. Arch Intern Med. 1984 Jul;144(7):1441–1444. [PubMed] [Google Scholar]
  10. Greenberg R., Osman G. H., Jr, O'Keefe E. H., Antonaccio M. J. The effects of captopril (SQ 14,225) on bradykinin-induced bronchoconstriction in the anesthetized guinea pig. Eur J Pharmacol. 1979 Aug 15;57(4):287–294. doi: 10.1016/0014-2999(79)90491-6. [DOI] [PubMed] [Google Scholar]
  11. Hallwright G. P., Maling T. B., Town G. I. Enalapril and cough: case report. N Z Med J. 1986 Feb 12;99(795):66–67. [PubMed] [Google Scholar]
  12. Havelka J., Vetter H., Studer A., Greminger P., Lüscher T., Wollnik S., Siegenthaler W., Vetter W. Acute and chronic effects of the angiotensin-converting enzyme inhibitor captopril in severe hypertension. Am J Cardiol. 1982 Apr 21;49(6):1467–1474. doi: 10.1016/0002-9149(82)90362-9. [DOI] [PubMed] [Google Scholar]
  13. Heel R. C., Brogden R. N., Speight T. M., Avery G. S. Captopril: a preliminary review of its pharmacological properties and therapeutic efficacy. Drugs. 1980 Dec;20(6):409–452. doi: 10.2165/00003495-198020060-00001. [DOI] [PubMed] [Google Scholar]
  14. Hodsman G. P., Robertson J. I. Captopril: five years on. Br Med J (Clin Res Ed) 1983 Sep 24;287(6396):851–852. doi: 10.1136/bmj.287.6396.851. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Mitchell A., Gillies A., Carney S., Smith A. J. Cough and captopril. Arch Intern Med. 1986 May;146(5):1017–1017. doi: 10.1001/archinte.1986.00360170275038. [DOI] [PubMed] [Google Scholar]
  16. Moncloa F., Sromovsky J. A., Walker J. F., Davies R. O. Enalapril in hypertension and congestive heart failure. Overall review of efficacy and safety. Drugs. 1985;30 (Suppl 1):82–89. doi: 10.2165/00003495-198500301-00012. [DOI] [PubMed] [Google Scholar]
  17. Riley L. J., Jr, Vlasses P. H., Ferguson R. K. Clinical pharmacology and therapeutic applications of the new oral converting enzyme inhibitor, enalapril. Am Heart J. 1985 May;109(5 Pt 1):1085–1089. doi: 10.1016/0002-8703(85)90252-2. [DOI] [PubMed] [Google Scholar]
  18. Salena B. J. Chronic cough and the use of captopril: unmasking asthma. Arch Intern Med. 1986 Jan;146(1):202–203. [PubMed] [Google Scholar]
  19. Semple P. F., Herd G. W. Cough and wheeze caused by inhibitors of angiotensin-converting enzyme. N Engl J Med. 1986 Jan 2;314(1):61–61. doi: 10.1056/NEJM198601023140119. [DOI] [PubMed] [Google Scholar]
  20. Sesoko S., Kaneko Y. Cough associated with the use of captopril. Arch Intern Med. 1985 Aug;145(8):1524–1524. [PubMed] [Google Scholar]
  21. Stark R. D. Mechanism of cough with angiotensin-converting enzyme inhibition. Arch Intern Med. 1986 Jun;146(6):1227–1227. [PubMed] [Google Scholar]
  22. Swartz S. L., Williams G. H. Angiotensin-converting enzyme inhibition and prostaglandins. Am J Cardiol. 1982 Apr 21;49(6):1405–1409. doi: 10.1016/0002-9149(82)90351-4. [DOI] [PubMed] [Google Scholar]
  23. Todd P. A., Heel R. C. Enalapril. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in hypertension and congestive heart failure. Drugs. 1986 Mar;31(3):198–248. doi: 10.2165/00003495-198631030-00002. [DOI] [PubMed] [Google Scholar]
  24. Town G. I., Hallwright G. P., Maling T. J., O'Donnell T. V. Angiotensin converting enzyme inhibitors and cough. N Z Med J. 1987 Mar 25;100(820):161–163. [PubMed] [Google Scholar]
  25. Varonier H. S., Panzani R. The effect of inhalations of bradykinin on healthy and atopic (asthmatic) children. Int Arch Allergy Appl Immunol. 1968;34(3):293–296. doi: 10.1159/000230120. [DOI] [PubMed] [Google Scholar]
  26. Vidt D. G., Bravo E. L., Fouad F. M. Medical intelligence drug therapy: captopril. N Engl J Med. 1982 Jan 28;306(4):214–219. doi: 10.1056/NEJM198201283060405. [DOI] [PubMed] [Google Scholar]

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