Lisinopril is a commonly prescribed medication for managing high blood pressure and various heart conditions. It belongs to a class of drugs known as Angiotensin-Converting Enzyme (ACE) inhibitors. While highly effective in its intended uses, a notable side effect that many individuals experience is a persistent cough. This cough is a recognized occurrence associated with ACE inhibitors.
The Connection Between Lisinopril and Cough
Lisinopril, like other ACE inhibitors, can induce a dry, persistent cough in some patients. This cough is typically non-productive, meaning it does not bring up mucus or phlegm, and is often described as a tickle in the throat. The cough can appear within weeks or months of starting the medication.
The prevalence of this side effect varies, but it is estimated to affect approximately 5% to 20% of individuals taking ACE inhibitors, including lisinopril. It is a well-documented and recognized adverse reaction. This cough can impact quality of life and medication adherence.
Understanding Why the Cough Occurs
The cough associated with lisinopril arises from its mechanism of action within the body. Lisinopril works by inhibiting the ACE enzyme, which plays a role in regulating blood pressure. The ACE enzyme is responsible for converting angiotensin I to angiotensin II, a hormone that narrows blood vessels and increases blood pressure. By blocking this conversion, lisinopril helps to relax blood vessels and lower blood pressure.
A secondary function of the ACE enzyme is to break down certain natural substances in the body, particularly bradykinin and substance P. When ACE is inhibited by lisinopril, these substances accumulate in the airways. This buildup of bradykinin and substance P can irritate nerve endings in the respiratory tract, specifically stimulating lung afferent C fibers, triggering the cough reflex. The irritation leads to a persistent cough.
What to Do About a Lisinopril-Induced Cough
If you develop a cough while taking lisinopril, it is important not to stop your medication without first consulting your healthcare provider. Abruptly discontinuing prescribed medication can have adverse health consequences. Your doctor can assess your symptoms and determine the best course of action.
Your healthcare provider may consider several approaches to manage a lisinopril-induced cough. They may choose to monitor the cough, adjust the dosage of lisinopril, or switch you to an alternative medication. Angiotensin Receptor Blockers (ARBs), such as losartan or valsartan, are frequently used alternatives. These work on the same pathway to lower blood pressure but do not typically cause the cough, as ARBs block the effects of angiotensin II directly, rather than inhibiting the ACE enzyme, avoiding bradykinin accumulation. The cough generally resolves within days to weeks after discontinuing lisinopril.