Losartan is a medication prescribed to manage high blood pressure and various heart conditions, including heart failure. It also helps decrease the risk of stroke in individuals with hypertension and left ventricular hypertrophy, and treats kidney disease in people with type 2 diabetes and high blood pressure. A common question is whether Losartan causes coughing as a side effect.
Losartan and Coughing
While coughing is a recognized side effect of a related class of medications called Angiotensin-Converting Enzyme (ACE) inhibitors, it is considerably less frequent with Losartan. ACE inhibitors are known to cause a dry, persistent cough in about 5-35% of patients. This occurs because ACE inhibitors block an enzyme that normally breaks down bradykinin, an inflammatory peptide. The accumulation of bradykinin in the lungs can then sensitize airway sensory nerves, triggering the cough reflex.
Losartan, an angiotensin II receptor blocker (ARB), works differently. It blocks the action of angiotensin II at specific receptors, which helps relax and widen blood vessels, lowering blood pressure. Unlike ACE inhibitors, Losartan does not typically lead to the same significant accumulation of bradykinin, which explains its lower incidence of cough.
The incidence of cough with Losartan is reported to be less than 1% in clinical data, similar to that of a placebo or hydrochlorothiazide. Despite this, some individuals may still experience a cough while taking Losartan, possibly due to individual sensitivity or other less understood mechanisms. Although rare, case reports exist where Losartan has been linked to cough, even resolving when switched to an ACE inhibitor in one instance.
Identifying a Losartan-Related Cough
A cough potentially related to Losartan often presents as dry, non-productive, and persistent. This type of cough may emerge weeks or even months after starting the medication. It differs from a cough with mucus and tends to linger without other typical cold or flu symptoms.
It is important to consider other common causes of chronic cough. These include:
- Allergies and asthma.
- Post-nasal drip, where mucus drips down the back of the throat.
- Acid reflux (GERD), where stomach acid irritates the throat.
- Infections like whooping cough or lingering effects from a severe cold or flu.
Smoking, exposure to secondhand smoke, or environmental irritants like chemicals can also contribute to chronic coughing. Given the various potential causes, a professional medical evaluation is necessary to accurately determine the origin of a persistent cough.
Managing a Cough While on Losartan
If a persistent cough develops while taking Losartan, do not stop the medication without consulting a doctor. Discontinuing Losartan abruptly can be dangerous, potentially leading to increased blood pressure or worsening heart conditions.
Contact your doctor if you suspect Losartan is causing your cough. The doctor will evaluate the cough, considering its characteristics and ruling out other potential causes. This assessment ensures an accurate diagnosis.
If Losartan is determined to be the cause of the cough, the physician may consider adjusting the dose or switching to an alternative medication. Other options are available for managing high blood pressure and heart conditions. Any changes to medication should occur under medical supervision to ensure safety and proper management.