Is a Simultaneous Beta-Blocker Therapy a Risk Factor for Enalapril-Induced Cough?

Puolijoki, Hannu; Nieminen, Markku M.; Siitonen, L; Lahdensuo, A; Reinikainen, Pekka

doi:10.1159/000195716

Cited by 7 publications

(4 citation statements)

References 6 publications

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“…However, BucKNALL et al [7] found that patients coughing during ACE inhibitor treatment had increased sensitivity to inhaled histamine even before therapy, which was further enhanced during ACE inhibition. We found an abnormal response to methacholine inhalation challenge in only one of our twelve patients with enalapril-induced cough [5]. Furthermore, some authors have reported induced or worsened asthma during ACE inhibitor therapy [8,9).…”

Section: Discussionmentioning

confidence: 66%

“…The prevalence of cough related to ACE inhibition has been reported to be in the range 1-6% among patients on captopril [2, 3] and 3-10% among those on enalapril [2,4]. Patients with heart failure show this side effect more rarely [2], probably due to lower doses or the usual absence of concomitant beta-blocker therapy in these patients [5). ToWN et al [6] noticed bronchial hyperreactivity in three of their ten patients with cough from enalapril.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cough induced by enalapril but not by captopril

Puolijoki¹,

Mm²,

Moilanen³

et al. 1989

Eur Respir J

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Cough induced by enalapril but not by captopril

Puolijoki¹,

Mm²,

Moilanen³

et al. 1989

Eur Respir J

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“…For each potential risk factor a crude matched exposure odds ratio was calculated. The following variables were considered as potential confounders : age, gender, number of prescriptions, number of consultations, smoking status and use of NSAID, fi-blockers [28], thiazides [29] or calcium-antagonists [30]. Treatment courses of these drugs were calculated as described above for ACE-inhibitors.…”

Section: Discussionmentioning

confidence: 99%

Cough due to ace inhibitors: a case-control study using automated general practice data

Visser

Vlug

Lei

et al. 1996

Eur J Clin Pharmacol

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Abstract. Objectives: To determine the risk of coughing as an adverse reaction to ACE inhibitors under everyday circumstances in a large population, and to study whether this adverse effect was duration or dose dependent.Design: A population-based case-control study. Setting: Ten general practices of 14 Dutch general practitioners (GP), in which all consultations, morbidity and medical interventions, including drugs prescribed, were registered over the 18 month period from 1st September, 1992 to 1st March, 1994. Subjects: 1458 patients with incident coughing and up to four controls per case were obtained (total 4182 controls), matched for GR All cases and controls were 20 years or older and had no record of respiratory infection, influenza, tuberculosis, asthma, chronic bronchitis, emphysema, congestive heart failure, sinusitis, laryngitis, haemoptysis or respiratory neoplasms during the study period.Results: Cases were 2.1-times more likely than controls to have been exposed to ACE inhibitors (95% CI 1.5-3.1), but after adjustment the odds ratio was 1.4 (95% CI 0.9-2.1). The crude odds ratio for captopril was 1.3 (95% CI 0.7-2.5), for enalapril 2.6 (95% CI 1.6-4.2) and for lisinopril 2.0 (95% CI 0.5-9.3). The adjusted odds ratio for captopril was 0.9 (95% CI 0.4 1.7), for enalapril 1.7 (95% CI 1.03-2.8) and for lisinopril 1.7 (95% CI 0.4-7.9). For patients who had been on ACE inhibitor treatment for no longer than 2 months the odds ratio was 4.8 (95% CI 1.7 13.3). The odds ratio declined to 2.0 (95% CI 1.1 3.8) for those who had taken an ACE inhibitor for 2-6 months, and to 1.6 (95% CI 0.9-2.7) for those on ACE-inhibitors for more than 6 months. Conclusion:The risk of coughing was increased twofold among ACE inhibitor users, but the odds ratios were no longer significant after controlling for several confounding factors. The risk of developing cough due to ACE-inhibitors declines with the duration of treatment, possibly due to depletion of susceptible persons.

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“…increased risk of the combination therapy to induce side effects in the respiratory tract [12]. Otherwise, another study showed Plasma potassium decreased in response to inhaled salbutamol as follows: with placebo by −0.77 mmol l −1 , that almost half the patients whose blood pressure was inadequately controlled while receiving atenolol monotherapy, benazepril −0.90, oral salbutamol −0.77, propranolol −0.05 (Table 1).…”

mentioning

confidence: 99%

Benazepril, an angiotensin converting enzyme inhibitor: drug interaction with salbutamol and bronchial response to histamine in normal subjects

Bauer¹,

Brunel²,

Nell³

et al. 1997

Brit J Clinical Pharma

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Aims To investigate the effect of the angiotensin converting enzyme inhibitor, benazepril, on pulmonary function. Methods We investigated the influence of benazepril, on lung function and the interaction with inhaled salbutamol (0.1 to 6.6 mg ) and histamine (0.03 to 30.69 g l −1 ) in normal subjects. Benazepril 20 mg, salbutamol 8 mg, propranolol 160 mg, and placebo were given orally once daily over 10 days.Results On day 8, there was no difference in the area under the salbutamol doseresponse curves between benazepril, placebo and oral salbutamol ( P >0.05), propranolol shifted the curves to the right ( P<0.05). On day 10, histamine challenge resulted in following PD 35 sGaw values (geometric mean and 95% CI): with placebo 1.02 (0.95-1.09) g l −1 , benazepril 1.04 (0.99-1.08), salbutamol 1.19(1.13-1.25), propranolol 0.57 (0.50-0.65).Conclusions Benazepril had no influence on baseline lung function, caused no interaction with inhaled salbutamol and the bronchial response to histamine was similar to placebo. However, our findings in normal subjects cannot be extrapolated automatically to asthmatics.

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Is a Simultaneous Beta-Blocker Therapy a Risk Factor for Enalapril-Induced Cough?

Cited by 7 publications

References 6 publications

Cough induced by enalapril but not by captopril

Cough induced by enalapril but not by captopril

Cough due to ace inhibitors: a case-control study using automated general practice data

Benazepril, an angiotensin converting enzyme inhibitor: drug interaction with salbutamol and bronchial response to histamine in normal subjects

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