Cough Side Effects from Diabetes and Hypertension Medications

Diabetes... Hypertension

My father is taking medication for diabetes and has previously taken medication due to a bacterial infection from a prostate examination.
Recently, he has been coughing frequently (he has quit smoking).
A while ago, I read in the newspaper that there is a medication for diabetes (or high blood pressure...
I forgot) that is more likely to cause coughing, but I didn't cut out that article in time.
Could you please tell me which medication might cause this issue? Thank you!

Xu, 30~39 year old female. Ask Date: 2002/10/04

Dr. Ke Zhengchang reply Internal Medicine

A class of antihypertensive medications is known to commonly cause cough; these medications are angiotensin-converting enzyme (ACE) inhibitors.
Common examples include Capoten, Renitec, Zestril, Tritace, and Acertil.

Reply Date: 2002/10/04

More Info

Coughing can be a distressing side effect for patients taking medications for diabetes and hypertension. In your father's case, it is essential to identify the specific medication that may be causing this symptom. Based on the information provided, it seems likely that the cough could be related to the use of certain antihypertensive medications, particularly those classified as Angiotensin-Converting Enzyme Inhibitors (ACE inhibitors).

ACE inhibitors, such as Ramipril (Tritace), Enalapril (Renitec), and Lisinopril (Zestril), are commonly prescribed for managing high blood pressure and heart failure. While these medications are effective in lowering blood pressure and providing cardiovascular protection, they are known to cause a persistent dry cough in some patients. This side effect occurs in approximately 10-20% of individuals taking ACE inhibitors, and it is thought to be related to the accumulation of bradykinin, a peptide that can irritate the respiratory tract.

In contrast, Angiotensin II Receptor Blockers (ARBs), such as Losartan (Cozaar), are less likely to cause cough as a side effect. If your father is taking an ACE inhibitor and experiencing a cough, it may be worth discussing with his healthcare provider the possibility of switching to an ARB, which typically has a similar therapeutic effect without the cough side effect.

Additionally, it is important to consider other factors that could contribute to coughing, especially since your father has a history of bacterial infection related to prostate examination. If he was treated with antibiotics, it is possible that he could have developed a secondary respiratory infection or other complications that might be causing his cough. Furthermore, if he has any underlying respiratory conditions, such as asthma or chronic obstructive pulmonary disease (COPD), these could also be exacerbated by certain medications or other environmental factors.

To address the cough effectively, I recommend the following steps:
1. Consult with a Healthcare Provider: It is crucial for your father to discuss his symptoms with his doctor. They can evaluate his current medications and consider switching from an ACE inhibitor to an ARB if appropriate.

2. Monitor Symptoms: Keep track of the frequency and severity of the cough, as well as any other accompanying symptoms (e.g., fever, shortness of breath, or wheezing). This information can help the healthcare provider make a more informed decision.

3. Consider Other Causes: Investigate other potential causes of the cough, such as allergies, environmental irritants, or respiratory infections. If necessary, the doctor may recommend further testing or a referral to a specialist.

4. Lifestyle Modifications: Encourage your father to stay hydrated, avoid irritants (like smoke or strong odors), and consider using a humidifier to ease throat irritation.

5. Follow-Up: If a medication change is made, ensure that your father has regular follow-ups to monitor his blood pressure and any new side effects.

In summary, while certain diabetes and hypertension medications can lead to coughing, it is essential to work closely with a healthcare provider to identify the specific cause and determine the best course of action. By doing so, your father can achieve better management of his conditions while minimizing uncomfortable side effects.

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