Lisinopril Side Effects
June 17, 2021 12:10 PM Subscribe
I am a week into taking lisinopril for high blood pressure, and I am experiencing what seems to be common side effects. For the last two days I have had a dry cough, and kind of an itchy, wheezy feeling in my lungs. My nose is also stuffy. I can handle the stuffy nose, but the coughing and wheeziness are getting old.
When I saw my doctor last month, and was diagnosed with blood pressure that needed treatment, my doctor said that I could choose between two medications, one that could lead to tiredness (lisinopril), and one that would cause more frequent peeing (a diuretic). She did not mention the dry cough as a side effect of lisinopril. Are these two my only two choices? (I am not super thrilled about needing to switch to a diuretic if I can't tolerate lisinopril).
My question, is this a side effect that will get better with time and should I just wait it out until my body gets used to it? Or will this be something that is permanent? I have a home blood pressure machine, and so far I am not seeing significant improvements, so maybe I still in the ramping up phase? (My readings are typically somewhere around 118-125/84-88).
When I saw my doctor last month, and was diagnosed with blood pressure that needed treatment, my doctor said that I could choose between two medications, one that could lead to tiredness (lisinopril), and one that would cause more frequent peeing (a diuretic). She did not mention the dry cough as a side effect of lisinopril. Are these two my only two choices? (I am not super thrilled about needing to switch to a diuretic if I can't tolerate lisinopril).
My question, is this a side effect that will get better with time and should I just wait it out until my body gets used to it? Or will this be something that is permanent? I have a home blood pressure machine, and so far I am not seeing significant improvements, so maybe I still in the ramping up phase? (My readings are typically somewhere around 118-125/84-88).
My lisinopril cough went away after a few months IIRC. But there are many classes of drugs to treat HBP besides ACE inhibitors (for which the cough is a common side effect) and diuretics. There are also beta-blockers, which have a different constellation of side effects, and angiotensin II receptor blockers. Any maybe more. You should talk to your doctor about your options.
posted by DrGail at 12:25 PM on June 17, 2021 [1 favorite]
posted by DrGail at 12:25 PM on June 17, 2021 [1 favorite]
My doctor did not mention the cough before I started taking this. I was waking up several times a night with a terrible dry cough. I thought maybe it was allergies until at my 3 month follow up she asked about it. She reduced my dosage and it basically stopped the coughing but it still worked to control my BP. Maybe you can ask about a change in how much you take.
posted by maxg94 at 12:26 PM on June 17, 2021 [2 favorites]
posted by maxg94 at 12:26 PM on June 17, 2021 [2 favorites]
I had this side effect (my doctor had mentioned it as a possibility). It did go away after about a month.
posted by lovecrafty at 12:28 PM on June 17, 2021 [1 favorite]
posted by lovecrafty at 12:28 PM on June 17, 2021 [1 favorite]
I was prescribed lisinopril and the dry hacking cough did not go away until was switched to something else 6 months later.
posted by tipsyBumblebee at 12:47 PM on June 17, 2021 [1 favorite]
posted by tipsyBumblebee at 12:47 PM on June 17, 2021 [1 favorite]
The cough never went away for me, so after a few months my doctor switched to another in the same class.
posted by 922257033c4a0f3cecdbd819a46d626999d1af4a at 1:36 PM on June 17, 2021 [1 favorite]
posted by 922257033c4a0f3cecdbd819a46d626999d1af4a at 1:36 PM on June 17, 2021 [1 favorite]
The dry cough is a relatively common side effect. There is a closely related class of medication mentioned above (angiotensin receptor blocker’s) that are almost the same but don’t produce the cough, So even if you are in a group of people where acei are preferred, there is very little loss. ARBs Are slightly more expensive, but still not an expensive drug.
posted by a robot made out of meat at 3:33 PM on June 17, 2021 [2 favorites]
posted by a robot made out of meat at 3:33 PM on June 17, 2021 [2 favorites]
The cough never went away for me, I am now on a BP med that is not lisinpril and not a diuretic and is inexpensive. There are options out there.
posted by ReiFlinx at 3:56 PM on June 17, 2021 [2 favorites]
posted by ReiFlinx at 3:56 PM on June 17, 2021 [2 favorites]
I really think the official incidence stats for "ACE inhibitor cough" are way too low. Because yeah, been there, done that, got off lisinopril.
I was on a beta blocker for a while, but a new doctor suggested amlodipine and it's been fine for me. There are DEFINITELY a lot of options for treating hypertension; I'm a little weirded out that your doctor only suggested two, unless (as may well be the case) there are other medical factors in play.
posted by humbug at 4:57 PM on June 17, 2021 [2 favorites]
I was on a beta blocker for a while, but a new doctor suggested amlodipine and it's been fine for me. There are DEFINITELY a lot of options for treating hypertension; I'm a little weirded out that your doctor only suggested two, unless (as may well be the case) there are other medical factors in play.
posted by humbug at 4:57 PM on June 17, 2021 [2 favorites]
I had similar symptoms. I switched to Losartan, which still has some hint of the cough symptom, but it is much less.
posted by demiurge at 5:23 PM on June 17, 2021 [1 favorite]
posted by demiurge at 5:23 PM on June 17, 2021 [1 favorite]
(I am not super thrilled about needing to switch to a diuretic if I can't tolerate lisinopril).
I've been prescribed a similar ACE inhibitor (perindopril), there may are other ACE inhibitor (and ARB) options if you can't tolerate lisinopril. I was definitely warned of cough with perindropril by both my doctor and pharmacist (it didn't happen for me, but it seems to be quite common).
As humbug mentioned, another class of drug are calcium-channel blockers (e.g., amlodipine) that aren't in the diuretic class, and are widely available as generics. I'm currently on a low dose of it, and I'm also surprised that it wasn't mentioned as an option, unless there is a compelling reason based on other stuff about you that your doctor's aware of. In my case, my doctor's preferred first-line drug was amlodipine, just as a data point.
posted by mandolin conspiracy at 5:34 PM on June 17, 2021 [2 favorites]
I've been prescribed a similar ACE inhibitor (perindopril), there may are other ACE inhibitor (and ARB) options if you can't tolerate lisinopril. I was definitely warned of cough with perindropril by both my doctor and pharmacist (it didn't happen for me, but it seems to be quite common).
As humbug mentioned, another class of drug are calcium-channel blockers (e.g., amlodipine) that aren't in the diuretic class, and are widely available as generics. I'm currently on a low dose of it, and I'm also surprised that it wasn't mentioned as an option, unless there is a compelling reason based on other stuff about you that your doctor's aware of. In my case, my doctor's preferred first-line drug was amlodipine, just as a data point.
posted by mandolin conspiracy at 5:34 PM on June 17, 2021 [2 favorites]
A related suggestion - before doing anything about your BP medication, perhaps arrange a Covid test just to rule out the most obvious cause of dry cough? Even if you're fully vaccinated it's still possible to catch it.
posted by altolinguistic at 6:02 AM on June 18, 2021
posted by altolinguistic at 6:02 AM on June 18, 2021
From my personal experience, the cough will not go away. Doctor will have to change your Rx, and most likely, add a water pill.
posted by james33 at 6:09 AM on June 18, 2021 [1 favorite]
posted by james33 at 6:09 AM on June 18, 2021 [1 favorite]
Your choices are not binary here - lisinopril is one of many inexpensive blood pressure medications, and diuretics are sometimes used in conjunction with them and not just instead of them. (I'm on a lisinopril/diuretic combo pill.)
In any case, the lisinopril cough is a real thing. It goes away for some people and not for others. One week in is, in my opinion, not enough time to know if you will be in the former or the latter category. That said, you should report the side effect to your doctor and see if she wants you to continue and see if the cough dissipates, or just switch to another medication.
posted by bedhead at 9:22 AM on June 18, 2021
In any case, the lisinopril cough is a real thing. It goes away for some people and not for others. One week in is, in my opinion, not enough time to know if you will be in the former or the latter category. That said, you should report the side effect to your doctor and see if she wants you to continue and see if the cough dissipates, or just switch to another medication.
posted by bedhead at 9:22 AM on June 18, 2021
You could change to an ARB like losartan.
Hypertension management guidelines: https://www.ajmc.com/view/the-jnc-8-hypertension-guidelines-an-in-depth-guide
The underlying evidence: https://www.pharmacytimes.com/view/the-clinical-core-of-the-jnc-8-hypertension-guidelines
posted by metatuesday at 5:48 PM on June 18, 2021
Hypertension management guidelines: https://www.ajmc.com/view/the-jnc-8-hypertension-guidelines-an-in-depth-guide
The underlying evidence: https://www.pharmacytimes.com/view/the-clinical-core-of-the-jnc-8-hypertension-guidelines
posted by metatuesday at 5:48 PM on June 18, 2021
In the midst of a respiratory virus pandemic, I have stopped new prescriptions of ACE inhibitors altogether because of the inconvenience that a new cough can entail.
Ask your doctor if he may consider swap to an ARB: same benefits, no cough. Also, worthwhile to make a visit to make sure it's not something else?
posted by ianK at 7:28 PM on June 20, 2021 [2 favorites]
Ask your doctor if he may consider swap to an ARB: same benefits, no cough. Also, worthwhile to make a visit to make sure it's not something else?
posted by ianK at 7:28 PM on June 20, 2021 [2 favorites]
Response by poster: Thanks, everyone. I got in touch with my doctor who said that the cough would not go away, and she switched me to an ARB (Losartan). In retrospect, it does make me question my doctor's first choice of medication, in light of the pandemic, and I may be switching doctors in the future because of this.
posted by nanook at 7:32 AM on June 29, 2021
posted by nanook at 7:32 AM on June 29, 2021
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(I was diagnosed with HPB in 2016 and have tried both diuretics and lisinopril. I don't know about the ramping up phase or if this is something your body gets used to, but this would concern me as a side effect and I would call.)
posted by Ms Vegetable at 12:18 PM on June 17, 2021