Comparative Study of Taste Disturbance by Losartan and Perindopril in Healthy Volunteers

Abstract

The aim of this study was to compare the degree of taste disturbance by losartan, an angiotensin II receptor blocker, with that of perindopril, an angiotensin-converting enzyme inhibitor. Perindopril erbumine (2 mg), losartan potassium (25 mg), or vehicle was given to Japanese volunteers (n = 7) for 14 days in a randomized, placebo-controlled, 3-way crossover design with a 14-day washout period. Gustometry by filter-paper test and electrogustometry were performed before and at the end of each trial. Plasma renin activity (PRA) and serum and salivary zinc concentrations were measured. One subject dropped out because of a perindopril-induced dry cough, but no one claimed a taste disturbance. Detection thresholds of 4 basic tastes (sweet, salty, sour, and bitter) by the paper-disc test and electrogustometry were significantly worsened, and plasma renin activity was elevated by the drugs, whereas the deteriorating effects of 2 drugs did not significantly differ. These drugs did not affect zinc concentrations in plasma and saliva. It was concluded that losartan and perindopril similarly alter taste sensitivity during repeated dosing of the drugs.

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“…6 The role of ACE2 in modulating taste perception has been highlighted in many studies analyzing the chemosensitive side effects of ACE2 inhibitors and angiotensin II blockers. 7,8 The mechanism by which ACE2 inhibitors cause taste disturbance is unclear but does not appear to be related to any alteration in serum 7,8 and saliva 7 zinc levels. Presumably, these drugs inactivate the Gprotein-coupled proteins and sodium-ion channels present in the taste receptors.…”

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“…In the current study, the subjects had no recent history of somatic disorders that are known to alter gustatory function. About 170 drugs, either alone or in combination, are reported to be associated with taste disturbances (Nolan, 2001;Schiffman, 1991;Tsuruoka et al, 2004Tsuruoka et al, , 2005. Angiotensin-converting enzyme (ACE) inhibitors and decreased Zn in the blood are well-known causes of taste disturbances.…”

The Authors Reply

“…In this regard, one has to consider the taste disturbance caused by angiotensinconverting enzyme inhibitors (ACEIs) and angiotensin-2 receptor blockers (ARBs). 2,3 The authors reported that ACEIs and/or ARBs were prescribed for 72% of the patients with CKD. This could explain the higher taste thresholds in CKD.…”