Cough and enalapril: assessment by spontaneous reporting and visual analogue scale under double‐blind conditions.

Yeo, W W; Maclean, Derek; Richardson, PJ; Ramsay, Lawrence E.

doi:10.1111/j.1365-2125.1991.tb05544.x

Cited by 35 publications

(11 citation statements)

References 8 publications

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“…Yeo and his colleagues (1991) did not report on the frequency with which enalapril was discontinued due to cough. In a larger more recent study, Yeo et al (1991) again reported cough in enalapril recipients to be more troublesome in women and in non-smokers. In this report, they indicate that postmarketing surveillance studies underestimate the frequency of this condition.…”

Section: Discussionmentioning

confidence: 87%

“…However, in a subsequent analysis of spontaneous reports of suspected adverse reactions to captopril, the New Zealand workers noted that captopril discontinuation due to cough was reported much more frequently than expected in female subjects , an observation confirmed by the present work. More recently, Yeo et al (1991) investigated the reported occurrence of cough in a small series of newly diagnosed hypertensives randomly allocated to a 6 month doubleblind parallel group study comparing enalapril with nifedipine. Cough was not recorded with nifedipine, but occurred in 6.2% of enalapril recipients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Postmarketing surveillance of captopril for hypertension.

Chalmers

Whitehead

Lawson

1992

Brit J Clinical Pharma

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1. A scheme for augmented spontaneous reporting of adverse drug events using advanced view data systems was developed and applied to study 67,698 consecutive patients prescribed captopril in general practice for the treatment of hypertension. 2. Captopril was an effective hypotensive agent in this population, as only 1.9% of patients were withdrawn because of apparent inefficacy. 3. Adverse effects of captopril resulted in withdrawal of treatment in 8.9% of recipients, and such effects were more frequent in elderly and female recipients. 4. Skin reactions‐usually maculopapular rashes‐tended to occur early during therapy whereas cough occurred much later and was reported more frequently in non‐smokers. 5. Some 1.1% of recipients died during follow‐up. There was no evidence of any unusual or unexpected causes of death which might be partially or totally captopril‐related in the study cohort. 6. The study confirms the feasibility of large scale postmarketing surveillance studied in general practice and allowed risk benefit assessments to be made on the use of captopril for treating hypertension.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Postmarketing surveillance of captopril for hypertension.

Chalmers

Whitehead

Lawson

1992

Brit J Clinical Pharma

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“…Support comes from observations of differences in incidence by sex (more common in females), race, smoking habit [15] and angiotensin converting enzyme gene polymorphism [16,17]. Furthermore, in some patients spontaneous resolution of cough occurs with uninterrupted treatment, without alteration of dose [18], whereas in others cough may even worsen with up to 6 months' continued treatment [19]. An objective measure of cough sensitivity would reduce patient and observer variability.…”

Section: Discussionmentioning

confidence: 99%

Reproducibility of angiotensin converting enzyme inhibitor induced cough: a double‐blind randomised study.

Charlon

Dollow

Fidel

et al. 1995

Brit J Clinical Pharma

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“…However among those who persist with treatment most consider their cough to be moderate or severe, and in the majority it disturbs sleep and is a nuisance to others [4]. The incidence of ACE inhibitor cough in controlled studies using validated methods of ascertainment is about 20% [4,5,7]. The cough is persistent, with a prevalence of 16% after 2 years of treatment [4] in addition to the 6% of patients who had stopped treatment because of cough [4].…”

Section: Introductionmentioning

confidence: 99%

Effect of dose adjustment on enalapril‐induced cough and the response to inhaled capsaicin.

Yeo

Higgins

Foster

et al. 1995

Brit J Clinical Pharma

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1 In nine hypertensive patients with enalapril-induced cough the effect of altering the dose of enalapril on subjective cough and the cough response to inhaled capsaicin was examined in a random single-blind balanced cross-over study. They received three doses of enalapril, each for 3 weeks; the dose at entry (mean 10 mg daily); double this dose (mean 20 mg daily); and half this dose (mean 5 mg daily). 2 The cough response to inhaled capsaicin was also measured in two control groups:hypertensive patients on long-term enalapril treatment with no cough (n = 18), and hypertensive patients taking nifedipine (n = 17). 3 In patients with enalapril-induced cough there were significant dose-responses for enalapril as regards severity of cough (P < 0.05) and night time waking by cough (P < 0.05), but not for frequency of cough. Although the cough was less severe (P < 0.02) and caused less night time waking (P < 0.03) on the lowest dose of enalapril (mean 5 mg daily) it did not disappear completely in any patient. 4 The sensitivity to inhaled capsaicin did not differ significantly on the three doses of enalapril. The relative potency of capsaicin on enalapril 20 mg compared with enalapril 5 mg was 1.0 (95% CI 0.4-2.2). The wide confidence limits indicate that an important dose-dependent shift in capsaicin sensitivity is not excluded. 5 The sensitivity to inhaled capsaicin differed significantly between patients with enalapril-induced cough and both control groups. The relative potency of capsaicin was 0.2 (95% CI 0.1-0.4, P < 0.001) in patients taking nifedipine, and 0.4 (95% CI 0.2-0.8, P < 0.005) in patients taking enalapril who had no cough, when compared with patients with enalapril-induced cough. 6 The dose-response for capsaicin was shifted significantly to the left in patients on enalapril who had no cough when compared with patients taking nifedipine (relative potency 0.5, 95% CI 0.3-1.0, P < 0.05). 7 In patients with enalapril-induced cough reducing the dose improves the severity of cough and night time waking, but this may be of limited value as the cough persisted to some degree in all patients. 8 The enhanced sensitivity to capsaicin in patients taking enalapril who had no cough suggests that ACE inhibitors may alter the cough reflex in all patients, with those who develop cough representing the extreme of this general shift. This hypothesis needs to be tested in a larger prospective study.

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Cough and enalapril: assessment by spontaneous reporting and visual analogue scale under double‐blind conditions.

Cited by 35 publications

References 8 publications

Postmarketing surveillance of captopril for hypertension.

Postmarketing surveillance of captopril for hypertension.

Reproducibility of angiotensin converting enzyme inhibitor induced cough: a double‐blind randomised study.

Effect of dose adjustment on enalapril‐induced cough and the response to inhaled capsaicin.

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