Blood pressure medications, like any other, have some side effects. Are you taking blood pressure medication and find yourself coughing? If so, you may want to know, which blood pressure medications cause coughing?

The most common blood pressure medications causing coughing are ACE inhibitors and angiotensin receptor blockers (ARBs). Coughing occurs because the drugs insoluble by-products lodge themselves in the lungs’ brachial tubes. Coughing is the body’s attempt to expel the by-products from the lungs.

This blog post will inform you of all the ACE inhibitors and angiotensin receptor blockers which may be causing coughing. In addition, what you can do to solve the problem.

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Blood Pressure Medications That Cause Coughing

Since ACE inhibitors¹ and angiotensin receptor blockers causes you to cough², you’ll want to know which medicines fall under each medication category. The following is a list of blood pressure medications that cause coughing:

ACE Inhibitors:

• Captopril (Capoten)
• Lisinopril (Prinivil, Zestril)
• Benazepril (Lotensin)
• Ramipril (Altace)
• Enalapril (Vasotec)
• Moexipril (Univasc)
• Fosinopril (Monopril)
• Perindopril (Aceon)
• Quinapril (Accupril)
• Trandolapril (Mavik)

Angiotensin 11 Receptor Blockers:

• Candesartan (Atacand)
• Eprosartan (Teveten)
• Losartan (Cozaar)
• Irbesartan (Avapro)
• Valsartan (Diovan)
• Telmisartan (Micardis)

In one study³ 79 people with type 2 diabetes and high blood pressure were given a combination drug treatment. The combination treatment was ACE inhibitors and thiazide diuretic.

The results showed the most common side effect was a cough which occurred in 13.9% of the people. The study backed up the claim ACE inhibitors cause upper respiratory symptoms like coughing⁴.

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Why Do Blood Pressure Medications Cause Coughing?

Battling high blood pressure with medication can be very difficult. Adding a cough to the situation complicates the problem even more. You’re probably wondering, why do blood pressure medications cause coughing?

Blood pressure medications, like ACE inhibitors, cause coughing because they affect how the kidneys filter impurities out of the blood. Kinins, the insoluble by-products of the medication, are unfiltered out of the blood. Instead, they lodge in the brachial tubes of the lungs. The coughing is the body attempting to expel the kinins from the lungs.

As a person ages, this makes the problem worse because an older person loses kidney function. This makes it harder for the body to clear drugs from the kidneys and blood⁵.

Even if a person stops taking the drugs or switches to a different medication, the coughing may persist for months. This is because the kinins in the lungs takes some time to clear out of the lungs.

Unfortunately, some people who have a cough from medication may be diagnosed as having another problem, like a sore throat or bronchitis.

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Blood Pressure Medications Causing Coughing: What To Do

If you’re taking blood pressure medicine and have developed a cough, you don’t have to live with it⁶. It is recommended to talk to your physician or health care provider about your problem. They may re-evaluate your treatment, change medication or give you something to stop a cough.

In addition, there’s always a possibility a cough is being caused by another issue and not the medication. As with any issue related to your health, always consult with your physician.

How Long After Starting Blood Pressure Medication Does a Cough Start?

Maybe you’re on an ACE inhibitor, like Lisinopril and you’re not coughing⁷. Hopefully things stay that way but you be wondering, how long after starting lisinopril does a cough start? Coughing after starting lisinopril may not occur immediately. Typically, coughing may start months or even a year later after starting the medication.

One study researched the use of the medication Ramipril, an ACE inhibitor and coughing. A ramipril related cough occurred 7.1% of the time. The researchers noted the longer it takes for a cough to develop, the more likely it’s not the medication as the cause⁸.

Pressure Medications That Don’t Cause Coughing

If ACE inhibitors or Angiotensin ll Receptor Blockers⁹ can cause a cough, you may be wondering which blood pressure medications don’t cause coughing?

The following blood pressure medications don’t cause coughing as a side effect:

Diuretics:

• Metolazone (Mykrox, Zaroxolyn)
• Bumetanide (Bumex)
• Amiloride (Midamor)
• Indapamide (Lozol)
• Triamterene (Dyrenium)
• Chlorthalidone (Hygroton)
• Chlorothiazide (Diuril)
• Furosemide (Lasix)
• Hydrochlorothiazide (Hydrodiuril, Esidrix, Microzide)
• Spironolactone (Aldactone)

Beta-blockers:

• Nadolol (Corgard)
• Timolol (Blocadren)
• Sotalol (Betapace)
• Atenolol (Tenormin)
• Acebutolol (Sectral)
• Bisoprolol (Zebeta)
• Betaxolol (Kerlone)
• Propranolol (Inderal)
• Pindolol (Visken)
• Nebivolol (Bystolic)
• Penbutolol (Levatol)
• Metoprolol (Toprol XL, Lopressor)
• Carteolol (Cartrol)

Calcium Channel Blockers:

• Amlodipine (Norvasc)
• Verapamil (Covera, Isoptin, Calan, Verelan)
• Isradipine (DynaCirc)
• Bepridil (Vasocor)
• Diltiazem (Cardizem, Tiazac, Dilacor)
• Felodipine (Plendil)
• Nicardipine (Cardene)
• Nifedipine (Adatta, Procardia)
• Nisoldipine (Sular)

Vasodilators:

• Hydralazine (Apresoline)
• Minoxidil (Loniten)

Central Agonists:

• Guanabenz (Wytensin)
• Clonidine (Catapres)
• Guanfacine (Tenex)
• Methyldopa (Aldomet)

Direct Renin Inhibitors:

• Aliskiren (Tekturna)

Peripheral Adrenergic Blockers:

• Guanadrel (Hylorel)
• Guanethidine Monosulfate (Ismelin)
• Reserpine (Serpasil)

Alpha Blockers:

• Doxazosin Mesylate (Cardura)
• Prazosin Hydrochloride (Minipress)
• Terazosin Hydrochloride (Hytrin)

As mentioned earlier, always consult with your physician about which medications are best for you and their side effects. All blood pressure medications come with some side effects¹⁰.

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FAQs:

What is the blood pressure medication cough like? A cough from blood pressure medication is a dry cough and persistent. Some people have reported, the cough is so bothersome they have stopped taking the medication.

The coughing spells may last long and some people have described them as violent.

Do all blood pressure medications cause coughing? Not all blood pressure medications cause coughing. Alpha blockers, diuretics, beta blockers, calcium channel blockers, vasodilators, direct renin inhibitors, peripheral adrenergic blockers and central agonists don’t list coughing as a side effect.

Which high blood medication has the least side effects? The blood medication with the least side effects are Alpha-2 receptor agonists. This blood pressure medication can cause drowsiness or dizziness.

What is the most common blood pressure medication causing a cough? The most common blood pressure medication causing a cough is lisinopril. This is because it’s an ACE inhibitor and more prescriptions are written for it than other medications.

How many people taking an ACE inhibitor will develop a cough? Some studies suggest from 7% to 33% of all patients taking an ACE inhibitor will develop a cough.

Wrapping Up The Blood Pressure Medications Causing a Cough

Don’t judge any one particular medication because of its possible side effects. Every medicine has them and not everybody is affected by them.

No drug is more superior than the other. The value of each drug and how it affects blood pressure is judged on an individual basis¹¹.

Most often, physicians can tailor a medication and treatment for each individual patient. The physician will often prescribe a medication that controls blood pressure with no side effects or coughing.

Disclaimer: The medications, medicine information, side effects listed in this article are for information and reference only. Blood Pressure Explained does not endorse or recommend any specific medication. It’s important to consult with your physician and pharmacist about any medication you may be taking as they are the best sources of information. Never stop taking medication or change your dose without consulting with the prescribing physician.

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4. National Center for Biotechnology Information: ACE inhibitors: upper respiratory symptoms [↩]
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6. FDA: High Blood Pressure–Medicines to Help You [↩]
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8. National Center for Biotechnology Information: Factors that favor the occurrence of cough in patients treated with ramipril – A pharmacoepidemiological study [↩]
9. NHS: Treatment High Blood Pressure [↩]
10. The American Heart Association: Types of Blood Pressure Medications [↩]
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