Cough linked to use of ACE inhibitors can be serious business
Q: I have had the cough from hell, with retching and even vomiting, for six months now.
The first doctor suggested I have a “postviral hyperreactive cough.” The second recommended drugs for acid reflux and the third prescribed an inhaler for asthma. I begged for a test for whooping cough, which was negative. I now have been referred to an ENT for a nasopharyngeal camera.
Today, I read on your website that my cough could be caused by ACE inhibitors. I take ramipril for blood pressure, and it is an ACE inhibitor.
Why isn’t this cough listed as a side effect of ramipril?
A: We are shocked that your doctors did not warn you about an ACE-inhibitor cough. It is a common side effect of drugs with “pril” in their names, like benazepril, captopril, enalapril, lisinopril and ramipril.
This cough is far more than a little tickle. It can keep people awake at night, and no cough medicine can calm it. The only solution is to switch to a different kind of bloodpressure medicine.
Q: My last visit to the cardiologist indicated that I have atrial fibrillation again in spite of the Multaq that I am taking. The doctor said to keep taking one aspirin at night, stop taking Multaq and take the anticoagulant Pradaxa twice a day. According to him, it’s better than Coumadin.
He was adamant that Pradaxa has an antidote, though I’d always heard that there is not one. What is the story on this?
A: Until this fall, there was no antidote to dabigatran (Pradaxa). In October, the FDA approved Praxbind to reverse the anticoagulant effect of Pradaxa in emergencies. The most serious side effect of Pradaxa is uncontrollable bleeding, so doctors will no doubt find it helpful to have a compound that can reverse the effects of Pradaxa within minutes (New England Journal of Medicine, Aug. 6, 2015).
Q: I’ve been drinking tonic water for leg cramps, but I developed severe pressure in the right side of my head and my temple. I was taking a few ounces of tonic water each night. Could this be causing the problem?
A: The active ingredient in tonic water is quinine. This natural compound gives tonic its distinctive bitter taste.
Quinine was once prescribed for nighttime leg cramps, but the Food and Drug Administration no longer permits that use because of serious side effects. Although rare, a blood disorder called idiopathic thrombocytopenic purpura can be lethal.
Some people are very sensitive to the adverse effects of quinine, which include headache, ringing in the ears, anxiety, confusion, visual disturbances, skin rash and fatigue. Perhaps it is causing your headaches.