The People's Perspective on Medicine

Horrible Cough from Blood Pressure Pill

A constant horrible dry cough that just won't go away could be a side effect of Lisinopril.

Q. I was given a prescription for lisinopril last year to lower my blood pressure. During the winter I developed a constant horrible dry cough that just wouldn’t go away.

One day at work I started coughing and couldn’t stop. It was so bad that the secretary called 911.

Various doctors tested me for sleep apnea (negative), throat polyps (negative), allergies (none) and lung function (normal). I couldn’t quit coughing.

On my own I dropped the lisinopril and within a week my cough vanished. I am upset that I was put through so many expensive tests when the real problem was a common drug side effect.

A. Hundreds of readers have reported a similar experience with ACE inhibitor blood pressure drugs like benazepril, captopril, enalapril, lisinopril, quinapril and ramipril. Some have lost bowel and bladder control from coughing so hard.

Because blood pressure control is essential to prevent heart attacks and strokes, we are sending you our Guide to Blood Pressure Treatment, which summarizes the pros and cons of medications and non-drug approaches. We don’t advise anyone to stop blood pressure medication without their doctor’s knowledge and supervision.

It is disappointing that you saw so many doctors who failed to correctly identify your cough as a common drug side effect. We consider this a major medical mistake. It is one that happens way to often. If you would like to learn more about how to avoid such devastating complications we suggest our autographed book, Top Screwups Doctors Make and How to Avoid Them. In it you will learn about the most common mistakes doctors make when prescribing medications. You will also find out about the most dangerous drugs in the drugstore and how to avoid deadly drug interactions. Protect yourself and those you love.

It should be possible to control high blood pressure without intolerable reactions. We are still astonished that so many specialists overlooked your medication as a cause for uncontrollable coughing. Every medical student in the country learns that ACE inhibitors like lisinopril can cause a bad cough. Every physician should know this. If doctors cannot recognize such a common side effect with such a frequently prescribed medication we shudder to think what else they are forgetting or ignoring when it comes to adverse drug reactions.

Rate this article
3.4- 26 ratings
About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
Blood Pressure Treatment

Download these eight pages on the pros and cons of the various medicines used to lower blood pressure. Details on non-drug approaches to blood pressure control such as diet, supplements and special foods.

Blood Pressure Treatment
Join over 150,000 Subscribers at The People's Pharmacy

We're empowering you to make wise decisions about your own health, by providing you with essential health information about both medical and alternative treatment options.

Showing 38 comments
Add your comment

I am having the same issues, only with losarten. Very bad cough and.had almost stopped. peeing. I see my doctor soon. Hope she has some answers for me.

I have taken drugs in all three classes and had the horrible cough. What can you do if none of the drugs can be taken?

I have high blood pressure that I’m trying to get down, but so far, I have tried losartan and linsinopril and I have a cough that won’t stop. It is very frustrating and keeping me up at night. Are there any blood pressure medicines that are cheaper that won’t do this?

My Mom had a heart attack in October and was given rampril and many other medications. She now has a racking cough and is bringing up white gluey stuff (her words). It is making her weak . We have a doctors appointment in 6 days . I wish I could help her now. She is taking 2 a day. Reading all of your comments helped but I am so worried and scared for her, it sounds like all of these drugs are so dangerous … I wish all of you well and pray for you to be free of pain and discomfort.

What do you take for the cough? Not much sleep in 5 or 6 weeks because of cough. Dr just today took me off blood pressure med but told me 3 months for it all to get out of system. Don’t think I could take 3 months of this cough.

I can’t seem to find a pill for blood pressure that does not cause a cough. What would you pick?

A diuretic (water pill) such as chlorthalidone doesn’t cause a cough.

Yes, some doctors must have come last in their class, and I have visited all of them! My Ramipril cough has come back even though I am on Karvea now. I will go back to my doctor this week but don’t have much confidence in him, sadly.

Karvea is irbesartan, an ARB. Although ARBs are less likely than ACE inhibitors like ramipril to cause cough, some people are sensitive to them and develop a cough on an ARB. You seem to be among them. Your doctor should pay attention.

Is there a site or a list of prescription drugs that will list the side effects of a drug? I have 4 prescription drugs that I take. I have a constant cough and none of the tests run show a reason for that cough. I would just like to find out if any of these prescribed drugs does have a side effect of coughing. Cannot seem to find any simple way to obtain this information. Have gone through all the logical tests, exams and doctors and no answers on the cough. The prescriptions are the next step in my mind.

Is there a site or a list of prescription drugs that will list the side effects of that drug? I have 4 prescription drugs that I take. I have a constant cough and none of the tests run show a reason for that cough. I would just like to find out if any of these prescribed drugs does have a side effect of coughing. Cannot seem to find any simple way to obtain this information. Have gone through all the logical tests, exams and doctors and no answers on the cough. The prescriptions are the next step in my mind.

I just got done going to the drs about a cough. Mine was from lotrel this time. She tried to get me to keep taking it like last month but I had already stopped. I also had migraines, and almost totally stopped peeing. It’s your health! You can refuse to take meds that make you feel bad. My dr knows me and if I am fair with trying but once I refuse that’s it.

I didn’t realize you could be on Lisiopril for years and just now develop a cough. I’ve been coughing my head off for three months now.Finally went to ENT and he tells me it could be my BP meds or reflux . He gave me meds for reflux but I still have the nagging dry cough so I’m guessing I need to change BP meds.

I have been on Losarten since about 2003. I have a dry hacking cough that I’ve been living with since then. I had told several Dr`s and not one has said that it is from this med. I definitely am going to talk to my Dr when I go for my next appointment. Also I get yelled at for my weight. That causes everything that comes wrong with me. I had my gall bladder out, a total hysterectomy, a colon resection, and my liver dissected. I was 265pds and now I am 240pds and just can’t lose anymore. I gain if I look at food! But every time I tell him about the cough or anything it’s because of the weight, get charged, and leave till 4 months, and then a repeat. This is what’s been going on since I started seeing him around 1998.

The MD needs to quit the weight shaming and partner with you to help you lose the weight: check you thyroid function, prescribe assistance with diet changes, exercise, supplements etc. There are many things a doctor can do to help a patient lose weight. Running his or her mouth isn’t one of them!

Can you go to a different doctor?

after being started on lisinopril , I developed a dry hacking coughing. was off lisinopril for a few days with cough continuing . Was given decradron before surgery. woke up, no cough. begin losartan two days after surgery. cough started again that same day. Doc doesn’t think it is related. I do. can someone help with this?

Sounds like you have a CRAPPY doctor with no empathy and NO BEDSIDE MANNER whatsoever! I’d look around for a different doctor.

Good for you Mary. I had a similar experience only that my former doctor wanted to increase my dosage of lisinopril instead of working on the issue of diet and lifestyle which I knew was the problem. I got another doctor and remained on the lower dosage of 10mg. Since then I have developed that aggressive dry cough and was switched to Losartan 50mg even considering my bp was down 118/62 because I did change my diet and lifestyle. I’m really skeptical of using any meds but I understand you have to be weaned off instead of stopping cold turkey. Good luck to you.

I agree. My doctor told me that since my cough developed a month after taking Zestril it could not be due to the medicine. He said it would have happened right away. So I was given an inhaler for asthma. After taking that I insisted that we change the BP medicine and the cough disappeared. You can “do your homework” but that doesn’t mean the doctor will pay attention to what you say.

I have been taking Lisinopril for 4 years. I have been using a generic form of linisopril. The drug stores and Walmart etc are buying the cheapest one (China) they can find. BUYER BEWARE.
I made it a point to make this a project of research until I resolved the problem others were having with Lisinopril including me.
Dizziness, coughing and insomnia. Ridiculous to have to live this way.
I asked my lovely doctor about this problem and she said you have to find a distributor that you can tolerate their meds. I DID.
Here it is and I get it from Walgreens and it is MADE IN AMERICA and I no longer have dizzy spells or that horrible coughing. This should tell you, by this reaction, that something isn’t right.
Name: QUALITEST manufacturer
Purchased at Walgreens
If Walgreens tells you they cannot order or find it go to another Walgreens because if they say NO its because they cannot buy it as cheap as the other brand they are selling from CHINA. This is what I had to do. I finally found a Walgreens that would go the extra mile for me.
I hope this helps. My problem with this drug is resolved.
Mine is not HCZ diruetic but they have it. Instead I use HIBISCUS for this and it works for me.

Take a washcloth and run it under very cold water and wring it out. Lay down flat and place the washcloth over your throat. Cover this with a dry hand towel.

I too developed a hacking cough with lisinopril but was lucky. My doctor took me off the lisinopril and put me on Diovan and told me that about 15% of patients can not take Lisinopril because of the coughing.
However, I have complained to no avail about meds interacting and being prescribed overdoses of meds. Norvasc and Zocor interact and I was being prescribed excessive amounts of both and my creatinine level rose alarmingly. I now take 1/2 the amount of each and have had no further kidney indicators.
The most troubling part of this was that I saw a kidney specialist and another specialist, had a scan of my kidneys (nothing found) and neither doctor asked about what meds I was taking or suggested any changes when I insisted on telling them what I was taking. The kidney specialist told me to come back when my kidneys failed since he could not do anything to help me until then. When I saw a cardiologist for an annual check up (I had had atrial fib) and told him there appeared to be a developing kidney problem he brushed it off and said that was not important.
By now 4 doctors could not figure out why the creatinine was going up but none reviewed the meds I was prescribed. Then the FDA posted a warning about the amount of Zocor that could be safely prescribed if the patient was also taking Norvasc, and I was taking at least twice as much that would be safe. I no longer have much faith in the medical profession and do not think they listen to or care very much about their patients.

You shouldn’t have to do that to relieve the cough (I couldn’t lie down at work, when I’d get coughing fits).

At what dosage does the Lisinopril cause the coughing? I’m on a tiny dose in addition to my oral diabetes medications. Should I be concerned?

I had a similar reaction and my doctor wanted to give me another pill to help the coughing. I had to ASK if there was another medication that I could take to control the blood pressure problem that wouldn’t make me cough. It seems doctors just want to pump you full of pills rather than fix the problem.

As you mentioned, this is not the first time you have learned of coughing as a side effect of Lisinopril from uninformed people. What I don’t understand is why these people do not read the description and side effects of the prescription–which information is always attached to my prescriptions. Is it possible that they do not receive this printed information?

I have the same type of Dr. In one ear ,& out the other. I’m on 14 different medications.

She should change both her doctor and pharmacy. I, too, had a cough with Lisinopril, though not as severe. My doctor warned me about this upon prescribing it, and the information that the pharmacy provided also listed it as a common side effect. I’ve since switched to a beta blocker, which has its own set of side effects.

I had the same problem of periodic spasmodic coughing that left me gasping for air–coughing that only an Albuterol inhaler could quell. I didn’t even THINK to mention the coughing to my doctor since I put it down to occasional symptoms of “reactive airways.” However, when I did finally tell her after years of these coughing episodes, my doctor said that one of the side effects of Lisinopril for some patients is coughing and she switched my blood pressure medication to Losartan. After about 10 days on Losartan I noticed that I coughed very rarely. I haven’t had another of the spasmodic coughing episodes since I started Losartan about three months ago.

It’s not the pharmacy it’s the people who supply the pharmacy. My cough develops with certain nanufactuers who make the same medication but with slightly different ingredients particularly wax coated tablets cause coughs

The lady who was on Lisinopril and suffered a severe cough was fortunate that her cough stopped after a week. I went off lisinopril and continued coughing for months. Thankfully that is over. My Dr. did tell me at the time he prescribed it that it could cause a cough. He did not say that the cough can continue for up to 6 months after stopping the medication.

I had a similar incidence with lisinopril and consequently with every ACE inhibitor I have tried. The thing that made me so mad was the fact that I went back to the doctor who prescribed lisinopril and asked her if the ACE inhibitor was causing the cough. She said “no” and proceeded to prescribe meds for the cough including an antibiotic. When I went to the pharmacist with the prescription he said I probably didn’t need the antibiotic that he was sure it was the lisinopril. I didn’t fill the antibiotic prescription and called the doctor. She still insisted it was not from the lisinopril and said I should fill the prescription she just gave me. I didn’t and I also got a new doctor.

Thank you for your precise info about having a cough for months after stopping your rx. I have been off it for only 3 days and was feeling hopeless because I thought the cough would decline right away. Actually, the first day, I hardly coughed and it doubled down since. I’ve been to my nurse practitioner twice and urgent care once. Feeling so defeated. Blood pressure is back up,but I want to try to see if this helps the cough which is tearing me up. Darlene

I too was put on a “pril” a number of years ago and developed a dry hacking cough. It improved after getting off the medicine. However, now every time I get a cold (sinus or respiratory) a have a return of “the cough” that it only stopped after a regimen of prednisone. This is very troubling as it elevates my blood sugar levels. Any suggestions?

This report underscores the importance of reading the package insert and looking up information on the web about any new drug you take.
This particular side-effect is listed as one of the most common ones for this group of drugs.

It has been my experience that doctors ask questions rather than listen to the patient. They start heaven knows where, but it has been nowhere near where I was. The message they get, or make up as they go along, is out of context which means it is incorrect. I truly think they mean well. But with the 10-15 minutes allotted, what else can they do. To add to the confusion, many patients haven’t done their homework and can’t state their symptoms clearly and precisely. Until doctors are willing to sacrifice their salary, they can’t give patients more time. And, many times, their listening is probably the most health-giving tool they have.
Patients, on the other hand, need to help by making their notes before they leave home (the short version) and sticking to them. Wouldn’t it be better to leave the listening to a staff member, with a lower salary who is empathic and a good listener, to determine what the symptoms really are and just use the doctor as the technician.

In the gynecology office we always ask about leaking urine, ACE inhibitors causing a cough, therefore a leak, is pretty common. It is disappointing that more clinicians don’t ask about it. Lisinopril and coughing has been documented since the drug was released more than a generation ago.

* Be nice, and don't over share. View comment policy^