The People's Perspective on Medicine

Lisinopril Cough Drove Reader to the End of the Rope

Lisinopril is an ACE-inhibitor blood pressure pill that can cause a persistent cough. The lisinopril cough may have a dramatic impact on quality of life.

Many readers report trouble with a side effect that ought to be more readily recognized. Why doesn’t everybody know about lisinopril cough?

One of the most commonly dispensed blood pressure medicines in the pharmacy is lisinopril (Prinivil, Zestril). It belongs to a class of medications called ACE (angiotensin converting enzyme) inhibitors. Similar drugs include benazepril, captopril, enalapril, quinapril and ramipril.

One of the most common side effects of ACE inhibitors is a persistent cough. The FDA official prescribing information for these blood pressure drugs suggests that it is relatively uncommon. But an analysis of clinical trials puts the actual incidence at nearly 12 percent and suggests this may be an underestimate (American Journal of Medicine, Nov. 2010).

Is It Difficult to Diagnose Lisinopril Cough?

A survey of primary care physicians concluded that ACE inhibitor cough, although well recognized, often goes undiagnosed (European Journal of Internal Medicine, July, 2016). Although a cough might seem like a minor complication, it can have a devastating impact on quality of life.

One Reader’s Story:

One reader shared her experience with lisinopril cough.

“I am a type 1 diabetic mother of three. Over a year ago my doctor prescribed lisinopril.

“A few weeks later, I started getting a persistent cough. I figured I’d caught a cold and took some OTC meds. When that didn’t work, I saw my doc and he prescribed antibiotics and a nasal spray.

“My cough then became harsh and hacking. I went to the ER and was given every test: x-rays and blood work but they found nothing. I was given Tessalon pills and antibiotics. Despite this, the cough was still there six months later.

“My cough became violent and I couldn’t keep any food down. My chest hurt horribly and my throat was painful. I became incontinent. When I felt like I was dying, my husband took me to the ER and once again they could not find anything wrong.

“Every single time I saw a doctor, I listed all the meds I took, always mentioning lisinopril. Yet not one doctor could put it together. They gave me antacids, pain medicine, Tessalon pills and azithromycin. I went home very depressed and feeling very sick.

“It has been over a year. I was suffering so much I felt that living a life like this was unbearable and I wanted to die.

“I finally went to see a new doctor. Within minutes of me talking and telling her what meds I took, she asked me if I was on blood pressure meds. I said yes and told her it was lisinopril. She said that was the cause of all of my pain and suffering, and I began to cry. I had contemplated suicide because of the side effects of this medicine.

“I hope no one else has to suffer like I did. How many other people out there are going through the same thing?

“I feel like I was tortured for a year. I am so tired and I’m only 44. There are other meds that work just as well. Why didn’t anyone catch this sooner?”

What Else Can You Do to Keep Blood Pressure Under Control?

This sad story is just one of hundreds we have received from patients who have suffered from a lisinopril cough. It underscores the importance for patients to learn the most common as well as the most dangerous side effects of their medications, whether they are ACE-inhibitor blood pressure pills or some other type of medicine. To aid you in obtaining such information, we offer a free Drug Safety Questionnaire.

While ACE inhibitors are excellent drugs for blood pressure control, there are some people who cannot tolerate the cough. Doctors have many other possible medications that are also useful in treating hypertension.

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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. .
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I’m not a Doctor but I would think that if you are taking an ACE inhibitor you will develop the cough (if you’re going to) within a couple of weeks of starting treatment. I did at first. I thought it was a coincidence. as I was started on Lisinopril around the same time I caught a cold. My cold symptoms went on for about three weeks but after seven weeks I still had this lingering cough. The best way I can describe it is as an itch in my throat and chest that made me cough suddenly and violently. I would be in the middle of drawing a patient’s blood, and I would apologize in advance for the violent cough.

Fortunately, my boss is also my practitioner, and I was sitting for the first time in front of during one of these cough attacks. She looked at me and said “I’m pretty sure it’s the Lisinopril that’s causing your cough!” So she’s switching me to Losartan. Hopefully, that will take care of the problem.

I was put on lisinopril and developed a cough that kept getting worse. My doctors told me it was asthma, allergies, sinus drainage, possibly lung cancer (I would cough up blood at times – probably from an irritated throat from coughing), gerd, etc. He sent me to an ENT who said it was caused by GERD and put me on a PPI. Still had the cough. I finally went to my pulmonologist’s PA, and she immediately took me off lisinopril and put me on losartan, and the cough went away. Now, I’ve heard that an ingredient in losartan can cause cancer. I’ve also developed a cough again which started when I was given propofol during a colonoscopy. That was ten months ago. I’m going to a new primary care doctor tomorrow and plan to ask him about the cough. I’m already on Toprol XL and Cardizem for A-Fib.

Lisinopril can also cause diabetes. It was published several years ago in The PHYSICIANS DESK REFERENCE.

I also had the severe cough from the lisinopril. When the cough started I went to my doctor and he sent me to an Ear Nose and Throat Doctor. The ENT doctor said the cough was from acid reflux. He gave me a prescription for the reflux and still no change in my cough. I had to quit my job because the coughing spell might come on at any time and if I was with a customer or on the phone, I had to get to the bathroom because I was gonna throw up from coughing. I started doing research online and found out the lisinopril could cause the cough but my doctor told me I needed to stay off the internet that that theory was nonsense. I decided to take myself off of the lisinopril and I had read that it may take 30 days or more to get it out of my system. About a month later the coughing stopped. My doctor didn’t like that I had diagnosed myself and that he was wrong. He put me on a different blood pressure medication and I started coughing again. I have very high blood pressure and I really need to find a blood pressure med that will lower it and not make me cough. I am so afraid to try any new meds because it takes so long for it to get out of my system and I just can’t take that cough for a month. Is there anyone who has tried several different BP meds and coughed, but has found one that worked? My BP has gotten to a scary level but I feel like I would rather die than live with the embarrassment and humiliation of that nasty cough that may happen at anytime or anywhere. People look at you like you have some kind of disease that they are gonna catch. So humiliating…

I have been taking lisinapril , for over 10 years and developed a cosistant cough. Took over the counter meds, including mucinex, and nothing worked, told my doctor, got blood work, I was told all is normal. Why are the dictors not relating this terrible hacking cough, that sometimes sounds like whooping cough, to lisinapril for high blood pressure

This is also my story since about April of 2016. It is now Feb 2017. Getting my meds changed tomorrrow.

Why does Lisinopril cause coughing?

I was on lisinopril for a short time but developed a cough and my doctor took me off of it. I am now taking carvedilol, furosemide, spirolactone, clopidogrel and losartan potassium. None of the information that comes with these drugs indicate they can cause a cough – but the cough is back and is so violent, sometimes I vomit.

I have had a persistent dry cough for several months.
After reading this article, I wonder if Amlodopine and /or Bystolic are causing this.
I have been on these drugs for years without that happening. Could they also be culprits? (I take other meds as well)

I also have that cough, though not as severe. It is very annoying. It usually hits when I lay down at night and sometimes sounds like I’m barking. I am relieved to know that this is common because I was beginning to think there was something else wrong with me. I am quite healthy otherwise.

My husband had the cough. Because I am a nurse and read everything, although my specialties are suicide prevention, mental health and nursing education, I immediately diagnosed him and sent him to the doc. I don’t understand why this is still on the market or not a warning sent to all docs, AGAIN. no excuse for them not knowing this and monitoring them.

I had the exact side effects ,the persistent, barking cough, that kept the whole household awoke at night, after night

Wow, this story might just have been a life saver. Now all I need to do is make an appointment with my physician. My cough has been driving me crazy, getting to the point where I hate to leave the house because all I do is cough and hack all day long.

My cardiologist prescribed lisinopril and I took it for more than two years. The persistent cough started almost immediately. I complained to the cardiologist and he pretty much shrugged it off. I finally complained to my pcp and she prescribed losartan. I’ve been on losartan for more than a year. My blood pressure is under control and I’m not coughing all the time.

As if angio-endema wouldn’t cause a person to cough!

In 2008, I was prescribed lisinopril and started coughing. I was lucky. My excellent family doctor immediately took me off the lisinopril and the cough disppeared. He told me at that time that about 12% of the population developed a cough from lisinopril.

Whenever I see a physician and they ask if I am allergic to any substance, I always mention lisinopril as an allergen. It is amazing that it is still being prescribed.

I had an almost identical experience. It took an ENT doctor to recognize the problem and take me off the drug.

I was one of the lucky ones that my cough, although consistent for a few minutes twice a day, every day, was not harsh, although annoying. As a matter of fact, I hadn’t even noticed it until a fellow worker asked me if I was taking anything for my cough (I usually hack for about a minute each time so I didn’t think it was anything bad).

I don’t remember anymore if my doctor let me know of this coughing side effect, but I did read about it in the description of lisinopril given to me by the drug store. I’ve been told by friends who have been very affected by the cough that their doctor has prescribed another pill; however, I have not asked mine to change because it took a long long time to come up with the cocktail of 3 meds to control my blood pressure (one of them being lisinopril).

I cannot take Lisinopril. It caused the worst cough. Luckily, a friend of mine had taken it and developed a cough. She told me that my cough sounded like the one she had when she was on Lisinopril. I immediately said that is what I am on. I spoke to the pharmacist and he said that most people can’t take it because of the cough!

I believe my chronic cough is also caused by lisinopril. I have it most days, especially in the morning, I mean the cough. I take lisinopril every night.

I have been going through this for a few months. At first, I thought it was from radiation and meds mixture when going through breast cancer. It is as if I had wrote this myself. Calling the doctor in the morning!

And it is prescribed for people with COPD, asthma and other lung problems with no warning that a cough might arise and little recognition of the problem when it does occur. A consistent dry cough on top of a lung problem is debilitating.

Look up side effects!

A gentleman I work with coughed so violently from this drug that it actually induced a stroke. It wasn’t too bad but so preventable and I just can’t understand why doctors don’t know about this very dangerous side effect.

My brother was on lisinopril for a out 3 years, with the cough, but it wasn’t a horrible cough. One morning, he woke up with his tongue so swollen he couldn’t keep it inside his mouth. He went to the ER and they called an emergency triage.

The ER doctor came out, rushing him into the ER, stripping his clothes off on the way, and giving him epinephrin, I think. He said if he had been five minutes later, he would probably be on a ventilator. Anaphaphylaxis is mentioned on the side effects but very far down the list.

I had Vasotec and it caused an awful cough too.

April 5, 2018 I had a coughing spell in church. It resulted in a stroke. I was able to get to ER in time to get special shot. I have no side effects of stroke. Grrrr. I do take Lisinopril. I certainly will check it out now that I know.

My doctor said that all ACE inhibitors will make you cough. I had to get off of them after I contracted pneumonia and my coughing got worse. I sure feel a lot better now.

All ACE inhibitors can cause cough in susceptible people, but only a minority of people are susceptible to ACE inhibitor induced cough.

A few years ago, my electrophysiologist wanted me to add Lisinopril to my regimen, despite the fact I told him I had bad reactions to other ACEs.

Well, I said I’d try . . . and 3 days later, I was so dizzy that I had to crawl to the phone to call 911. The ER put me into the hospital and it wasn’t until I insisted I wouldn’t continue Lisinopril that the fall-down dizziness disappeared.

My husband was taking Lisinopril and he had the terrible cough, too. It even woke him up at night so badly that he would lay down to sleep and all of the sudden he would start coughing and jump up because it would get so bad he couldn’t breathe.

He suffered for about 6 months and used a lot of throat drops before we determined it had to be that. The Dr. switched him to Amlodipine and the cough is gone and it regulates his blood pressure better.

This story is heartbreaking, not just because of how long it took to pinpoint Lisinopril as the problem, but maybe even more so because of the incredible amount of other medications and procedures she was given in the meantime, each with their own set of risks and side effects. Truly horrifying.

Great comment! You know, Ms. Lisa, as a retired auto mechanic, observing the ‘keystone cops’/docs of modern medicine, it occured to me, that we’d all be walking, limping, or six feet under if these doctors repaired cars.

After being prescribed generic lisinopril, I also experienced the dreaded cough. It got to the point that I could not catch my breath. After reading about this side effect, I talked to my pharmacist and tried using a British-made version (made by Watson) instead of the $4/made in India version, and found relief. Watson brand has since become unavailable, and I successfully made the switch to Zestril (thanks to my doctor for listening to me!) with still no cough. I do pay $50+ monthly now for this med, but it is worth that and more for a drug that works very well in my case without any side effects.

I, too, am on lisinopril, but fortunately have not had a major problem with a cough, but I do have a slight one and am watching it carefully in case it gets worse. Also, I find that my voice seems to be more scratchy than before. My husband, however, was on Toprol after he had a heart attack, and the effect was excruciating. Thankfully, when we told an insurance company nurse hot line of the problem, she told us that it was probably the Toprol, and thankfully his doctor concurred that he probably should not take it!

My doctor did not seem to know about the cough either. I was on it for years, constantly clearing my throat (instead of a full-on cough,) and it was I who finally figured it out after reading online. The doctor dismissed my complaints but agreed to give me a different drug when I finally told him I wanted to change it. The pharmacist said, “Oh, you’re here because of the ‘ahems’, right? His wife had had the cough as well. The irritation drove me and my family who had to listen to my throat-clearing up a wall. Since this seems to be an extremely common side effect, why on Earth are doctors not warning their patients and worse than that, not catching the cough once it starts??

I also had a cough for years. Allergy meds didn’t help. Fortunately my cough usually wasn’t bad unless I was in a room that was too warm (for me). I often left a meeting etc. and went out to the hall or restroom until I stopped coughing. But my eyes would be all red, my face also.
I did mention my cough to my MD and he didn’t seem concerned and once made a comment “it could be your blood pressure med.”
One time I couldn’t stop coughing and my nose started to bleed so bad I had to go to ER. After that I decided I was going to an ENT Dr. and have him check my throat etc to see if there was a physical cause. I did and he checked and said my throat etc was in excellent shape and he thought the cough was caused by my blood pressure med. He sent a note to my regular Dr.
After that, when I went to the Dr. he prescribed another med and I was fine. BUT! When I went to the Dentist, the Dental Asst. asked what meds I took (as they always do) She said that lisinopril is known for that.
Someone ought to take the med off the market or it should come with a big red warning label on the bottle.

I, too experienced the dry cough on amlodipine (calcium channel blocker) for high blood pressure along with edema (water retension) not only in the lower extremedies but over my entire body…the tissues in the nose swelled causing sneezing, pain in my back and legs, gums growing over my teeth. The medication didn’t lower my blood pressure..then the doc wanted to add benazapril…I said no after researching it’s side effects. I’ve titrated down off the amlodipine trying some natural remedies…I’m feeling better and not wanting to commit suicide.
If I didn’t have the internet to research I would still be miserable…the doctor didn’t inform me of the side effects of the medication and neither did the pharmacist. Thanks to all of you for your helpful comments.

Lisinopril was the first blood pressure medicine I was prescribed. I too began to cough but did not know it was a side effect of the medicine. I coughed so hard at one point, I coughed myself a hernia.
After that I went to the doctor, she took me off the Lisinopril and put me on a different medicine.
Too bad she didn’t give me a heads up in the first place. I lived with the hernia for 5 years (another doctor said surgery wasn’t necessary as long as it stayed soft and I could push it back in, I should be OK. But if it gets hard and you can’t push it back in go to the Emergency room.) then one day it became strangulated. I had emergency surgery with 4 – 6 inches of small intestine removed, at 11-O clock at night. That ordeal was traumatic – if I knew then what I know now – I would have had the hernia repaired immediately.

I was taking enalapril and developed a persistent cough for over a year or two. The doctor could not diagnose the cause. I had difficulty sleeping and the cough was very annoying. My quality of life sure went way down. I finally went on line to look at all medications I was taking and then called my pharmacist to see if one of my medications could cause the cough. He agreed with what I had found that enalapril could be causing the cough. I talked with my doctor again and she agreed to change my medication. I have been cough free ever since and my quality of life is so much better. I have all my medications at one pharmacy so the pharmacist can keep track of any possible interactions also,

Before taking a medicine, always read the paperwork that comes with it. Lisinopril is clearly identified as having a side effect of coughing. So when I got the “cough,” I knew exactly what the culprit was. I endured it for a while, sometimes having to lean over the sink while coughing, in case I vomited. I popped hard candy after hard candy to help ~ and it did help. As soon as I noticed my throat starting to be affected, I would suck on a candy, and I was okay. After a few months of this and blood work was done, my glucose rose to 106. I told the doctor that I knew exactly why. After that I decided to stop the Lisinopril (2.5 mg.) After a few weeks, the cough stopped, and I stopped the hard candy. Three months later, blood work reveals glucose at 93. Never take a medicine without reading about it first.

I guess I am one of the lucky ones, I have taken Lisinopril for years with no side effects so I find it very effective for me. I do have two friends who had coughs and had to take other drugs but side effects vary from person to person. I tolerate the drug very well. I would say don’t refuse the drug because of hearing the side effect of coughing, it is effective and there is the possibility that it will work for you, if coughing occurs then stop taking the drug.

Enalapril since 1999. Once in a while I cough from dryness. Sometimes experience a dinginess when standing over something and looking down. Have the wringing in ears. Read it could be a side effect. Both of the above have started in the last 2-3 yrs.

My mother and my husband both had that same symptom. Why do they even prescribe lisinopril?

I had this cough. From the beginning I suspicions the Lisinoptil I had been given several months prior. It was a dry hack cough that drive my coworkers crazy. It took me awhile to search out the reason but finally narrowed it down and told my nurse practitioner who also said she had done some research and found the same thing out. I stopped the medication and the cough subsided in a few months.

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