Quinapril/enalapril Cough: first report with quinapril *

Four patients with hypertension received enalapril 10 mg/day (patient 3) or 20 mg/day (patients 6 and 7), or quinapril 40 mg/day (patient 8). Four patients with congestive heart failure received enalapril 10 mg/day (patient 4), enalapril 20 mg/day plus digitalis and furosemide [frusemide] (patients 1, 2 and 5), or enalapril 10 mg/day plus amiodarone 100 mg/day (patient 7). ACE inhibitor therapy was continued for a mean of 127 days. Patients 1, 2 and 5 had been previously treated with captopril 75 mg/day (patient 5) or 150 mg/day.

After a mean of 39 days' treatment, all 8 patients presented with throat irritation and dry cough, usually at night. Symptomatic treatments were unsuccessful but cough resolved within 48 hours after ACE inhibitor therapy was discontinued in 6 patients, and after 6 and 12 days in patients 5 and 7, respectively. Patients 1,2,3,4,5,6 and 8 were administered half dosages of the respective ACE inhibitor 8-15 days after resolution of cough; patients discontinued treatment on day 3 because of recurrence of cough at night. After a further 8 days, patients 1 and 2 received captopril 100 mg/ day, patients 5 and 6 received quinapril 20 mg/day and patient 8 received enalapril 10 mg/day. Patients 2, 6 and 8 experienced cough but patients 1 and 5 had no adverse effects after 30 days' treatment.

Although cough in response to treatment with captopril and enalapril has been noted before, such a response following quinapril has not been previously reported. Ollivler JP, Ducrocq MS, Droniou J. Presse Medlcale 16. 759-761,2 May 1987 [Translated from the of/glnal published In French]

0157-7271/87/1017-0011/0$01.00/0 © ADIS Press REACTIONS' 17 October 1987 11