more than coincidence

[doats4]

I had high blood pressure and a racing heart so I was put on Metropolol for it and shortly after I developed a persistent cough. My doctor changed me to Atenolol but the cough did not go away. This has been going on for several years. The dry cough starts very mild and infrequent, but over a couple weeks it becomes more frequent and within 4 weeks it's almost constant. I have to sleep sitting up. It interferes with eating, sleeping, talking on the phone, etc. It will last until I get on powerful antibiotics--then it subsides and goes away. Within 6 months it starts all over again. A lung doctor put me on symbicort and also albuteral which helps, but within a few months, it starts up again. Also during this time frame of about 6 years, I developed severe itching which is diagnosed as uticaria. I have to take an Allegra pill daily to help control that or the hives are red, sometimes massive and terrible with itching. I'm thinking that both are a result of my blood pressure medicine. The literature states cough & itching as "infrequent" side effects, but I think it's causing both of mine. I go to my doctor on 6/15/12 and I'd like to suggest a different medicine. What substitutes would not cause these side effects?

[doats4]

Thank you for your advise. I researched blood pressure medications and learned that up to 35% of people taking ace inhibitors develope a cough so I ruled that out as a replacement for the beta blocker I'm taking. I chose to try an angiotension receptor blocker. Hopefully it will eliminate the cough without other side effects. I'll look into the "cough variant asthma" that you mentioned. I do believe we are each responsible for our own health and our doctors are there to assist and inform us in the journey. We have to think of ourselves as partners with our doctors....not just expect him/her to perform miracles while we "passively" await results. Diet, exercise, rest, not smoking etc., all play vital roles along with communication with our doctor. Thank you for your advise which is helpful..

[David Tinkelman, M.D.]

A possible scenario is that you were predisposed to what is called cough variant asthma and that, as you suggest, your cough was precipitated by the beta antagonist drugs you cite.  In this class, even the so-called selective drugs can cause such side effects.  Another class of drugs used to treat high blood pressure are the ACE Inhibitor Drugs and with these, up to 10% or more patients develop a dry cough.

Your developing Urticaria adds another dimension to your problem with cough.  There are myriad causes of Urticaria.  It could be informative for you and your doctor to consider an anti-hypertensive drug unrelated to the group you have been taking, of which there are many, most notably the group known as Calcium Channel Blocker Drugs.  In addition, both you and he/she might want to consider requesting consultation with an Allergist for the Urticaria.  The cause of the Urticaria could also be related to the cause of your cough and, treatment for the Urticaria  might even provide cough relief.

Another simple method to determine if a med is causing your problems is to withhold that drug or use an unrelated substitute.  Don’t do this on your own but only after consultation with your doctor.

Good luck