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ACE inhibitor cough — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsACE inhibitor coughGPhC CRA

A 61-year-old patient started ramipril 5 mg daily six weeks ago for hypertension. They report a persistent dry cough with no fever, wheeze or sputum. BP is now 136/78 mmHg. What is the most appropriate alternative?

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Correct answer: E — Discuss switching to an angiotensin-II receptor blocker

A persistent dry cough is a recognised adverse effect of ACE inhibitors. If troublesome, switching to an angiotensin-II receptor blocker is a common alternative because it retains renin-angiotensin system benefit with a lower risk of cough. Long-term cough suppressants do not address the cause. Potassium supplementation could be dangerous and is not a substitute antihypertensive.

Reference: BNF; NICE CKS