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ACE inhibitor cough — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsACE inhibitor coughGPhC CRA

A 58-year-old woman started ramipril for hypertension six weeks ago. Her blood pressure is controlled but she has developed a persistent dry cough. She has no breathlessness, fever or wheeze. What is the most appropriate alternative?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Candesartan

A persistent dry cough is a recognised adverse effect of ACE inhibitors. Switching to an angiotensin receptor blocker is the usual alternative when renin-angiotensin system blockade remains appropriate. Candesartan is a suitable ARB option, subject to renal function and potassium monitoring.

Reference: BNF; NICE CKS