Dry cough and BP medds

I’m not asking for medical advice. You are not my doctor, etc., etc., etc. I’ve got an appointment with my doctor in a couple of weeks.

Dry cough is associated with ACE inhibitors. The Wiki article says there is some dispute about why ACE inhibitors cause this.

I’m on a beta blocker, Toprol. A dry cough is also listed as a side effect of this drug.

Whatever. The dry cough is driving me freakin’ nuts.

Does any medical literature really explain why a dry cough is a side effect of BP meds, be they ACE inhibitors or beta blockers?

And is this a side effect that is likely to go away, as some side effects do once your body gets adjusted to the meds?

Beta blocker medications can affect beta-receptors other than the ones found in the heart. (How specific they are for the cardiovascular system is called cardioselectivity). The cardiac beta receptors (beta 1) respond slightly differently from the respiratory (and other) beta 2 receptors.

Beta receptors in the smooth muscle of the respiratory tree generally cause relaxation, and so blocking them can cause constriction of the airways–“bronchospasm”–in some people. Bronchospasm, like asthma, can present with various degrees of coughing. Cough-Variant Asthma Symptoms, Treatments, Causes, and More

This is not a perfect, nor a universal, explanation, but often a patient on a relatively non-cardioselective beta blocker who develops a cough might be switched to a more cardioselective beta blocker (or a different medication) on the assumption that the cough might be from beta-blocker-induced bronchospasm.

When do you get the dry cough?

I sometimes have one right before I fall asleep. It’s sometimes triggered by alcohol, like if I have a glass of wine at supper, sometimes not.

I either have a cough drop or a shot of Hot Damn 100 proof Cinnamon Schnapps.

Except for the cough, the medication seems to be working. The last kind of beta blocker I used gave me a MONSTER HEADACHE so I didn’t want to switch meds. The doctor didn’t have a problem with my remedy so long as I wasn’t drinking the whole bottle.

This is the same doctor who, when he did my prostate exam, told me to stop whining about it or he would tell people I liked it. He’s a funny guy.

I also wanted to add that the dry cough seems to be triggered by stress, at least in my case.

Any idea why wine and stress would both trigger a cough? They seem diametrically opposed.
And to further add, these are my experiences and no one should start drinking Hot Damn based on my post :).

I’ve been on lisinopril/HCTZ for several years, and was on Toprol for roughly a year before switching to Lopressor. It does feel like the coughing has decreased in frequency a bit, but it could be that I just don’t notice it anymore.

ACE inhibitors can cause the dry cough due to a build up of Bradykinin, which is degraded by the same enzyme that converts Angiotensin I to Angiotensin II. Normally, when someone has the dry cough side effect, they are changed to an ARB (Angiotensin Receptor Blocker), which blocks the action of Angiotensin II, instead of blocking the formation of Angiotensin II.