How do you get rid of a ramipril cough?

October 14, 2025 •

4 min read

A dry, persistent cough is a common side effect of ramipril, an ACE inhibitor, affecting up to 20% of users. This can significantly impact daily life, often prompting patients to seek information on how do you get rid of a ramipril cough.

Quick Summary

A dry cough is a common side effect of ramipril, an ACE inhibitor. The most effective treatment is often switching to an alternative medication, like an ARB, under medical supervision. Lifestyle changes and home remedies can provide temporary relief.

Key Points

Medical Consultation is Key: The most effective solution is to discuss the cough with your doctor to explore alternative medication options, rather than attempting to self-treat.
Switching to an ARB: The best alternative is often an Angiotensin II Receptor Blocker (ARB), which works similarly to ramipril but does not cause the same bradykinin buildup that triggers the cough.
Temporary Relief: Home remedies like drinking warm liquids with honey, using lozenges, and elevating your head while sleeping can provide temporary comfort but do not cure the underlying cause.
Avoid OTC Medications: Over-the-counter cough suppressants are generally ineffective against a ramipril cough and do not address the root cause, so it's best to consult a medical professional first.
Resolution Time: The cough typically resolves within a few weeks after discontinuing ramipril, although it can take up to a month in some cases.
Nighttime Exacerbation: If the cough is worse at night, elevating your head with extra pillows can help alleviate symptoms.

Understanding the Ramipril Cough

Ramipril is an angiotensin-converting enzyme (ACE) inhibitor, often used to treat high blood pressure and heart failure. It works by blocking the enzyme that produces angiotensin II, which narrows blood vessels. While helpful for lowering blood pressure, it also affects the breakdown of bradykinin. The buildup of bradykinin in the lungs and throat irritates nerve endings, triggering a chronic, dry cough.

This is not an allergic reaction, and the cough is typically not harmful to the lungs. However, it can affect a person's quality of life and is a common reason to stop ACE inhibitor therapy. The cough can develop within days or months of starting the medication.

The Most Effective Treatment: A Medical Change

For most people, the only consistently effective way to eliminate a ramipril cough is to switch to a different class of medication. Never stop taking your medication on your own. Always consult a healthcare provider about alternative treatments. Abruptly stopping medication can worsen underlying conditions.

Switching to an ARB

The most common and effective alternative is an angiotensin II receptor blocker (ARB). ARBs, such as losartan or candesartan, work on the same pathway as ACE inhibitors but block the angiotensin II receptor, preventing bradykinin accumulation. Over 90% of patients who switch from an ACE inhibitor to an ARB find their cough resolves within a week. Many ARBs are available as generics, making them a cost-effective alternative.


Comparison of ACE Inhibitors vs. ARBs	Feature	ACE Inhibitors (e.g., Ramipril)	Angiotensin II Receptor Blockers (ARBs)	Other Medications
Mechanism of Action	Inhibits the enzyme that produces angiotensin II and breaks down bradykinin.	Blocks the receptor for angiotensin II, without affecting bradykinin breakdown.	Other classes, such as calcium channel blockers or diuretics, have different mechanisms entirely.
Cause of Cough	Bradykinin accumulation irritates nerves in the throat and lungs.	Does not typically cause a cough because the bradykinin pathway is unaffected.	Minimal or no cough risk, depending on the specific medication.
Effectiveness	Highly effective for high blood pressure, heart failure, and kidney disease.	Equally effective for many conditions where an ACE inhibitor is prescribed.	Effectiveness varies based on the specific condition being treated.
Cough Incidence	Up to 20% of patients experience a persistent dry cough.	Incidence of cough is similar to that of a placebo.	Varies widely by drug class.

Other Pharmacological Options

If switching to an ARB is not suitable, other medications may manage the cough or the underlying condition.

Other Antihypertensives: A doctor may switch to a different class of blood pressure medication, such as calcium channel blockers or diuretics.
Add-on Therapy: Your doctor may add a medication to control blood pressure and lessen the cough while the new regimen is adjusted.
Targeted Cough Suppression: Some studies have explored medications like sodium cromoglycate, theophylline, or ferrous sulfate for cough suppression, but the evidence is less robust than switching medications. OTC cough syrups containing dextromethorphan are generally ineffective and do not address the root cause.

Home Remedies and Lifestyle Adjustments for Temporary Relief

While home remedies cannot resolve the root cause of a ramipril cough, they can offer temporary relief and help manage the symptoms. Always consult your doctor before trying new treatments.

Soothing Your Throat

Warm Liquids: Sip warm water or herbal tea with honey. The warmth and moisture can soothe an irritated throat. Honey has natural antibacterial and anti-inflammatory properties.
Lozenges: Use sugar-free cough drops or throat lozenges.
Saltwater Gargle: Gargling with warm salt water can help soothe throat inflammation.

Addressing the Nighttime Cough

Many patients find their cough worsens at night when lying down. Several strategies can help:

Elevate the Head of Your Bed: Using extra pillows to elevate your head can reduce airway pooling and quiet the cough.
Change Dosing Schedule: For some, moving the ramipril dose to earlier in the evening can help reduce nighttime coughing. Discuss this with your doctor first.
Use a Humidifier: A humidifier adds moisture to the air, which can soothe irritated airways.

Avoiding Irritants

Steer Clear of Smoke: Exposure to smoke, including secondhand smoke, can worsen the cough.
Limit Evening Irritants: Avoid fragrances, strong smells, or pollutants, which can irritate the throat.
Stay Hydrated: Drinking plenty of fluids keeps your throat moist.

When to Contact Your Doctor

While a ramipril cough is not inherently dangerous, it can signal a different or more serious condition. Consult your doctor if the cough is persistent or if you experience warning signs:

Shortness of Breath: Especially during minimal exertion, as this could indicate heart failure.
Wheezing or Chest Tightness: These symptoms can signal asthma.
Pink, Frothy Sputum: This can indicate a medical emergency like pulmonary edema.
Persistent Fever: A fever points towards an infection.

Your doctor may run tests, such as a chest x-ray or blood tests, to rule out other causes of the cough before deciding on a medication change. The most definitive way to diagnose an ACE inhibitor cough is to discontinue the medication and see if the cough resolves within a few days to weeks.

Conclusion

For those seeking solutions on how do you get rid of a ramipril cough, a collaborative approach with a healthcare professional is most effective. While home remedies and lifestyle adjustments can offer temporary relief, the primary strategy involves exploring alternative medications. Switching to an angiotensin II receptor blocker (ARB) has proven successful for most patients. Always consult your doctor before making any changes to your medication regimen.(https://www.aarp.org/health/conditions-treatments/chronic-cough-ace-inhibitors/)

Frequently Asked Questions

The cough is caused by the buildup of a natural chemical called bradykinin in the lungs and throat. Ramipril, an ACE inhibitor, blocks the enzyme responsible for breaking down this substance.

No, standard over-the-counter cough syrups and medicines are typically ineffective because they do not address the underlying bradykinin buildup that causes the cough.

The most effective treatment is to switch to an alternative medication, such as an Angiotensin II Receptor Blocker (ARB), under your doctor's supervision.

The cough usually begins to subside within a few days to a week after discontinuing ramipril, but it can take up to a month for complete resolution.

Yes, temporary relief can be found by drinking warm liquids with honey, using throat lozenges, staying hydrated, and elevating the head of your bed to reduce nighttime coughing.

No, the cough is generally not dangerous and does not cause harm to your lungs. However, it can be quite bothersome and disrupt sleep and daily life.

It is not recommended to switch to another ACE inhibitor. The cough is a 'class effect,' meaning it's caused by the same mechanism in all ACE inhibitors, so the cough will almost certainly recur.

You should contact your doctor if the cough is persistent and bothersome, or if you experience other symptoms like shortness of breath, wheezing, chest tightness, or pink, frothy sputum.