How to Treat Lisinopril Cough: Understanding Causes and Finding Relief

October 9, 2025 •

2 min read

It is estimated that between 5% and 35% of people on ACE inhibitors will experience a persistent, dry cough. For those wondering how to treat lisinopril cough, the most definitive intervention involves a change in medication, which should only be done under a doctor's supervision.

Quick Summary

A persistent dry cough from lisinopril is caused by the accumulation of bradykinin in the airways. The only uniformly effective treatment is discontinuing the drug under a doctor's guidance, often switching to an alternative like an ARB.

Key Points

Identify the Cause: Lisinopril cough is a persistent, dry cough caused by the medication's effect on bradykinin levels in the airways.
Consult Your Doctor: The cough requires a change in medication and should only be addressed under the supervision of a healthcare professional.
Consider an Alternative: The most common and effective alternative is switching to an Angiotensin Receptor Blocker (ARB), which has a much lower risk of causing cough.
Allow Time for Resolution: After stopping lisinopril, the cough may take several weeks, or even up to three months, to fully disappear.
Use Home Remedies for Symptom Relief: While not a cure, staying hydrated, using a humidifier, and taking honey can help soothe the throat during the transition.
Avoid Self-Medication: Over-the-counter cough suppressants are generally not effective for this type of cough because they don't address the underlying mechanism.

Understanding the Lisinopril Cough

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor prescribed for conditions like high blood pressure and heart failure. A common side effect for a notable percentage of patients is a persistent, dry, irritating cough.

The Mechanism Behind the Cough

ACE inhibitors lower blood pressure by blocking the ACE enzyme, which reduces angiotensin II. However, ACE also breaks down bradykinin, an inflammatory compound. Inhibiting ACE allows bradykinin to build up in the airways, irritating nerves and causing a dry, non-productive cough. The cough can begin hours or months after starting the medication.

Diagnosing a Lisinopril Cough

A lisinopril cough is typically a dry, tickling cough without phlegm. It is usually diagnosed by observing if the cough stops after discontinuing the medication under medical supervision. Doctors will first rule out other causes of chronic cough before attributing it to lisinopril.

The Primary Solution: Discontinuation and Alternatives

Because the cough is caused by the medication's action, standard cough suppressants are not effective. The most effective treatment is to stop lisinopril and switch to a different medication class under a doctor's guidance.

Switching to Angiotensin Receptor Blockers (ARBs)

Angiotensin Receptor Blockers (ARBs), such as losartan or valsartan, are often the preferred alternative. ARBs target the same pathway but block angiotensin II at the receptor, not by inhibiting ACE. This avoids bradykinin buildup and significantly lowers the risk of cough. {Link: Dr.Oracle https://www.droracle.ai/articles/146383/losartan-vs-lisinopril-in-a-patient-with-chronic-cough}

Conclusion: Consulting Your Doctor Is Key

To resolve a lisinopril cough, it's essential to address the cause, not just the symptom. Over-the-counter cough medicines are generally ineffective. If you develop a persistent dry cough while on lisinopril, speak with your healthcare provider. They can assess your situation and recommend a suitable alternative medication, like an ARB, to provide relief without compromising your health. Additional information on the mechanism can be found on the {Link: National Institutes of Health website https://pubmed.ncbi.nlm.nih.gov/16428706/}

Frequently Asked Questions

A lisinopril cough is a persistent, dry, and tickly cough that is a side effect of taking the blood pressure medication lisinopril. It is caused by the accumulation of a substance called bradykinin in the airways.

Standard cough medicines do not work because they treat the symptom, but not the underlying cause. A lisinopril cough is caused by a chemical buildup, and the only way to resolve it is to stop the medication that is causing the problem.

The cough typically resolves within one to four weeks after discontinuing lisinopril. In some cases, however, it may linger for up to three months.

Common alternatives include Angiotensin Receptor Blockers (ARBs) like losartan or valsartan, which are recommended for patients with ACE inhibitor-induced cough. Other options may include calcium channel blockers or diuretics.

No, you should never stop or switch medication without consulting your doctor. A healthcare provider will determine the most appropriate alternative and ensure your blood pressure remains controlled.

While the cough is a nuisance and can affect quality of life, it is not typically dangerous. However, it is important to speak with a doctor to confirm the cause and switch medication to avoid unnecessary discomfort.

Some studies suggest that certain factors may increase the risk of developing a lisinopril cough, including being female or of Asian descent, and being a non-smoker.