A 79-year-old man with a CFS of 5 and stable chronic heart failure has been on Enalapril 10 mg BD. He develops a persistent dry cough that started 3 w...

Question

A 79-year-old man with a CFS of 5 and stable chronic heart failure has been on Enalapril 10 mg BD. He develops a persistent dry cough that started 3 weeks after Enalapril initiation and is significantly affecting his quality of life. The cough is not productive and there are no signs of heart failure decompensation. What is the MOST appropriate medication change?

Accepted Answer

Switch Enalapril to Candesartan (an ARB) at equivalent dose

Answer

Stop Enalapril and do not replace it

Answer

Add a cough suppressant (Codeine linctus)

Answer

Increase Enalapril as the cough will resolve at a higher dose

Answer

Switch to Amlodipine as a replacement

uk-dgm MCQ (SBA): ACE Inhibitor Cough - Switching to ARB