J Med Assoc Thai 2010; 93 (1):48

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Comparison of the Incidence of Imidapril and Enalapril Induced Cough
Boonyapisit W Mail, Tresukosol D

Background: Imidapril is an angiotensin converting enzyme (ACE) inhibitor without a sulfhydril group
which has been shown from previous study to have low incidence of ACE inhibitor induced cough.

Objective:
To compare the incidence of cough between two ACE inhibitors, imidapril and enalapril

Material and Method:
A comparative cross over study was performed in 119 patients with hypertension or left
ventricular dysfunction. Patients were assigned to one of the two treatment groups, either a group receiving
imidapril or enalapril for 4 weeks (Period I) and then these same groups were crossed over to receive either
enalapril or imidapril for 4 weeks (Period II). The occurrence of cough during treatment was monitored by
interviewing the patients.

Results: The incidence of cough was 44 % while on imidapril treatment and 66% while on enalapril treatment
(p = 0.0014). The antihypertensive effects of two drugs were not different.

Conclusion: The incidence of cough was significantly less under imidapril than under enalapril treatment,
while there was no difference in the antihypertensive effects between the two ACE inhibitors.

Keywords:
Angiotensin converting enzyme inhibitors, Angiotensin converting enzyme inhibitors induced
cough

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