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Been on HCTZ and Metoprolol and changed metroprolol to lisinopril. Voice is hoarse, coughing, high BP and heart rate

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I have been on HCTZ 25mg and Metoprolol 25 mg bid. My doc changed my metoprolol to lisinopril 10 mg and my voice is hoarse and coughing. (I had taken it in the past with same symptoms) On HCTZ and Lisinopril my BP is running 165/100, hr of 100-120 resting. He had mentioned ARBS and I think a calcium channel blocker would be better to lower HR and BP. Yes, I am a nurse, which in itself can be harmful. LOL
Posted Sun, 29 Sep 2013 in General Health
Answered by Dr. Jorge Brenes-Salazar 47 minutes later
Brief Answer:

Detailed Answer:

The harm on being a nurse depends on what type of nurse! You are actually being a very good nurse at identifying a change in terms of symptoms along with a change of medication, which, as you know in practice, usually is reflective of a side effect; most likely you are experiencing some side effects related to the ACE inhibitor, namely the dyr cough and hoarse voice; these are unlikely to resolve unless the medication is changed; if your physician wants to continue the same line of medications, then an ARB is reasonable; otherwise, a calcium channel blocker such as amlodipine would be good as well.

Dr Brenes-Salazar MD
Mayo Clinic MN
Above answer was peer-reviewed by
Follow-up: Been on HCTZ and Metoprolol and changed metroprolol to lisinopril. Voice is hoarse, coughing, high BP and heart rate 10 minutes later
I thought arb and ace inhibitors basically do same thing..I am going off ace because of dry cough. But if ace is not working..arb is angiotensin block also...ccb just seems smarter to me..and will help hr more also?
Answered by Dr. Jorge Brenes-Salazar 5 minutes later
Brief Answer:
Similar but not the same

Detailed Answer:

They are quite similar in terms of their actions, they eventually reduce production of aldosterone, but ARBs do not have the cough side effect as they do not affect the metabolism of a substance called bradykinin, which is responsible for it. So, that is what we usually do in practice: change ACE for ARB. Trying a CCB is also reasonable; if you try the central CCB like verapamil and diltiazem they will also slow heart rate.


Dr B
Above answer was peer-reviewed by
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