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Taking bisoprolol and losartan for BP. Thyroid removed. Have cough, low appetite and tiredness. Remedy?

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My husband is prescribed both Bisoprolol,Amlodipine and Losartan ,for blood pressure he also takes Throxin as he has had the thyroid removed he has had a persistant cough since January, no energy, loss of appetite, tired. He recently had a chest exray which showed he had an infection all other blood tests are normal. He also has to take warfarin having regular INR blood tests he had to have Cardioversion after having surgery for a knee replacement.Have you any sugestions as to why he is feeling so low he is fed up of feeling ill, the cough is really draining together with no sleep we are both on the edge
Posted Wed, 15 May 2013 in General Health
Answered by Dr. Satyadeo Choubey 34 minutes later

Thanks for your query.

Among the medications being taken, both bisoprolol and losartan may cause respiratory symptoms in a small group of patients. Losartan may cause cough in 3% of patients while bisoprolol can cause shortness of breath or wheezing.

But before blaming the drugs let's come to the x-ray finding suggestive of infection, and since it has been a longer duration since January, it will be better to go for sputum examination (Gram's staining, ziehl Neelsen staining, culture and sensitivity, and routine microscopy to see for sputum eosinophilia). Early morning sputum sample has got better yield.

If the sputum reports show evidence of bacterial infection, then targeted antibiotic therapy will be beneficial. If it comes to be negative, then based on chest xray finding of infection, empirical trial of antibiotic can be given.

It is also advisable to go for a simple breath test called spirometry to look for constriction of airways and if it is there then inhaled bronchodilator will help along with antibiotics.

I wish if you have provided information regarding diurnal variation of cough, colour and amount of sputum, history of weight loss, previous history of allergy or asthma, smoking history etc.
You can get back to me with above information.

Best wishes
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