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WINTER 2011
Health
Pulse
ACE Inhibitors Can Make You Cough
Angiotensin-converting enzyme (ACE) inhibitors are widely used to treat high blood pressure.
The drugs typically are well-tolerated. However, a common side-efect is a persistent dry
cough, which often presents after taking the medicine for some time and which may persist
for a few weeks after stopping the medication.
An analysis of studies involving a total of nearly 200,000 people, published in 2010 in the
American Journal of Medicine, found that the incidence of ACE inhibitor-associated cough
was signifcantly higher than the rate reported in the Physicians’ Desk Reference (PDR) and on
the drug label (11.48 per cent versus the 1.3 per cent for enalapril). Also, the percentage of patients who withdrew from ACE
inhibitor therapy due to cough from enalapril was higher in the study (2.57 per cent) than indicated in the PDR/label (0.1
per cent). The incidence of cough is similar among all ACE inhibitors, the researchers wrote.
If you are taking an ACE inhibitor and are bothered by a cough, ask your doctor to evaluate whether the medication may be
the cause.
Common angiotensin-converting enzyme (ACE) inhibitors include benazepril (Lotensin), captopril (Capoten), enalapril
(Vasotec), fosinopril (Monopril),lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quiapril (Accupril),
ramipril (Altace) and trandolapril (Mavik).
Source: Men’s Health Advisor
Grapefruit & Lipitor
A Deadly Combination
Grapefruit products have a potential for harm
if you’re taking atorvastatin (Lipitor), lovastatin
(Mevacor, Altoprev) or simvastatin (Zocor).
Drinking eight ounces or more of grapefruit juice
can slow the way in which your body metabolizes
(processes) these drugs, causing high concentra-
tions of the statins to remain in your blood.
This can lead to muscle pain or weakness and a
breakdown of muscle cells – a condition called
rhabdomyolysis– that can severely damage the
kidneys.
Reactions among people vary, and
grapefruit’s efect can last for
24 to 72 hours. So if you
want to drink grapefruit
juice, it’s probably
best to speak with
your doctor frst to
fnd out whether
it’s a risk which
you should
personally take.
Source: John
Hopkins Medicine
Supplies of the Shingles
Vaccine are Limited
Zostavax is recommended as an immunization to prevent
shingles (herpes zoster) in individuals 60 years of age or
older. A single injection has been shown to have few side-
efects and to last for at least four years, possibly longer.
Although not 100% efective in preventing the illness, it
reduces the intensity and duration of shingles pain in cases
that do occur.
Recently, Zostavax has only been available in limited sup-
plies. Because of its cost (about $200.00), its limited demand
and the difculty in storing the product, it has only ever
been available in only a small number of doctors’ ofces,
clinics, pharmacies and municipal public health units. Now,
many of these outlets are creating waiting lists for patients.
Persons wanting to be vaccinated may have to wait for up
to six months before getting immunized. Fortunately for
snowbirds, they may fnd it a little easier to get their shot
while away on their winter vacation in the U.S., as many of
the large chain pharmacies have the vaccine available. Merk,
the company which produces Zostavax, hopes to return
supplies of the vaccination to adequate levels in 2012. It is
anticipated that at that time, experts will recommend that
persons in the age group 50-59 get the vaccine as well.
For help fnding a vaccination site in Canada, visit:
For help fnding a vaccination site in the United States, visit: