Use of baclofen to suppress cough induced by angiotensin-converting enzyme inhibitors.

OBJECTIVE

To determine whether baclofen can suppress the cough induced by angiotensin-converting enzyme (ACE) inhibitors.

DESIGN

Prospective, open-label, clinical trial of a 4-week course of low-dose oral baclofen (5 mg tid days 1-7, 10 mg tid days 8-28).

SUBJECTS

Seven patients with severe, persistent ACE inhibitor-induced cough.

SETTING

University-affiliated teaching hospital.

MAIN OUTCOME MEASURES

Study participants kept daily diaries monitoring the frequency of cough during and after completion of baclofen therapy.

RESULTS

All subjects demonstrated diminution of cough after initiation of baclofen. Initial improvement was noted by a mean of 4.0 days (range 3-6), and maximal improvement during treatment was achieved by a mean of 10.7 days (range 5-15). In addition, all subjects demonstrated persistent suppression of cough (range 25-74 d) after discontinuation of the study drug.

CONCLUSIONS

Low-dose oral baclofen therapy caused a prolonged antitussive effect in all subjects without inducing any adverse reactions. Baclofen may offer an alternative to the discontinuation of ACE inhibitor therapy in patients for whom these drugs are required.