Drug Week Series - 17.1

General
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1

A 56-year-old man with newly diagnosed hypertension has a history of persistent dry cough while taking enalapril. His physician switches him to Telmisartan.

Question:

Why is Telmisartan considered a suitable alternative for this patient?

  • It inhibits angiotensin-converting enzyme (ACE).
  • It blocks angiotensin II (AT₁) receptors without increasing bradykinin levels.
  • It directly relaxes vascular smooth muscles.
  • It increases renin secretion.
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2

Enalpril is ACE inhibitor, which increases bradykinin level and cause persistent dry cough. Whereas, Telmisartan is ARB class of drug which blocks angiotensin II receptor without affecting bradykinin metabolism. Because of this, it has lower risk of causing dry cough.

3

Telmisartan is an angiotensin || receptor blocker which doesn’t interfere with bradykinnin metabolism.