Houston asked
Can Hydrochlorothiazide (HCTZ) cause a chronic cough? I am also on Metoprolol and Amlodipine but I feel like ever since I started the HCTZ I got this dry, chronic cough. I can't even sleep at night because it keeps me awake. My doctor thought it was due to my acid reflux but an EGD ruled that out. My GI doctor thought it could be allergies but I've had this cough for over a year now, through fall, winter, summer. Allergies just don't make sense to me. Please help.
Answer
Coughing is not a listed adverse reaction to hydrochlorothiazide. I have checked a few different medical references and none have coughing, or any kind of throat irritation as a side effect. In my personal experience, I have not seen HCTZ ALONE cause causing. Any coughing associated with HCTZ has been when HCTZ is in combination with an ACE-inhibitor such as lisinopril. In fact, many studies have shown that hydrochlorothiazide significantly reduces the cough associated with ACE inhibitor treatment.
The cough, in my opinion, probably is not due to the HCTZ. That of course doesn't help you much in determining the root cause of the problem. In terms of the other medications you mentioned, neither is really associated with cough. Metoprolol is sometimes associated with cough and bronchospasm, but only at really high doses and is not very common at all. A bronchospasm is typically manifested as a non-productive cough, and it typically happens often at night time. Again, this isn't a common side effect but it certainly is a possibility. You may want to see if you can take a break from the metoprolol and see if that helps matters..
It is really tough to find the underlying reason to a cough as there are just so many possibilities. A possible clue into what could be causing your cough is letting your doctor know if it is a productive cough or a dry cough as both indicate different things. I am going to guess your cough in non-productive meaning that you are not coughing up phlem. A non-productive cough may in fact be produced by the metoprolol that you are taking. Other possibilities are asthma, or exposure to allergens/irritants. You don't necessarily have to have an allergy to have a cough produced by some sort of irritant. I would recommend to have your lungs checked to see if there are any signs of damaged. You never really know if you have inhaled something over the long term that has caused damage. I would also recommend some sort of air purifier and see if that helps at nighttime.
