People’s pharmacy

Q: My husband has been taking lisinopril for years now to control hypertension. We never associated his persistent nonstop coughing with this drug until today.

He passed out a number of times today from the cough. One time, when he lost consciousness from coughing nonstop, he hit his head and put a hole in the wall. I was very worried.

I Googled “passing out from coughing” and found your website. What an eye-opener! He is going to stop taking lisinopril and will try to maintain his blood pressure in alternative ways.

A: No one should ever stop taking medication without first checking with the prescriber. That said, we are disappointed that no one warned your husband that lisinopril and similar ACE-inhibitor drugs (benazepril, enalapril, ramipril, etc.) commonly trigger an uncontrollable cough.

We have heard from many people who have thrown up or wet their pants because of an overwhelming cough caused by an ACE inhibitor. But passing out and falling is far worse.

There are many other medicines (and nondrug approaches) that could control hypertension without causing a cough. Your husband should ask his health care provider for an alternate treatment.

Q: I am 59 years old. When I was a child, my mother would give us terpin hydrate for coughs. It really worked, but I have not been able to find it anywhere! Do you know if it is available?

A: Terpin hydrate is not available in the U.S. The Food and Drug Administration decided in the mid-1990s that this old-fashioned cough medicine had inadequate proof of effectiveness.

Instead, you may want to use a home remedy against cough such as honey, thyme or ginger tea, or Vicks VapoRub on the soles of the feet. You’ll find details on these and other cough remedies (dark chocolate!) in the Guide to Colds, Coughs and the Flu we are sending you. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (70 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. Q-20, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website:

Q: You’ve written about misleading television ads for prescription drugs. I have been in the pharmaceutical industry for 18 years, and I can tell you the biggest reason for direct-to-consumer ads is because the pharmaceutical industry is being shut out of seeing the prescribers to detail products.

I hear time and again that health care professionals don’t tell their patients how to start a new drug properly. If the provider would just listen to the drug representative about the proper way to start, a lot more patients would have a positive experience. I know some reps may exaggerate the benefits of a drug, but most are ethical and do not. If there were more of a partnership between physicians and drug companies, there would much better outcomes for patients.

A: We agree that it is crucial that prescribers understand the benefits and risks of the drugs they prescribe. They also need to know how to advise patients about starting or stopping their medications.

We disagree that drug-company sales reps are the best way for health-care professionals to get this information. It would be better for them to do their own homework using objective sources. In our opinion, television commercials don’t qualify.

Joe and Teresa Graedon answer letters from readers via their website, Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”