Paul S. Heckerling, MD
To the Editor: Enalapril is an angiotensin-converting enzyme inhibitor that has proved to be effective in treating hypertension. Inhibition of converting enzyme may decrease the degradation of bradykinin, and elevated levels of bradykinin may result in increased production of prostaglandin E2 (1). Side effects of enalapril include cough (2, 3), bronchospasm (4), and flushing (5), which have been hypothesized to be bradykininor prostaglandin-mediated (1). Vulvovaginal pruritis and dysuria have not, to our knowledge, been reported in association with the use of enalapril.
An 80-year-old woman with essential hypertension was begun on enalapril (Vasotec, Merck Sharp & Dohme, West Point, Pennsylvania),
Heckerling PS. Enalapril and Vulvovaginal Pruritis. Ann Intern Med. ;112:879–880. doi: 10.7326/0003-4819-112-11-879_2
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Published: Ann Intern Med. 1990;112(11):879-880.
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