The platelet anti-aggregate picotamide, which is an inhibitor of thromboxane synthesis has been tri

Fråga: The platelet anti-aggregate picotamide, which is an inhibitor of thromboxane synthesis has been tried in a very small study on patients suffering from cough induced by angiotensin-converting enzyme inhibitors with remarkable success. Is this drug commercially available?

Sammanfattning: Picotamide, a thromboxane antagonist has been shown to have a promising good result in treating cough induced by angiotensin-converting enzyme inhibitors.

Svar: Angiotensin-converting enzyme inhibitors may cause cough in about 10 per cent of patients. The cough is dry and persistent, but usually disappears on withdrawal of the drug. The mechanism is unclear but it has been speculated that the effect can be mediated by bradykinin and prostaglandines (1,2,3).

The thromboxane antagonist, picotamide was used in nine patients with an enalapril-induced cough (4). Picotamide led to the complete disapppearance of cough within 72 h in eight of the nine patients. The authors suggest that picotamide treatment is well tolerated, and that cough suppression is sustained with therapy for up to 6 months.

Picotamide is produced and manufactered with the trade name Samil in Italy by Novartis. It can be prescribed in Sweden on license. 1 How to stop ACE-inhibitor-induced cough. Lancet 1997; 350: 3 2 Drugline nr 11406 (year 1995) 3 Drugline nr 08297 (year 1991) 4 Malini PL, Strocchi E, Zanardi M, Milani M, Ambrosioni E: Thromboxane antagonism and cough induced by angiotensin-converting-enzyme inhibitor. Lancet 1997; 350: 15-18