Frågedatum: 1992-04-28
RELIS database 1992; id.nr. 9123, DRUGLINE
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Does captopril (Capoten) impair hearing?/nThe question concerns an 82-year-old woman who has been t



Fråga: Does captopril (Capoten) impair hearing? The question concerns an 82-year-old woman who has been treated with Capoten (captopril) 25 mg 3x2 since June 1991. In connection with the captopril treatment the patient experienced a severe impairment of hearing. The patient is also being treated with Doloxene (dextropropoxyphene), Tenormin (atenolol), Rohypnol (flunitrazepam), Theo-Dur (theophylline), 0.13 mg digoxin and Negram (nalidixic acid).

Sammanfattning: There have been no reports of impaired hearing due to captopril or other ACE-inhibitors in the literature except a letter from the Drug Safety Research Unit in Southampton where it is suggested that deafness may be a rare side-effect of enalapril treatment. Despite this, twelve cases of hearing disorders have been reported to WHO related to captopril treatment, 22 cases related to enalapril, and 12 cases related to lisinopril.

Svar: Impaired hearing as a side-effect of captopril treatment has not been reported in relevant handbooks (1,2). The only publication concerning hearing disorders and angiotensin-converting enzyme inhibitors, when looking into the database Medline, is a letter regarding deafness as a possible side-effect of enalapril (3). It was stated that deafness had been reported only while patients were taking enalapril, never after patients had stopped it. The data was derived from prescription event monitoring and there were 19 reports of deafness among a total of 12.543 patients.

Two cases of impaired hearing during Renitec (enalapril) treatment with possible relation to the drug treatment have been reported to the Swedish medical products agency

Several cases of hearing disorders and ACE-inhibitors therapy have been reported to the WHO´s side-effects register, including: 11 cases of deafness and one case of ear disorder due to captopril treatment; 16 cases of deafness, two cases of ear disorder, two cases of ear ache and two cases of decreased hearing related to enalapril treatment; eight cases of deafness, two cases of ear disorder, one case of congenital deafness and one case of ototoxicity related to lisinopril treatment.

It should be pointed out, since the patient is treated with atenolol, that betablockers have also been reported to cause loss of hearing (4).

We suggest that this case should be reported to the medical product agency.

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