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Canadian Pharmacist Qualifying Exam Practice · Question

A 68-year-old male with a 40-pack-year smoking history developed a chronic dry cough approximately 3 months after starting ramipril 10 mg daily for hypertension. He reports no other new medications or changes in health. Which of the following is the most likely cause of his cough?

Angiotensin-converting enzyme (ACE) inhibitors like ramipril are well-known to cause a persistent, dry cough in some patients, typically developing weeks to mon

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Question: A 68-year-old male with a 40-pack-year smoking history developed a chronic dry cough approximately 3 months after starting ramipril 10 mg daily for hypertension. He reports no other new medications or changes in health. Which of the following is the most likely cause of his cough?

Answer options:

  • Chronic Obstructive Pulmonary Disease (COPD)
  • Gastroesophageal Reflux Disease (GERD) ✅ Ramipril-induced cough
  • Allergic rhinitis

Correct answer: Ramipril-induced cough

Explanation: Angiotensin-converting enzyme (ACE) inhibitors like ramipril are well-known to cause a persistent, dry cough in some patients, typically developing weeks to months after initiation. Given the timeline and absence of other new factors, this is the most probable cause.

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