Dry Eyes Part 2: Blood Pressure Medications

In late March, I began considering that blood pressure medications could be part of the problem.

I will start with the backstory, since it is relevant. 

I was on lisinopril paired with hydrochlorothiazide for around 8 years from around 2006 to July 2014.  I was fine on it at first, but towards the end, I coughed constantly.  The coughing impacted my quality of life, and I was switched to Bystolic.  Over the years, my blood pressure gradually increased, so I needed to be put on a secondary medication.

In November, it was suggested that we try chlorthalidone, which is a diuretic.  I was hesitant, because of my problem with coughing before and how excessively dry I am.  I agreed to try it, and I didn't cough, so I thought I was okay.  Unexpectedly, routine labs in early February showed that my electrolytes were dangerously low.  I was pulled off the diuretic.

Lisinopril without a diuretic was suggested.  I agreed, since the medication would not be paired with a diuretic.  At first, I thought I was fine, and I didn't realize anything was amiss.  In fact, I ignored the obvious due to my preoccupation with my eye trouble.

I detailed in my previous post my attempt to fix my eye trouble that began in late February.  I thought I had figured it out on March 23, but I worsened again.  It was on the morning of March 26—and not in relation to anything with my eye trouble—that I suddenly thought about how much I had been coughing.

I realized that I was taking lisinopril and that I was coughing uncontrollably.  The coughing was violent and caused loss of bodily functions.  Really awful coughing.  I was sure that it was worse than the coughing that I had previously while on lisinopril paired with hydrochlorothiazide.  I couldn't believe that I hadn't made the connection.  I had been so distracted by my eye condition that I hadn't realized that lisinopril was making me cough.

I now know that I cannot take lisinopril with or without a diuretic because of the coughing caused by it.  And to think it took me over a month to figure it out.

As soon as I realized that I was coughing too much, I typed up a message to my doctor explaining and requesting a change.  After I did that, I considered my eye situation.  Hmm...

I thought through the sequence of events.  I figured out that I took my first dose of lisinopril on February 17.  The coughing began around February 23, nearly one week later.  I believe the coughing worsened on February 24 and 25.  I know that the coughing became a problem early that week.

Once I worked that out, I came to a huge realization.  My eye appointment was on February 26, three days after I started coughing from the lisinopril.  I also recalled vaguely but without specifics that my eyes had worsened a little in the few days before my eye appointment.  They became dramatically worse immediately after my appointment.

It seemed that lisinopril could be what caused my eye trouble.  I would never have suspected that, since I previously took lisinopril for eight years with no eye trouble.

I quit taking the lisinopril as soon as I realized that it was the cause of my terrible cough.  I noticed that my eyes were immediately less dry.  I thought maybe I had figured it out, but no.  Once I started on losartan, my eyes became more dry again.

I did believe that the blood pressure medications were a part of the problem with my eyes, but I knew that something else was at play.  After all, I've been on blood pressure medication since around 2006 without the eye pain that just developed this year.