Ask the doctor: Is my blood pressure medicine changing my ability to taste?

Published: October, 2008

Q. My sense of taste isn't as good as it was a few months ago. The only big change in my health is that I started taking Capoten on top of the diuretic I have been taking for some time to control my blood pressure. Am I imagining this, or could the new drug be affecting my sense of taste? If it is, what can I do about it?

A. Hundreds of prescription and over-the-counter medicines can alter the sense of taste. They usually do this by directly affecting taste receptors, by changing the way the taste buds send and receive nerve impulses, or by changing the amount or chemical composition of saliva.

The ACE inhibitor captopril (Capoten) is in this group. In some people, captopril causes a long-lasting sensation of bitterness or saltiness. In others, it makes sweet foods taste salty. Some people notice a diminished sense of taste.

Although captopril is a likely suspect, it is possible that your diuretic may be causing or contributing to the problem. Because diuretics prompt the kidneys to remove water from the body, they can make the mouth dry. The potassium-sparing diuretic amiloride can cause a persistent bitter taste. Fortunately, changes in taste are not as common with the most frequently used diuretics, hydrochlorothiazide and chlorthalidone.

Other cardiovascular drugs that have been reported to alter taste include statins, clopidogrel (Plavix), and various beta blockers, calcium-channel blockers, and rhythm-controlling drugs (see list). Noncardiac drugs with this side effect include antibiotics, steroids, antidepressants and other mood- or behavior-stabilizing medications, and thyroid drugs.

Cardiovascular medications reported to affect taste:

ACE inhibitors

captopril (Capoten), enalapril (Vasotec), lisinopril (Prinivil, Zestril)

Angiotensin receptor blocker

losartan (Cozaar)

Antianginal agent


Antiarrhythmic drugs

amiodarone (Cordarone), flecainide (Tambocor), procainamide (Procanbid), propafenone (Rythmol), sotalol (Betapace)

Antiplatelet agent

clopidogrel (Plavix)

Beta blocker

propranolol (Inderal)

Calcium-channel blockers

diltiazem (Cardizem, others), nifedipine (Procardia, others)

Cholesterol-lowering agents

atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor)


amiloride (Moduretic), spironolactone (Aldactone)

Two other possibilities: The first has to do with age. Beginning around age 60, many people experience a gradual loss of taste and smell. It is conceivable that your starting to take captopril is a red herring and you might be noticing a change even if you weren't taking the drug.

The second involves the sense of smell, which largely dictates the flavor of most foods. Volatile molecules moving from the mouth to the nasal passages produce the complicated flavors of chocolate, steak sauce, pizza, banana, peppermint, coffee, and many other foods. Damage from viruses, bacteria, pollution, and other insults can weaken the sense of smell.

Smell, and thus taste, can also be affected by nasal obstruction and inflammation caused by an allergy, secondhand smoke or other irritants, a persistent sinus infection, or polyps. Conditions such as diabetes, liver disease, kidney disease, Alzheimer's disease, and Parkinson's disease can also diminish the senses of taste and smell.

If the change you have noticed in your sense of taste is indeed due to captopril, switching to another ACE inhibitor or a different type of blood pressure drug may fix the problem. If it is because of a dry mouth from your diuretic, try sipping water between bites of food.

Just don't stop taking your medications without talking with your doctor. As you know, high blood pressure is a leading cause of stroke, which can permanently alter all the senses, not just taste and smell.

"" Richard L. Doty, Ph.D.Director, Smell and Taste Center, University of Pennsylvania Medical Center

Image: © Meinzahn/Getty Images

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