Subclinical alteration of taste sensitivity induced by candesartan in healthy subjects.
OBJECTIVE
There have been case reports of taste disturbance for the angiotensin II receptor blockers losartan and valsartan, but not for candesartan. This study was undertaken to examine whether candesartan causes taste disturbance.


METHODS
Candesartan cilexetil (4 mg day(-1)) or vehicle was given to healthy volunteers (n = 8) for 7 days in a randomized, double-blind, placebo-controlled, cross-over design with a 2-week washout period. Clinical gustometry using the filter-paper disc test and electrogustometry were sequentially performed before and at the end of each trial. Serum and salivary zinc concentrations were also measured.


RESULTS
Detection thresholds of four basic tastes (sweet, salty, sour and bitter) determined by the paper disc test were significantly (P < 0.05 in all tests) worsened (i.e. score of test increased) after repeated dosing of the drug, although the subjects did not notice such changes. The mean +/- SEM (and 95% CI) scores of the four tastes at just before the seventh dosing of candesartan or vehicle was 3.38 +/- 0.32 (3.02, 3.74) and 2.63 +/- 0.18 (2.18, 3.08) for sweetness, 3.63 +/- 0.38 (4.49, 2.77) and 2.63 +/- 0.26 (3.27, 1.98) for salt, 4.01 +/- 0.42 (3.04, 4.98) and 2.61 +/- 0.32 (3.35, 1.87) for sourness, 4.01 +/- 0.38 (3.22, 4.80) and 2.99 +/- 0.33 (2.24, 3.74) for bitterness, for candesartan and placebo, respectively. Electrogustometry confirmed the candesartan-related taste disturbance. Serum and salivary zinc concentrations were not influenced by candesartan.


CONCLUSIONS
These data suggest that candesartan subclinically reduces taste sensitivity after repeated dosing in healthy subjects. Because similar events are reported for losartan and valsartan in case reports, this adverse effect might be a class effect of angiotensin-II receptor blockers (ARBs).
Tsuruoka
Shuichi
S
Department of Pharmacology, Division of Clinical Pharmacology, Jichi Medical School, Tochigi 329-0498, Japan. tsuru@jichi.ac.jp
Wakaumi
Michi
M
Nishiki
Kenta
K
Araki
Nobutaka
N
Harada
Kenichi
K
Sugimoto
Koichi
K
Fujimura
Akio
A
D000328:Adult; D000959:Antihypertensive Agents / Q000009:adverse effects*; D001562:Benzimidazoles / Q000009:adverse effects*; D001713:Biphenyl Compounds; D018592:Cross-Over Studies; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D008875:Middle Aged; D012684:Sensory Thresholds; D013651:Taste Disorders / Q000139:chemically induced*; D013777:Tetrazoles / Q000009:adverse effects*
D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; C081643:candesartan