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Medications that Cause Taste Disorders

Worst Pills, Best Pills Newsletter article April, 2019

Taste plays a critical role in an individuals overall sense of well-being and quality of life.[1] Disturbances in taste can adversely affect appetite and food intake, leading to dehydration, weight loss and malnutrition, and significantly impair quality of life and mood.[2]

Drugs are the most frequent cause of taste disturbances.[3] More than 200 medications, including many that are commonly used, can cause taste disorders (see Table, below for examples).[4],[5],[6] In one survey...

Taste plays a critical role in an individuals overall sense of well-being and quality of life.[1] Disturbances in taste can adversely affect appetite and food intake, leading to dehydration, weight loss and malnutrition, and significantly impair quality of life and mood.[2]

Drugs are the most frequent cause of taste disturbances.[3] More than 200 medications, including many that are commonly used, can cause taste disorders (see Table, below for examples).[4],[5],[6] In one survey study that examined the oral adverse effects of drugs in more than 1,100 adults living independently at home, one-third of the participants reported drug-induced loss or alteration of taste.[7] These effects can lead patients to stop taking important prescription medications.

Importantly, when new drugs are being developed, their effects on taste rarely are evaluated in animal toxicology studies.[8] Moreover, knowledge about how to study such adverse effects reportedly is very limited among toxicology experts.[9]

In some cases, the adverse effects of drugs on taste are long-lasting and do not rapidly resolve following discontinuation of the drug.[10] By knowing which drugs can cause taste disturbances, patients can be alert for symptoms of these adverse effects and consult with their doctors before they suffer serious adverse health consequences.

Types of taste disorders

The most common type of drug-induced taste disorder is dysgeusia, a condition in which patients' taste sensations while eating are distorted.[11] Patients with dysgeusia can experience a metallic taste or excessive sweet, bitter or salty sensations. Parageusia, a subtype of dysgeusia, is the sensation of a foul or spoiled food taste while eating.[12]

Another type of drug-induced taste disturbance is the total loss of one or more of the four basic taste sensations — salt, sweet, sour and bitter — a condition known as ageusia.[13]

How drugs can affect taste

Many drugs contain active ingredients that have an unpleasant bitter taste. In some cases, after such a drug is ingested and absorbed in the stomach or intestines, the active ingredient is transferred from the blood into the saliva in amounts sufficient to trigger a bitter taste.[14] Other bitter-tasting drugs can, with prolonged use, accumulate in the taste buds over time to levels high enough to trigger a bitter taste.[15]

Other drugs can elicit an unpleasant metallic sensation by activating specific chemical receptors in the mouth.[16]

Finally, many other drugs that do not induce unpleasant tastes of their own cause taste disturbances, such as dysgeusia, by disrupting the normal function of taste buds on the tongue or of the nerves that transmit taste signals from the taste buds to the brain.[17]

What You Can Do

Always ask your doctor about adverse effects before starting any new medication. If a drug has the potential to cause taste disorders, be alert for changes in your taste sensation. If you experience changes in taste that significantly affect your appetite, food intake, quality of life or mood, talk with your doctor about reducing your dose or starting another medication for your condition that does not cause taste disturbances.

It is very important that you do not stop taking any prescription drug without first talking to your doctor. Many of the drugs in the table treat serious and even life-threatening conditions. Stopping treatment without supervision from a doctor could be very dangerous.

Examples of Oral Drugs That Have Been Linked to Taste Disorders†

Drug Family Examples
Antibiotics for bacterial infections
  • amoxicillin (AMOXIL, AUGMENTIN, LAROTID)
  • ampicillin (generic only)
  • azithromycin (ZITHROMAX)*
  • ciprofloxacin (CIPRO)*
  • clarithromycin (generic only)*
  • metronidazole (FLAGYL, PYLERA)*
  • ofloxacin (generic only)*
  • sulfamethoxazole (BACTRIM, SEPTRA, SULFATRIM PEDIATRIC)
  • tetracycline (ACHROMYCIN V, PYLERA)*
Antidepressants Selective Serotonin Reuptake Inhibitors (SSRIs)
  • citalopram (CELEXA)*
  • escitalopram (LEXAPRO)*
  • fluoxetine (PROZAC, SARAFEM, SELFEMRA, SYMBYAX)*
  • paroxetine (PAXIL, PEXEVA)*
  • sertraline (ZOLOFT)*
  • trazodone (generic only)**
Tricyclics
  • amitriptyline (generic only)**
  • clomipramine (ANAFRANIL)*
  • desipramine (NORPRAMIN)*
  • doxepin (SILENOR)**
  • imipramine (TOFRANIL)**
  • nortriptyline (PAMELOR)*
Other
  • bupropion (APLENZIN, FORFIVO XL, WELLBUTRIN)*
  • venlafaxine (EFFEXOR XR)*
Antifungal drugs
  • griseofulvin (GRIS-PEG)
  • terbinafine (LAMISIL)**
Antihistamines for allergy relief
  • loratadine (ALAVERT, CLARITIN)*
Antipsychotics Atypical antipsychotics
  • clozapine (CLOZARIL, FAZACLO ODT, VERSACLOZ)*
  • olanzapine (SYMBYAX, ZYPREXA, ZYPREXA ZYDIS)*
  • risperidone (RISPERDAL)*
Traditional or typical antipsychotics
  • haloperidol (generic only)*
  • trifluoperazine (generic only)*
Antiviral drugs
  • acyclovir (SITAVIG, ZOVIRAX)
  • amantadine (GOCOVRI, OSMOLEX ER)
  • oseltamivir (TAMIFLU)*
Bipolar disorder drugs
  • lithium (LITHOBID)*
Cardiovascular drugs for hypertension, heart failure or abnormal heart rhythms Angiotensin-converting enzyme (ACE) inhibitors
  • captopril (generic only)*
  • enalapril (EPANED, VASOTEC)*
  • lisinopril (PRINIVIL, QBRELIS, ZESTRIL)*
Angiotensin II receptor blockers (ARBs)
  • losartan (COZAAR)*
Beta-blockers
  • metoprolol (KAPSPARGO SPRINKLE, LOPRESSOR, TOPROL-XL)
  • propranolol (HEMANGEOL, INDERAL, INNOPRAN XL)
Calcium channel blockers
  • amlodipine (NORVASC)*
  • diltiazem (CARDIZEM, CARTIA XT, DILTZAC, TAZTIA XT, TIAZAC)*
  • nifedipine (ADALAT CC, PROCARDIA XL)*
  • nisoldipine (SULAR)
Diuretics
  • amiloride (MIDAMOR)
  • furosemide (LASIX)*
  • hydrochlorothiazide (MICROZIDE)*
  • spironolactone (ALDACTONE, CAROSPIR)*
Epilepsy (seizure) drugs
  • carbamazepine (CARBATROL, EPITOL, EQUETRO, TEGRETOL, TERIL)
  • clonazepam (KLONOPIN)
  • phenytoin (DILANTIN, PHENYTEK)
  • topiramate (QUDEXY XR, TOPAMAX, TROKENDI XR)*
Gastrointestinal drugs
  • omeprazole (PRILOSEC, ZEGERID)*
  • ranitidine (ZANTAC)
Sedatives and sleeping pills Benzodiazepines
  • alprazolam (XANAX)***
  • diazepam (VALIUM)**
  • flurazepam (generic only)**
Other
  • eszopiclone (LUNESTA)**
  • zolpidem (AMBIEN, EDLUAR, INTERMEZZO, ZOLPIMIST)**
Statins for treating high cholesterol
  • atorvastatin (LIPITOR)
  • fluvastatin (LESCOL XL)**
  • lovastatin (ALTOPREV)
  • pravastatin (PRAVACHOL)
  • simvastatin (FLOLIPID, ZOCOR)

†Note: Most combination drugs were excluded from this table.
*Designated as Limited Use
**Designated as Do Not Use
***Designated as Do Not Use, except for panic disorder

 



References

[1] Naik BS, Shetty N, Maben EV. Drug-induced taste disorders. Eur J Intern Med. 2010 Jun;21(3):240-243.

[2] Doty RL, Shah M, Bromley SM. Drug-induced taste disorders. Drug Saf. 2008;31(3):199-215.

[3] Schiffman SS. Influence of medications on taste and smell. World J Otorhinolaryngol Head Neck Surg. 2018;4(1):84-91.

[4] Wang T, Glendinning J, Grushka M, et al. Drug-induced taste disorders in clinical practice and preclinical safety evaluation. Toxicol Sci. 2017 Apr 1;156(2):315-324.

[5] Doty RL, Shah M, Bromley SM. Drug-induced taste disorders. Drug Saf. 2008;31(3):199-215.

[6] Schiffman SS. Influence of medications on taste and smell. World J Otorhinolaryngol Head Neck Surg. 2018;4(1):84-91.

[7] Shinkai RS, Hatch JP, Schmidt CB, Sartori EA. Exposure to the oral side effects of medication in a community-based sample. Spec Care Dentist. 2006;26(3):116-120.

[8] Wang T, Glendinning J, Grushka M, et al. Drug-induced taste disorders in clinical practice and preclinical safety evaluation. Toxicol Sci. 2017 Apr 1;156(2):315-324.

[9] Ibid.

[10] Doty RL, Shah M, Bromley SM. Drug-induced taste disorders. Drug Saf. 2008;31(3):199-215.

[11] Naik BS, Shetty N, Maben EV. Drug-induced taste disorders. Eur J Intern Med. 2010 Jun;21(3):240-243.

[12] Ibid.

[13] Ibid.

[14] Schiffman SS. Influence of medications on taste and smell. World J Otorhinolaryngol Head Neck Surg. 2018;4(1):84-91.

[15] Ibid.

[16] Ibid.

[17] Naik BS, Shetty N, Maben EV. Drug-induced taste disorders. Eur J Intern Med. 2010 Jun;21(3):240-243.