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Medications: Smell & Taste Cheat Sheet (DRAFT) by [deleted]

Medications: Smell & Taste

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Introd­uction: Smell and Taste

The senses of taste and smell serve several functions and allow for a full apprec­iation of the flavors of foods. Smell and taste begin the initial response for saliva formation and digestion. Deficits in taste and smell can adversely affect food choices and intake, especially in the elderly, which can contribute to weight loss, malnut­rition, impaired immunity, mood change, and functional decline.

Secondary conseq­uences to older adults' changes in taste and smell may be evidenced by patients increasing intake of sugar and/or salt to compen­sate, which can have serious adverse effects in patients with diabetes, hypert­ension, and other cardio­vas­cular diseases.


Good nutrit­ional support with zinc supple­men­tation may reduce the possib­ility of the onset of drug-i­nduced smell and taste disorders. It's not uncommon for patients to experience a metallic taste with some medica­tions. Good oral hygiene coupled with prevention of dry mouth may reduce the incidence of taste distur­bances. If a patient shows signs of such a distur­bance, an early discon­tin­uation of the offending drug may prevent complete loss or irreve­rsible distortion of smell or taste. Note that while a number of orally given (systemic medica­tions) can affect smell and taste, medica­tions admini­stered nasally are especially troubl­esome for many persons.

Medica­tions That Alter Smell & Taste

Common Medica­tions Affecting Smell & Taste

Although this list is not compre­hen­sive, common medica­tions associated with taste or smell distur­bances include the following:
angiot­ens­in-­con­verting enzyme inhibitors (notably captop­ril), which are among the medica­tions most commonly associated with taste distur­bances, including decreased sense of taste (hypog­eusia) and a strongly metallic, bitter, or sweet taste;
medica­tions known to dry the oral cavity (eg, antich­oli­ner­gics, antihi­sta­mines, and antide­pre­ssa­nts);
antibi­otics (eg, penici­llin, tetrac­ycline, macrol­ides, and fluoro­qui­nol­ones, among others);
antipa­rki­nsonian agents (levod­opa­/ca­rbi­dopa);
antico­nvu­lsants (eg, carbam­aze­pine, phenyt­oin); and
antith­yroid agents, choles­ter­ol-­low­ering agents, blood pressure medica­tions, and muscle relaxers.