From the Guidelines
Medications that most commonly cause altered taste include certain antibiotics, such as metronidazole, clarithromycin, and tetracyclines, as well as antihistamines like azelastine and olopatadine, which can cause bitter taste in up to 19.7% and 12.8% of patients, respectively.
Common Causes of Altered Taste
- Antibiotics: metronidazole, clarithromycin, and tetracyclines frequently cause metallic taste sensations 1
- Antihistamines: azelastine and olopatadine can cause bitter taste, with azelastine affecting up to 19.7% of patients and olopatadine affecting up to 12.8% of patients 1
- Chemotherapy agents: cisplatin and carboplatin commonly cause taste disturbances as they damage taste receptor cells
- Other medications: anticonvulsants (phenytoin), antidepressants (particularly SSRIs like fluoxetine), antifungals (terbinafine), and the anti-thyroid drug methimazole can also cause taste alterations
Mechanisms of Altered Taste
- Direct damage to taste receptors
- Alteration of saliva composition
- Excretion of the drug into saliva where it directly contacts taste buds
Management of Altered Taste
- Consult a healthcare provider if significant taste changes occur while taking medication
- Dosage adjustments or alternative medications may be available
- Recovery from altered taste typically occurs after discontinuation of the medication, but may take weeks to months in some cases, particularly with chemotherapy agents 1
From the Research
Drugs that Commonly Cause Altered Taste
The following drugs have been reported to cause altered taste:
- Antihypertensives, antimicrobials, and antidepressants 2
- Antineoplastic and immunomodulating agents, antiinfectives for systemic use, and nervous system drugs 3
- Keratolytic agents, chemotherapeutic and cancer medication, antihistamine, antibiotics, and angiotensin-converting enzyme inhibitors 4
- Metronidazole, ranitidine, and clarithromycin combination 5
Specific Drugs and Their Effects on Taste
Some specific drugs that have been reported to cause altered taste include:
- Metronidazole, which can cause altered taste as a side effect 5
- Ranitidine, which can cause altered taste as a side effect 5
- Clarithromycin, which can cause altered taste as a side effect 5
- Chemotherapeutic agents, which can cause dysgeusia (an unpleasant alteration in taste) 4
Prevalence of Drug-Induced Taste Disorders
It is estimated that 17% of drugs can cause dysgeusia and 3.7% can cause hypogeusia (a decrease in taste) 3. Additionally, 45% of patients who experience taste disorders also experience dry mouth as a side effect 3.
Management of Drug-Induced Taste Disorders
There are currently no standard treatments for drug-induced taste disorders, but some options include adding simulated flavors to food to compensate for losses and to override offending tastes and smells 6.