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Captopril
Generic Name: Captopril
Brand Name: Capoten
Indications
Captopril is indicated in the treatment of hypertension, congestive heart failure, kidney problems caused by diabetes, and to improve survival after a heart attack.
Dosage and Administration
Captopril is available for oral administration as 12.5mg, 25mg, 50mg and 100mg tablets.
Normal dosage:
Hypertension: The initial dose of Captopril tablets, is 25 mg. If satisfactory reduction of blood pressure has not been achieved after one or two weeks, the dose may be increased to 50 mg. The dose of Captopril in hypertension usually does not exceed 50 mg. If further blood pressure reduction is required, the dose of Captopril may be increased to 100 mg and then, if necessary, to 150 mg (while continuing the diuretic). The usual dose range is 25 to 150 mg. A maximum daily dose of 450 mg Captopril should not be exceeded.
Heart Failure: For most patients the usual initial daily dosage is 25 mg. After a dose of 50 mg is reached, further increases in dosage should be delayed, where possible, for at least two weeks to determine if a satisfactory response occurs. Most patients studied have had a satisfactory clinical improvement at 50 or 100 mg. A maximum daily dose of 450 mg of Captopril should not be exceeded. Captopril should generally be used in conjunction with a diuretic and digitalis.
Overdose?
Symptoms of a captopril overdose may include feeling extremely dizzy or light-headed, or fainting.
Drug Description
Captopril is a specific competitive inhibitor of angiotensin I-converting enzyme (ACE), the enzyme responsible for the conversion of angiotensin I to angiotensin II.
Captopril is designated chemically as 1-[(2S)-3-mercapto-2- methylpropionyl]-L-proline [MW 217.29] and has the following structure:
Captopril is a white to off-white crystalline powder that may have a slight sulfurous odor; it is soluble in water (approx. 160 mg/ mL), methanol, and ethanol and sparingly soluble in chloroform and ethyl acetate.
Side Effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
- feeling light-headed, fainting;
- urinating more or less than usual, or not at all;
- fever, chills, body aches, flu symptoms;
- pale skin, easy bruising or bleeding;
- fast, pounding, or uneven heartbeats;
- chest pain; or
- Swelling, rapid weight gain.
Less serious side effects may be more likely to occur, such as:
- cough;
- loss of taste sensation, loss of appetite;
- dizziness, drowsiness, headache;
- sleep problems (insomnia);
- dry mouth, sores in the mouth or on the lips;
- nausea, diarrhea, constipation; or
- Mild skin itching or rash.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or is especially bothersome.
Precautions
- Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Captopril could cause birth defects in the baby if you take the medication during pregnancy.
- Captopril can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
- Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of captopril. Do not use salt substitutes or potassium supplements while taking captopril, unless your doctor has told you to.
- Do not use this medication if you are allergic to captopril or to any other ACE inhibitor, such as benazopril (Lotensin), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).
- Before using captopril, tell your doctor if you have kidney disease (or if you are on dialysis); liver disease; heart disease or congestive heart failure; diabetes; a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis.
Drug Interactions
Before taking captopril, tell your doctor if you are taking any of the following drugs:
- lithium (Lithobid, Eskalith);
- a potassium supplement such as K-Dur, Klor-Con;
- salt substitutes that contain potassium;
- drugs that can dilate blood vessels, such as alprostadil (Caverject, Edex), nitroglycerin, nitroprusside (Nitropress), nesiritide (Natrecor), minoxidil (Loniten), or isosorbide dinitrate (Imdur, Isordil);
- aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil),diclofenac (Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), naproxen (Aleve, Naprosyn),and others; or
- a diuretic (water pill).
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