about Captopril class, uses, side effects contraindications
Captopril
Short Description
Captopril is a medicine used to treat??high blood pressure and?is one of a group of medicines called angiotensin-converting enzyme (ACE) inhibitors.
As with many other medicines that lower high blood pressure levels, captopril dilates blood vessels and facilitates blood flow.
Captopril can be given to patients after a myocardial infarction in order to reduce the pressure on the heart and improve its performance, and it may also be used to protect the kidneys in case of diabetic nephropathy
Category
Chemical class: ACE inhibitor
Therapeutic class: Antihypertensive
Pregnancy category: C
(first trimester), D (later trimesters)
Indications
To control hypertension Adults and adolescents. Initial: 25 mg b.i.d. or t.i.d. Increased to 50 mg b.i.d. or t.i.d. after 1 to 2 wk, if needed. If blood pressure isn’t well controlled at this dosage and with the addition of a diuretic, dosage increased to 100 mg b.i.d. or t.i.d. and then, if needed, to 150 mg b.i.d. or t.i.d. while continuing diuretic. Maximum: 450 mg daily. To control accelerated or malignant hypertension when temporary discontinuation of current antihypertensive therapy isn’t practical or when prompt titration of blood pressure is needed Adults and adolescents. Initial: 25 mg b.i.d. or t.i.d while continuing diuretic but discontinuing current antihypertensive drug. Increased every 24 hr as needed until satisfactory response is obtained or maximum dosage is reached. Maximum: 450 mg daily. To treat heart failure that’s unresponsive to conventional therapy Adults and adolescents. Initial: 25 mg b.i.d. or t.i.d. Increased to 50 mg b.i.d. or t.i.d., as needed. After 14 days, increased to 100 mg t.i.d. and then to 150 mg t.i.d, if needed. Maximum: 450 mg daily. To treat left-sided heart failure after MI Adults and adolescents.Initial: 6.25 mg as single dose starting 3 days after MI and then 12.5 mg t.i.d. Increased to 25 mg t.i.d. for several days and then again to maintenance dosage. Maintenance: 50 mg t.i.d. To treat diabetic nephropathy Adults and adolescents. 25 mg t.i.d.
DOSAGE ADJUSTMENT Starting dosage reduced to 6.25 mg b.i.d. or t.i.d. if patient with hypertension also has heart failure, is undergoing dialysis, or is being vigorously treated with diuretics that result in hyponatremia or hypovolemia. Route Onset Peak Duration P.O. 15–60 min 60–90 min 6–12 hr
Mechanism of Action
By inhibiting angiotensin-converting enzyme, captopril:
prevents conversion of angiotensin I to angiotensin II, a potent vasoconstrictor that also stimulates the adrenal cortex to secrete aldosterone. Inhibiting aldosterone increases sodium and water excretion, reducing blood pressure. may inhibit renal and vascular production of angiotensin II. decreases serum angiotensin II level and increases renin activity. This decreases aldosterone secretion, slightly increasing serum potassium level and fluid loss. decreases vascular tone and blood pressure. Contraindications
Hypersensitivity to captopril, other ACE inhibitors, or their components captopril 173 C Interactions
allopurinol: Increased risk of hypersensitivity reactions, including Stevens-Johnson syndrome, skin eruptions, fever, arthralgia antacids: Possibly impaired captopril absorption capsaicin: Possibly cause or worsening of cough from ACE inhibitor cyclosporine, potassium-containing , potassium-sparing diuretics, potassium supplements: Increased risk of hyperkalemia digoxin: Increased blood digoxin level diuretics; hypotension-producing , such as hydralazine: Additive hypotensive effects gold: Increased risk of nitritoid reaction, including facial flushing, nausea, vomiting, and hypotension lithium: Increased risk of lithium toxicity
NSAIDs: Decreased antihypertensive response to ACE inhibition probenecid: Increased blood level and decreased total clearance of captopril
alcohol use: Additive hypotensive effects Side Efect
CNS: Fever
CV: Chest pain, hypotension, orthostatic hypotension, palpitations, tachycardia
EENT: Loss of taste
GU: Dysuria, impotence, nephrotic syndrome, nocturia, oliguria, polyuria, proteinuria, urinary frequency
HEME: Eosinophilia
MS: Arthralgia
RESP: Cough
SKIN: Photosensitivity, pruritus, rash
Other: Angioedema, hyperkalemia, hyponatremia, positive ANA titer Cautions
Closely monitor patient’s blood pressure, especially when therapy starts and dosage increases. Keep patient supine if hypotension occurs. Monitor renal function tests for signs of nephrotic syndrome, such as proteinuria and increased BUN and serum creatinine levels. Also watch for such renal evidence as oliguria, polyuria, and urinary frequency. Monitor WBC regularly, as ordered, especially if patient has collagen vascular disease or renal disease. PATIENT SAFTY
Instruct patient to take captopril 1 hour before meals. Tell patient to rise slowly from sitting or lying to minimize orthostatic hypotension. Tell patient to avoid sunlight or wear sunscreen in direct sunlight because photosensitivity may occur. Warn patient not to stop drug abruptly. Urge patient not to use salt substitutes that contain potassium and to consult prescriber before increasing potassium intake to avoid increasing risk of hyperkalemia. Urge patient to tell prescriber about signs and symptoms of infection, such as sore throat or fever.
Trade Name & Company Name
effect of Captopril in Pregnancy, Fetal Health
and Breast feeding
Pregnancy
. There are no adequate reports or well-controlled studies of captopril in pregnant women. ACEIs are contraindicated across gestation unless there is no option. Improved Pregnancy
outcome was noted in diabetic mothers treated prenatally with low doses of captopril. The lowest dose effective should be used when captopril is required during pregnancy. Close monitoring of AF and fetal well-being is recommended. Fetal Health
There are no adequate reports or well-controlled studies in human fetuses. Captopril apparently crosses the human placenta, though the kinetics remain to be elucidated. ACEIs are considered both teratogenic and fetotoxic. They are contraindicated throughout Pregnancy
as all members of this class may cause cranial hypoplasia, reversible or irreversible renal failure, oligohydramnios, anuria, death, prematurity, IUGR, and patent ductus arteriosus. Captopril is embryocidal and causes stillbirths in a variety of animals (sheep, rabbits, rats). Breastfeeding
Captopril is excreted in breast milk at a very low concentration and is generally considered compatible with breastfeeding. 130
the follwing drugs will increse Captopril by inhepiting cyp450
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the follwing drugs will decrease Captopril by inhancing cyp450
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trad drugs based on Captopril
| Gen name | Trade name | Catagory name |
| captopril / hydrochlorothiazide | Capozide | ACE inhibitors with thiazides |
| captopril / hydrochlorothiazide | Capozide 25/15 | ACE inhibitors with thiazides |
| captopril / hydrochlorothiazide | Capozide 50/15 | ACE inhibitors with thiazides |
| captopril / hydrochlorothiazide | Capozide 50/25 | ACE inhibitors with thiazides |
| captopril / hydrochlorothiazide 1 review | Capozide 25/25 | ACE inhibitors with thiazides |
| Captopril | ACETAB 50 MG TABLETS | |
| Captopril | CAPOCARD 50MG TAB | |
| Captopril | CAPOTEN 25MG TAB | |
| Captopril | CAPRIL 25MG TAB | |
| Captopril | CAPTOPHAR 25MG TABLETS | |
| Captopril | Cardiopril 25 Tablets | |
| Captopril | NOVO-CAPTORIL 12.5MG TAB | |
| Captopril | NOVO-CAPTORIL 50MG TAB | |
other drugs from same cataogory