{"id":1699,"date":"2023-06-25T17:32:50","date_gmt":"2023-06-25T17:32:50","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/captopril\/"},"modified":"2023-06-25T19:40:16","modified_gmt":"2023-06-25T19:40:16","slug":"captopril","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/captopril\/","title":{"rendered":"Captopril"},"content":{"rendered":"

<\/p>\n

Captopril<\/h1>\n

CLINICAL USE<\/h3>\n

Angiotensin-converting enzyme inhibitor:<\/p>\n

  • Hypertension<\/li>\n
  • Heart failure<\/li>\n
  • Post myocardial infarction<\/li>\n
  • Diabetic nephropathy
    \n

    DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

    6.25\u201350 mg 2\u20133 times daily<\/li>\n

  • Diabetic nephropathy: 75\u2013100 mg daily in divided doses
    \n

    PHARMACOKINETICS<\/h3>\n<\/li>\n
  • Molecular weight                           :217.3<\/li>\n
  • %Protein binding                           :25\u201330<\/li>\n
  • %Excreted unchanged in urine     : 40\u201350<\/li>\n
  • Volume of distribution (L\/kg)       :2<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :2\u20133\/21\u201332
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Start low \u2013 adjust according to response<\/li>\n
  • 10 to 20     : Start low \u2013 adjust according to response<\/li>\n
  • <10           : Start low \u2013 adjust according to response
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :Not dialysed. Dose as in GFR <10 mL\/min<\/li>\n
  • HD                     :Dialysed. Dose as in GFR<\/li>\n
  • <10           : mL\/min<\/li>\n
  • HDF\/high flux   :Dialysed. Dose as in GFR<\/li>\n
  • <10           : mL\/min<\/li>\n
  • CAV\/VVHD      :Dialysed. Dose as in GFR=10\u201320 mL\/min
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Anaesthetics: enhanced hypotensive effect cinAnalgesics: antagonism of hypotensive effect and increased risk of renal impairment with NSAIDs; hyperkalaemia with ketorolac and other NSAIDs<\/li>\n
  • Ciclosporin: increased risk of hyperkalaemia and nephrotoxicity<\/li>\n
  • Diuretics: enhanced hypotensive effect; hyperkalaemia with potassium-sparing diuretics<\/li>\n
  • Epoetin: increased risk of hyperkalaemia; antagonism of hypotensive effect<\/li>\n
  • Lithium: reduced excretion, possibility of enhanced lithium toxicity<\/li>\n
  • Potassium salts: increased risk of hyperkalaemia.<\/li>\n
  • Tacrolimus: increased risk of hyperkalaemia and nephrotoxicity
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    Oral<\/p>\n

    Rate of Administration<\/h4>\n

    \u2013<\/p>\n

    Comments<\/h4>\n

    Tablets may be dispersed in water<\/p>\n

    OTHER INFORMATION<\/h4>\n

    A<\/li>\n

  • dverse reactions, especially hyperkalaemia, are more common in patients with renal impairment<\/li>\n
  • Effective sub-lingually in emergencies As renal function declines a hepatic elimination route for captopril becomes increasingly more significant<\/li>\n
  • Renal failure has been reported in association with ACE inhibitors in patients with renal artery stenosis, post renal transplant, or in those with congestive heart failure<\/li>\n
  • A high incidence of anaphylactoid reactions has been reported in patients dialysed with high-flux polyacrylonitrile membranes and treated concomitantly with an ACE inhibitor \u2013 this combination should therefore be avoided<\/li>\n
  • Close monitoring of renal function during therapy is necessary in those with renal insufficiency.<\/li>\n","protected":false},"excerpt":{"rendered":"

    Captopril CLINICAL USE Angiotensin-converting enzyme inhibitor: Hypertension Heart failure Post<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1699","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1699","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1699"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1699\/revisions"}],"predecessor-version":[{"id":2828,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1699\/revisions\/2828"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1699"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1699"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1699"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}