Name Captopril
Classes Cardiovascular Agent
Antihypertensive
ACE Inhibitor
Diseases Cardiovascular Disease
Congestive Heart Failure (CHF)
Diabetic Nephropathy
Hypertension (High Blood Pressure)
Myocardial Infarction

Captopril

Captopril competitively inhibits the conversion of angiotensin I (ATI) to angiotensin II (ATII), thus resulting in reduced ATII levels and aldosterone secretion. It also increases plasma renin activity and bradykinin levels.

Captopril is indicated for the following conditions-

  • Heart failure
  • Hypertension
  • Left Ventricular Dysfunction After Myocardial Infarction
  • Diabetic Nephropathy
  • Captopril is available as tablets. It should be taken 1 hour before meal and dosage should be individualized. Captopril therapy must be initiated under very close medical supervision
  • Hypertension: Captopril is given in 25 mg twice or thrice a day. If blood pressure reduction is not satisfactory after one or two weeks, the dose may be increased to 50 mg. When Captopril is administered alone, concomitant sodium restriction may be advantageous.
  • Diabetic nephropathy: The adult dose for Type 1 diabetes patients is 25 mg/day in divided doses.
  • Left Ventricular Dysfunction After Myocardial Infarction: A target maintenance dose of 50 mg twice a day is indicated for long-term usage in patients who have had a myocardial infarction.
  • Heart Failure: The usual starting daily dosage for most people is 25 mg thrice a day. Further increases in dosage should be deferred for at least two weeks after reaching a dose of 50 mg t.i.d. to assess if a good response occurs. At 50 or 100 mg thrice a day, the majority of the individuals investigated showed good clinical improvement. Captopril should not be taken in excess of 450 mg per day.
  • Dosage adjustment is required for significantly renally impaired patients.

 

Captopril can cause the following side effects-

  • Proteinuria
  • Neutropenia
  • Pancytopenia
  • Anemia
  • Rash/ Pruritus
  • Eosinophilia
  • Photosensitivity
  • Hypotension
  • Dry cough
  • Patients should be instructed to report any signs or symptoms of angioedema to their doctor right away (e.g., swelling of the face, eyes, lips, tongue, throat, and extremities; difficulty swallowing or breathing; hoarseness) and to stop taking the medication.
  • Patients should be urged to visit their doctor before taking potassium-sparing diuretics, potassium supplements, or potassium-containing salt replacements.
  • Patients should be warned against interruption or discontinuation of medication unless instructed by the physician.
  • Heart failure patients on captopril therapy should be cautioned against rapid increases in physical activity.

Contraindication

Captopril is contraindicated in patients who are hypersensitive to this product or any other angiotensin-converting enzyme inhibitor (e.g., a patient who has experienced angioedema during therapy with any other ACE inhibitor). Such as-

Captopril is also contraindicated in patients receiving renin inhibitors such as-

Captopril taking patients should avoid foods that are rich in potassium; such as banana.