Captopril is an inhibitor of angiotensin converting enzyme (ACE), which converts angiotensin I to angiotensin II, a potent endogenous vasoconstrictro substance.
Indications
- Hypertension, Management of hypertension alone or with other antihypertensive agents, especially thiazide-type diuretics. The blood pressure-lowering effects of captopril and thiazide are approximately additive. Captopril may be used as initial therapy for patients with normal renal function. In patients with impaired renal function, particularly those with collagen vascular disease, reverse captopril for hypertensive patients who have either developed unacceptable side effects on other drugs, or have failed to respond satisfactorily to drug combinations.
- Heart Failure, For treatment of CHF usually in combination with diuretics and digitalis. The beneficail effects of captopril in heart failure does not required the presence of digitalis; however, most controlled clinical trial experience with captopril has been in patients receiving digitalis, as well as diuretic treatment
Administration and Dosage
Individualize dosage, Administered 1 hour before meal
Hypertension:
- Initial dose 25 mg 2 or 3 times daily
- If possible, discontinue previous antihypertensive drug regimen 1 week before starting captopril
- If satisfactory blood pressure reduction is not achieved after 1 or 2 weeks, increased to 50 mg 2 times daily
- Dosage ussualy doesnot exceed 50 mg 3 times daily
Heart Failure:
- In patients with normal or low blood pressure who have been vigorously treated with diuretics and who may be hyponatremic or hypovolemic, a starting dose of 6.25 or 12.5 mg 3 times daily may minimize the magnitude or duration of the hypotesive effect.
- Titrate to usual daily dosage within the next several days
- Usual initial dose is 25 mg 3 times daily
Side Effects:
The side effects of captopril is related to dosage and to preexisting renal disease. The side effects may occur is hypotension 1 to 25%, dizziness 1 to 5%, myocardial infarction <1%, palpitations <1%, angina pectoris <1%, and angioedema< 0.1%.
