Captopril Tablet
Captopril
25mg
Albion Laboratories Ltd.
| Pack size | 100's pack |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 3.00 AED |
Indications
Captopril Tablet is used for:
Hypertension, Congestive heart failure, Post Myocardial infarction, Diabetic nephropathy
Adult Dose
Adult:
Hypertension
Adult: Initially 12.5–25 mg twice daily, then increased if necessary up to 150 mg daily in 2 divided doses, doses to be increased at intervals of at least 2 weeks,
once-daily dosing may be appropriate if other concomitant antihypertensive drugs are taken
Essential hypertension if used in volume depletion, cardiac decompensation, or renovascular hypertension
Adult: Initially 6.25–12.5 mg for 1 dose, then 6.25–12.5 mg twice daily;
increased if necessary up to 100 mg daily in 1–2 divided doses, doses to be increased at intervals of at least 2 weeks, once-daily dosing may be appropriate if other concomitant antihypertensive drugs taken
Heart failure
Adult (under close medical supervision): Initially 6.25–12.5 mg 2–3 times a day, then increased if tolerated to up to 150 mg daily in divided doses, dose to be increased gradually at intervals of at least 2 weeks
Short-term treatment within 24 hours of the onset of myocardial infarction in clinically stable patients
Adult: Initially 6.25 mg, then increased to 12.5 mg after 2 hours, followed by 25 mg after 12 hours; increased if tolerated to 50 mg twice daily for 4 weeks
Prophylaxis of symptomatic heart failure after myocardial infarction in clinically stable patients with asymptomatic left ventricular dysfunction (starting 3–16 days after infarction)
Adult: Initially 6.25 mg daily, then increased to 12.5 mg 3 times a day for 2 days, then increased if tolerated to 25 mg 3 times a day, then increased if tolerated to
75–150 mg daily in 2–3 divided doses, doses exceeding 75mg per day to be increased gradually
Diabetic nephropathy in type 1 diabetes mellitus
Adult: 75–100 mg daily in divided doses
Child Dose
Oral
Hypertension
Child: Neonates and infants: 0.15 mg/kg. Max: 6 mg/kg in 2 or 3 divided doses according to response. Childn and adolescents: 0.3 mg/kg. Max: 6 mg/kg in 2 or 3 divided doses according to response.
Heart failure
Child: Initially, 0.25 mg/kg/day, increased up to 2.5 or 3.5 mg/kg/day in 3 divided doses.
Renal Dose
Renal impairment:
CrCl (ml/min)
<10 Initially, 6.25 mg/day. Max: 37.5 mg/day.
10-20 Initially, 12.5 mg/day. Max: 75 mg/day.
21-40 Initially, 25 mg/day. Max: 100 mg/day.
Administration
Should be taken on an empty stomach.
Take on an empty stomach 1 hr before or 2 hr after meals.
Contra Indications
Known hypersensitivity to the drug. Bilateral renal artery stenosis, hereditary angioedema; renal impairment; pregnancy.
Precautions
Discontinue as soon as pregnancy detected; during the second and third trimesters of pregnancy, drugs that act directly on the renin-angiotensin have been associated with fetal injury that includes hypotension, neonatal skull hypoplasia, anuria, reversible or irreversible renal failure, and death
Aortic stenosis/hypertrophic cardiomyopathy, hypotension, biliary cirrhosis or biliary obstruction, myelosuppression, electrolyte imbalance, hyperuricemia or gout, SLE, hepatic or renal impairment
Avoid concomitant use with lithium
Less effective in African-Americans
Excessive hypotension if concomitant diuretics or volume-depleted; start with 6.25 mg q8hr
Risk of hyperkalemia, especially with K+ sparing diuretics
Dual blockade of the renin angiotensin system with ARBs, ACE inhibitors, or aliskiren associated with increased risk for hypotension, hyperkalemia, and renal function changes (including acute renal failure) compared to monotherapy
Blood levels don't correlate with BP response
Food decreases absorption
ACE inhibition also causes increased bradykinin levels which putatively mediates angioedema
Coadministration with mTOR inhibitors (eg, temsirolimus, everolimus, sirolimus) may increase risk for angioedema
Intestinal angioedema, that presented with abdominal pain, reported in patients treated with ACE inhibitors
Neutropenia (<1000/mm³ with myeloid hypoplasia reported with captopril; risk is dependent on clinical status of patient
Causes false positive urine acetone
Pregnancy-Lactation
Pregnancy Category: C; D in 2nd & 3rd trimesters
Discontinue as soon as pregnancy detected; during the second and third trimesters of pregnancy, drugs that act directly on the renin-angiotensin have been associated with fetal injury that includes hypotension, neonatal skull hypoplasia, anuria, reversible or irreversible renal failure, and death
Lactation: enters breast milk/not recommended (AAP states compatible with nursing)
Interactions
Concurrent treatment w/ NSAIDs reduces hypotensive action and increases the risk of nephrotoxicity. Additive hyperkalaemic effect w/ K supplements, K-sparing diuretics, and other drugs (e.g. heparin). May increase risk of leucopenia w/ procainamide, allopurinol, cytostatic or immunosuppressants. May increase risk of lithium toxicity. Increased risk of nitritoid reactions w/ gold (Na aurothiomalate).
Potentially Fatal: Increased risk of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) w/ aliskiren in diabetic patients.
Contraindicated (3)
aliskiren
mavorixafor
sacubitril/valsartan
Adverse Effects
Side effects of Captopril :
>10%
Hyperkalemia (1-11%)
1-10%
Hypersensitivity rxns (4-7%),Skin rash (4-7%),Dysgeusia (2-4%),Hypotension (1-2.5%),Pruritus (2%),Cough (0.5-2%),Chest pain (1%),Palpitations (1%),Proteinuria (1%),Tachycardia (1%)
Frequency Not Defined
Cardiac arrest,Orthostatic hypotension,Ataxia,Confusion,Depression,Somnolence,Angioedema,Photosensitivity,Neutropenia,ARF if renal artery stenosis,Renal impairment,Impotence
Potentially Fatal: Neutropenia, usually occurs within 3 mth of starting therapy especially in patients with renal dysfunction or collagen diseases. Hyperkalaemia. Anaphylactic reactions.
Mechanism of Action
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. Reduction of ATII leads to decreased Na and water retention. This promotes vasodilation and BP reduction.
Note
Captopril 25mg Tablet manufactured by Albion Laboratories Ltd.. Its generic name is Captopril. Captopril is availble in Bangladesh.
Farmaco BD drug index information on Captopril Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.