captopril

Generic Name: captopril (KAP toe pril)Brand Names: Capoten

What is captopril?

Captopril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme.

Captopril is used to treat high blood pressure (hypertension), congestive heart failure, kidney problems caused by diabetes, and to improve survival after a heart attack.

Captopril may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about captopril?

Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Captopril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment. Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of captopril. Do not use salt substitutes or potassium supplements while taking captopril, unless your doctor has told you to.

Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking captopril. Drink plenty of water each day while you are taking this medication.

What should I discuss with my healthcare provider before taking captopril?

Do not use this medication if you are allergic to captopril or to any other ACE inhibitor, such as benazepril (Lotensin), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

If you have certain conditions, you may need a dose adjustment or special tests to safely take this medication. Before you take captopril, tell your doctor if you have:

• kidney disease (or if you are on dialysis);

• liver disease;

• heart disease or congestive heart failure;

• diabetes; or

• a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis.

FDA pregnancy category D. Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Captopril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment. Captopril can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take captopril?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Take each dose with a full glass of water.

Captopril is usually taken 1 hour before meals. Follow your doctor's instructions.

Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking captopril. Drink plenty of water each day while you are taking this medication.

To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking captopril. You may need to stop using the medicine for a short time.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

Store captopril at room temperature away from moisture and heat.

See also: Captopril dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include feeling extremely dizzy or light-headed, or fainting.

What should I avoid while taking captopril?

Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of captopril. Do not use salt substitutes or potassium supplements while taking captopril, unless your doctor has told you to.

Captopril side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

• feeling light-headed, fainting;

• urinating more or less than usual, or not at all;

• fever, chills, body aches, flu symptoms;

• pale skin, easy bruising or bleeding;

• fast, pounding, or uneven heartbeats;

• chest pain; or

• swelling, rapid weight gain.

Less serious side effects may include:

• cough;

• loss of taste sensation, loss of appetite;

• dizziness, drowsiness, headache;

• sleep problems (insomnia);

• dry mouth, sores in the mouth or on the lips;

• nausea, diarrhea, constipation; or

• mild skin itching or rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Captopril Dosing Information

Usual Adult Dose for Hypertension:

Initial dose: 25 mg orally 2 to 3 times a day one hour before meals.Maintenance dose: 25 to 150 mg orally 2 to 3 times a day one hour before meals.

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 25 mg orally 3 times a day (6.25 to 12.5 mg orally 3 times a day if volume depleted or hypotensive).Maintenance dose: After a dose of 50 mg three times a day is reached, further increases in dosage should be delayed, where possible, for at least 2 weeks to determine if a satisfactory response occurs. Most patients studied have had a satisfactory clinical improvement at 50 to 100 mg three times a day. Captopril should generally be used in conjunction with a diuretic and digitalis.

Usual Adult Dose for Left Ventricular Dysfunction:

Initial dose: 6.25 mg orally for one dose, then 12.5 mg orally 3 times a day.Increasing dose: The dose is increased to 25 mg orally 3 times a day during the next several days. Maintenance dose: The dose is increased to a target dose of 50 mg orally 3 times a day over the next several weeks as tolerated.Therapy may be initiated as early as three days following a myocardial infarction. Captopril may be used in patients treated with other post-myocardial infarction therapies, e.g., thrombolytics, aspirin, beta blockers.

Usual Adult Dose for Diabetic Nephropathy:

The recommended dose for long-term use is 25 mg orally 3 times a day.

Usual Adult Dose for Hypertensive Emergency:

When prompt titration of blood pressure is indicated, continue diuretic therapy and halt current medication therapy and initiate 25 mg two or three times daily under close supervision. Increase the dose every 24 hours or less until a satisfactory response is obtained or the maximum dose is reached.

Usual Adult Dose for Cystinuria:

Initial dose: 25 mg orally 2 to 3 times a day one hour before meals. Initial doses may be titrated as tolerated approximately every 1 to 2 weeks to reduce the degree of cystinuria.Limited data have shown significant reductions in the urinary excretion of cystine after daily doses of captopril of 150 mg.

Usual Pediatric Dose for Congestive Heart Failure:

Neonates: 0.1 to 0.4 mg/kg/day orally given every 6 to 8 hours Infants: 0.15 to 0.3 mg/kg/dose orally; titrate upward if needed to a maximum dose of 6 mg/kg/day in 2 to 4 divided dosesChildren: 0.3 to 0.5 mg/kg/dose orally every 8 hours; titrate upward if needed to a maximum dose of 6 mg/kg/day in 2 to 4 divided dosesAdolescents: 12.5-25 mg/dose orally 2 to 3 times per day; increase weekly if necessary by 25 mg/dose to maximum dose of 450 mg per day

Usual Pediatric Dose for Diabetic Nephropathy:

Neonates: 0.1 to 0.4 mg/kg/day orally given every 6 to 8 hours Infants: 0.15 to 0.3 mg/kg/dose orally; titrate upward if needed to a maximum dose of 6 mg/kg/day in 2 to 4 divided dosesChildren: 0.3 to 0.5 mg/kg/dose orally every 8 hours; titrate upward if needed to a maximum dose of 6 mg/kg/day in 2 to 4 divided dosesAdolescents: 12.5-25 mg/dose orally 2 to 3 times per day; increase weekly if necessary by 25 mg/dose to maximum dose of 450 mg per day

Usual Pediatric Dose for Hypertension:

Neonates: 0.1 to 0.4 mg/kg/day orally given every 6 to 8 hours Infants: 0.15 to 0.3 mg/kg/dose orally; titrate upward if needed to a maximum dose of 6 mg/kg/day in 2 to 4 divided dosesChildren: 0.3 to 0.5 mg/kg/dose orally every 8 hours; titrate upward if needed to a maximum dose of 6 mg/kg/day in 2 to 4 divided dosesAdolescents: 12.5-25 mg/dose orally 2 to 3 times per day; increase weekly if necessary by 25 mg/dose to maximum dose of 450 mg per day

What other drugs will affect captopril?

Before taking captopril, tell your doctor if you are taking any of the following drugs:

• gold injections to treat arthritis;

• lithium (Lithobid, Eskalith);

• a potassium supplement such as K-Dur, Klor-Con;

• salt substitutes that contain potassium;

• drugs that can dilate blood vessels, such as alprostadil (Caverject, Edex), nitroglycerin, nitroprusside (Nitropress), nesiritide (Natrecor), minoxidil (Loniten), or isosorbide dinitrate (Imdur, Isordil);

• aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), naproxen (Aleve, Naprosyn), and others; or

• a diuretic (water pill).

This list is not complete and there may be other drugs that can interact with captopril. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about captopril.

• Remember, keep this and all other medicines out of the reach of children. Never share your medicines with others and only use this medication for the condition prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 6.03. Revision Date: 07/09/2009 9:17:30 AM.