Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: captopril
BRAND NAME: Capoten
DRUG CLASS AND MECHANISM: Captopril is an oral drug and a member of a
class of drugs called angiotensin converting enzyme (ACE) inhibitors. ACE inhibitors are used for treating high blood pressure, heart failure, and for
preventing kidney failure due to high blood pressure and diabetes. Other ACE
inhibitors include enalapril (Vasotec), quinapril (Accupril), ramipril (Altace),
fosinopril (Monopril), benazepril (Lotensin), lisinopril (Zestril, Prinivil),
moexipril (Univasc) and trandolapril (Mavik).
Angiotensin II is a very potent
chemical that causes the muscles surrounding blood vessels to contract, thereby
narrowing the vessels. The narrowing of the vessels increases the pressure
within the vessels causing high blood pressure (hypertension). Angiotensin II is
formed from angiotensin I in the blood by the enzyme angiotensin converting
enzyme or ACE. ACE inhibitors are medications that slow (inhibit) the activity
of the enzyme ACE and decrease the production of angiotensin II. As a result,
blood vessels enlarge or dilate, and blood pressure is reduced. The lower blood
pressure makes it easier for the heart to pump blood and can improve the
function of a failing heart. In addition, progression of the blood vessel
disease within the kidney caused by high blood pressure or diabetes is slowed.
The FDA approved captopril in April 1981.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 12.5, 25, 50, 100 mg
STORAGE: Captopril should be stored at room temperature, 15 to 30 C
(59 to 86 F) and away from moisture.
PRESCRIBED FOR: Captopril is used alone or in combination with other
drugs for the treatment of high blood pressure and heart failure. Captopril also
is used for improving survival and preventing heart failure and hospitalizations
for heart failure after a heart attack. Like other ACE inhibitors, captopril may
slow the progression of kidney failure in patients with diabetes or high blood
pressure.
DOSING: The recommended dose of captopril is 25-150 mg two or three
times daily. The maximum dose is 450 mg daily. It should be taken on an empty
stomach one hour before or two hours after meals since absorption of captopril
is reduced when it is taken with food.
DRUG INTERACTIONS: The use of ACE inhibitors with potassium
supplements, salt substitutes or diuretics , for example, spironolactone
(Aldactone), that increase potassium in the blood may lead to excessive
potassium levels (hyperkalemia). Potassium levels should be monitored whenever ACE inhibitors
are used in combination with these drugs.
There have been reports of increased lithium (Eskalith, Lithobid) levels when
lithium is used in combination with ACE inhibitors. The reason for this
interaction is not known, but the increased levels may lead to toxicity from
lithium.
There have been reports that aspirin and other
nonsteroidal antiinflammatory
drugs (NSAIDs) such as ibuprofen (Advil, Children's Advil/Motrin, Medipren,
Motrin, Nuprin, PediaCare Fever, etc.), indomethacin (Indocin, Indocin-SR), and
naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effects of ACE
inhibitors.
PREGNANCY: ACE inhibitors, including captopril, can be harmful to the
fetus and should not be taken by pregnant women.
NURSING MOTHERS: Captopril is secreted in
breast milk. Therefore it
should be avoided by nursing mothers.
SIDE EFFECTS: Captopril generally is well tolerated, and side effects
are usually mild and transient. A dry, persistent cough has been reported
commonly with the use of captopril and other ACE inhibitors. Coughing resolves
after discontinuing the drug. Other side effects include abdominal pain,
constipation, diarrhea, rash, dizziness, fatigue, headache, loss of taste, loss
of appetite, nausea,
vomiting, fainting and numbness or tingling in the hands or
feet. Captopril and other ACE inhibitors also may cause kidney failure and
increased levels of potassium in the blood. Serious but, fortunately, very rare
side effects are liver failure and angioedema (swelling of lips and throat that
can obstruct breathing).
Last Editorial Review: 3/12/2009
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- ACE Inhibitors - Read about ACE inhibitors like Altace, lisinopril, enalapril, ramparil, Zestril and more. Information includes side effects, drug interactions, and pregnancy safety information.
- Kidney Failure - Learn about kidney failure, in which the body has fluid retention, risen blood pressure, toxin build up and lack of red blood cells. Symptoms include fatigue, nausea, and apetite loss.
- lisinopril, Zestril, Prinivil - Explains the medication lisinopril (Zestril, Prinivil) an ACE inhibitor drug used to treat elevated blood pressure and heart failure.
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