captopril, Capoten

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GENERIC NAME: captopril


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.



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.

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