captopril and hydrochlorothiazide, Capozide (cont.)

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Hydrochlorothiazide reduces the elimination of lithium (Lithobid) by the kidneys and can lead to lithium toxicity. Nonsteroidal antiinflammatory drugs, for example, ibuprofen, may reduce the blood pressure lowering effects of hydrochlorothiazide. Blood sugar levels can be elevated by HCTZ, necessitating adjustment in the doses of medications that are used for treating diabetes. Combining HCTZ with corticosteroids may increase the risk for low levels of blood potassium and other electrolytes. Low blood potassium can increase the toxicity of digoxin (Lanoxin). Cholestyramine (Questran, Questran Light) and colestipol (Colestid) bind to hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by 43%-85%.

PREGNANCY: When used in the second or third trimester of pregnancy ACE inhibitors can cause injury and even death to the fetus. Capozide should not be used during pregnancy.

NURSING MOTHERS: Both captopril and HCTZ are excreted in breast milk and may potentially affect nursing infants.

SIDE EFFECTS: A dry, persistent cough has been reported commonly with the use of ACE inhibitors. Coughing resolves after discontinuing the drug. Other common side effects include diarrhea, rash, itching, dizziness, loss of taste, weight loss, low blood pressure, and sexual dysfunction. Increased blood glucose and potassium levels also may occur.

Serious but, fortunately, very rare side effects are liver failure and angioedema (swelling of lips and throat that can obstruct breathing).



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