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Captopril (Capoten)

Category:

  • Antihypertensive

Description:

  • Angiotensin-converting enzyme (ACE) inhibitor

Indications:

  • Hypertension, heart failure, left ventricular dysfunction after MI

  • Diabetic nephropathy in Type 1 patients (proteinuria > 500mg/daily)

Contraindications:

  • Heart block

  • Bilateral renal artery stenosis

Precautions:

  • Pregnancy category C (1st trimester) and D (3rd trimester)

  • Dialysis patients, hypovolemia, leukemia, scleroderma, lupus erythematosus

  • Blood dyscrasias, thyroid disease, COPD, asthma, CHF, hyperkalemia

  • Potassium sparing diruretics, cough, aortic stenosis, pediatric use

Adverse Reactions (Side Effects):

  • CNS: chills, fever

  • CV: chest pain, hypotension, palpitations, postural hypotension, tachycardia

  • GI: loss of taste

  • GU: acute reversible renal failure, dysuria, frequency, impotence, nephrotic syndrome, oliguria, polyuria, proteinuria

  • HEME: agranulocytosis, neutropenia

  • METAB: hyperkalemia, hyponatremia

  • RESP: angioedema, bronchospasm, cough, dyspnea

  • SKIN: rash

Dosage:

Administered orally

  • Adult:            

    • Hypertensive crisis: PO 25mg, increasing every 2 hours until desired response; do not exceed 450mg daily

    • Hypertension: PO initial dose 12.5mg 2-3 times daily; may increase to 50mg 2-3 times daily at 1-2 week intervals; usual range 25-150mg 2-3 times daily; max 450mg daily

    • Diabetic nephropathy: PO 25mg 3 times daily

    • Congestive heart failure: PO 12.5mg 2-3 times daily; may increase to 50mg 2-3 times daily; after 14 days, may increase to 150mg 3 times daily if needed

  • Child:            

    • Hypertension: PO initiate 0.15 mg/kg/dose; double at intervals of approximately 2 hours until blood pressure controlled; max 6 mg/kg/day

Drug Interactions:

  • Allopurinol: increased risk of hypersensitivity reactions including Stevens-Johnson syndrome, skin eruptions, fever, and arthralgias

  • NSAIDS: inhibits the antihypertensive response to ACE inhibition

  • Lithium: increased risk of lithium toxicity

 


The information contained here is an abbreviated summary. For more detailed and complete information, consult the manufacturer's product information sheets or standard textbooks

Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300

This information is provided by The Brookside Associates.  The Brookside Associates, LLC. is a private organization, not affiliated with any governmental agency. The opinions presented here are those of the author and do not necessarily represent the opinions of the Brookside Associates or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. All material presented here is unclassified.

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