Captopril(kap’ toe pril)
Apo-Capto (CAN), Gen-Captopril (CAN), PMS-Captopril (CAN)
PREGNANCY CATEGORY D
Drug Classes
ACE inhibitor
Antihypertensive
Therapeutic Actions
Blocks ACE from converting angiotensin I to angiotensin II, a powerful vasoconstrictor, leading to decreased BP, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synthesis also may be involved in the antihypertensive action.
Indications
Treatment of hypertension alone or in combination with thiazide-type diuretics
Treatment of heart failure in patients unresponsive to conventional therapy; used with diuretics and cardiac glycosides
Treatment of diabetic nephropathy
Treatment of left ventricular dysfunction after MI
Unlabeled uses: Management of hypertensive crises; treatment of pediatric hypertension; Raynaud syndrome
Contraindications and Cautions
Contraindicated with allergy to captopril, history of angioedema, second or third trimester of pregnancy.
Use cautiously with renal impairment, heart failure, salt or volume depletion, history of renal artery stenosis, lactation.
Available Forms
Tablets—12.5, 25, 50, 100 mg
Dosages
Adults
Hypertension: 25 mg PO bid or tid; if satisfactory response is not noted within 1–2 wk, increase dosage to 50 mg bid–tid; usual range is 25–150 mg bid–tid PO with a mild thiazide diuretic. Do not exceed 450 mg/day.
Heart failure: Initially, 6.25–12.5 mg PO tid in patients who may be salt or volume depleted. Usual initial dose, 25 mg PO tid; maintenance dose, 50–100 mg PO tid. Do not exceed 450 mg/day. Use in conjunction with diuretic and cardiac glycoside therapy.
Left ventricular dysfunction after MI: Initially, 6.25 mg PO, then 12.5 mg PO tid; increase slowly to 50 mg PO tid starting as early as 3 days post MI.
Diabetic nephropathy: Reduce dosage; suggested dose is 25 mg PO tid.
Pediatric patients
Safety and efficacy not established.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
