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
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Treatment of hypertension alone or in combination with thiazide-type diuretics
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Treatment of heart failure in patients unresponsive to conventional therapy; used with diuretics and cardiac glycosides
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Treatment of diabetic nephropathy
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Treatment of left ventricular dysfunction after MI
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Unlabeled uses: Management of hypertensive crises; treatment of pediatric hypertension; Raynaud syndrome
Contraindications and Cautions
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Contraindicated with allergy to captopril, history of angioedema, second or third trimester of pregnancy.
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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
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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.
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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.
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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.
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Diabetic nephropathy: Reduce dosage; suggested dose is 25 mg PO tid.
Pediatric patients
Safety and efficacy not established.
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