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Captopril: Brands, Price & Uses in Bangladesh
Captopril is an angiotensin-converting enzyme (ACE) inhibitor with the following FDA-approved and guideline-supported uses: Hypertension: Established first-line or add-on therapy for management of…
About Captopril
Indications of Captopril
Captopril is an angiotensin-converting enzyme (ACE) inhibitor with the following FDA-approved and guideline-supported uses:
- Hypertension: Established first-line or add-on therapy for management of high blood pressure, used alone or in combination with other antihypertensive agents (e.g., thiazide diuretics).
- Heart failure: Approved adjunct therapy (usually combined with diuretics and, where appropriate, digitalis) to improve symptoms and reduce mortality in patients with reduced ejection fraction.
- Left ventricular dysfunction after myocardial infarction: Approved to improve survival in clinically stable patients with left ventricular dysfunction following a heart attack.
- Diabetic nephropathy: Approved for patients with type 1 diabetes and established nephropathy (proteinuria greater than 500 mg/day) to slow progression of kidney disease.
Guideline bodies also support use of Captopril and other ACE inhibitors as part of broader cardiovascular risk reduction in select high-risk patients, but this should be individualized by a physician.
Dosage & Administration of Captopril
Adult Dose
| Indication | Typical Dosing |
|---|---|
| Hypertension | Initial 25 mg two to three times daily; may be increased to 50 mg two to three times daily after 1–2 weeks if needed. Usual maintenance range is 25–150 mg two to three times daily. |
| Heart failure | Initial 6.25–12.5 mg three times daily, titrated gradually (over days to weeks) to a target dose of 50 mg three times daily as tolerated, usually with a diuretic. |
| Left ventricular dysfunction post-MI | Started as early as 3 days after myocardial infarction with a low test dose (e.g., 6.25 mg), then increased gradually to a target of 50 mg three times daily. |
| Diabetic nephropathy | 25 mg three times daily. |
Pediatric Dose
Use in children requires individualized, weight-based dosing under close physician supervision, starting at the lowest possible dose and titrating slowly with monitoring of blood pressure and renal function; safety and efficacy in neonates are not well established (see Use in Special Populations).
Renal Impairment
Dose reduction and/or extended dosing intervals are required in patients with renal impairment, as Captopril is primarily renally excreted.
Administration
Take Captopril on an empty stomach, one hour before meals, unless a physician advises otherwise.
Side Effects of Captopril
Common and important side effects of Captopril include:
- Common: Dry, persistent, non-productive cough; taste disturbance (metallic taste or loss of taste); skin rash; dizziness; headache; mild increase in serum potassium.
- Less common but important: First-dose hypotension, especially in volume-depleted patients; proteinuria.
- Rare but serious: Angioedema (swelling of face, lips, tongue, or throat — requires immediate discontinuation and medical attention); neutropenia or agranulocytosis (more common with renal impairment or collagen vascular disease); acute renal failure (especially with bilateral renal artery stenosis); cholestatic jaundice progressing rarely to hepatic necrosis.
Patients should seek prompt medical attention for swelling of the face/throat, difficulty breathing, signs of infection (fever, sore throat), or yellowing of the skin/eyes while taking Captopril.
Contraindications of Captopril
Captopril is absolutely contraindicated in the following situations:
- Known hypersensitivity to Captopril or any other ACE inhibitor.
- History of angioedema related to previous treatment with Captopril or another ACE inhibitor, or hereditary/idiopathic angioedema.
- Pregnancy (see Pregnancy and Lactation for the boxed warning on fetal toxicity).
- Concomitant use with aliskiren in patients with diabetes mellitus.
Frequently Asked Questions about Captopril
What is Captopril used for?
Captopril is used to treat high blood pressure (hypertension), heart failure, left ventricular dysfunction after a heart attack, and kidney disease (nephropathy) in people with type 1 diabetes.
How should I take Captopril?
Captopril is usually taken one hour before meals, two to three times a day, exactly as prescribed by your physician. Do not stop taking it suddenly without medical advice.
Can I take Captopril during pregnancy?
No. Captopril carries a boxed warning because it can cause serious injury or death to a developing baby when taken during pregnancy, especially in the second and third trimesters. Tell your doctor immediately if you are or become pregnant while taking Captopril, so it can be stopped and replaced with a safer alternative.
Why do I have a dry cough since starting Captopril?
A persistent dry cough is a known side effect of Captopril and other ACE inhibitors. It is usually not dangerous, but if it bothers you, discuss it with your physician rather than stopping the medicine on your own.
What should I do if I miss a dose or take too much Captopril?
If you miss a dose, take it as soon as you remember unless it is close to the next dose. If you or someone else has taken too much Captopril and shows signs such as severe dizziness or fainting, seek immediate medical attention or contact a poison control center.
Can Captopril be taken with other blood pressure medicines?
Captopril is often combined with diuretics, but combining it with certain other medicines that act on the same hormone system (such as ARBs or aliskiren) can increase the risk of high potassium, low blood pressure, and kidney problems. Always inform your physician of all medicines you take.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.