| name | Captopril |
| Classification | ACE Inhibitor |
| Pharmacokinetics | | absorption | Rapidly absorbed from the gastrointestinal tract, peak plasma concentrations typically achieved within 1-2 hours. | | distribution | Distributes throughout the body, with some binding to plasma proteins. | | metabolism | Minimal metabolism, primarily excreted unchanged by the kidneys. | | excretion | Primarily eliminated by the kidneys; renal function significantly impacts its clearance. |
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| suggested dosage | | initial | 25-50 mg orally 2-3 times daily for mild-moderate hypertension, or 12.5-25 mg BID or TID for heart failure, increasing gradually based on response and tolerability. | | adult maintenance | 50-150 mg per day in divided doses. | | notes | Dosage adjustments may be necessary in patients with renal impairment, hepatic impairment, or other significant medical conditions. | | patient specific details | | age | 25 years - No dosage adjustment typically needed compared to general adult recommendations. | | weight | 70 kg - No dosage adjustment needed for a standard weight individual. |
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| indications | | 1 | Hypertension | | 2 | Heart failure | | 3 | Diabetic nephropathy (in selected cases) | | 4 | Myocardial infarction (in selected cases) after stabilization. |
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| Safety in pregnancy | | category | D | | details | Captopril is contraindicated in pregnancy. It may cause fetal harm when administered to pregnant women during the second and third trimesters. If pregnancy occurs during treatment, the drug should be discontinued as soon as possible. The physician should determine the best approach to managing the hypertension or heart failure in the pregnant individual. | | additional notes | Discuss with the prescribing physician the specifics of appropriate management for hypertension or heart failure in pregnancy |
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| Safety in breastfeeding | | details | Not recommended. Because it is extensively cleared by the kidneys and can enter breast milk, captopril is generally not recommended for use during breastfeeding. Alternative, safer therapies should be explored if possible. |
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| side effects | | 1 | Dizziness | | 2 | Headache | | 3 | Fatigue | | 4 | Cough (dry, persistent) | | 5 | Hypotension (especially with initial doses) | | 6 | Renal dysfunction (especially in patients with pre-existing renal impairment) | | 7 | Angioedema (swelling of face, lips, tongue, or throat) | | 8 | Taste disturbances | | 9 | Rash | | 10 | Nausea/Vomiting | | 11 | Diarrhea | | 12 | Dysgeusia (altered taste) |
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| alternatives | |
| contraindications | | 1 | Hypersensitivity to captopril or other ACE inhibitors | | 2 | History of angioedema associated with previous ACE inhibitor use | | 3 | Bilateral renal artery stenosis | | 4 | Severe renal impairment (eGFR <30 mL/min) | | 5 | Pregnancy (Category D) |
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| interactions | | 1 | NSAIDs (can reduce the efficacy of ACE inhibitors) | | 2 | Potassium-sparing diuretics (can increase potassium levels) | | 3 | Lithium (can increase lithium levels) | | 4 | Other antihypertensive medications (additive hypotensive effects) |
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| warnings and precautions | | 1 | Patients with bilateral renal artery stenosis should be treated with extreme caution. | | 2 | Monitor blood pressure closely during initial therapy and dosage adjustments. | | 3 | Renal function tests are crucial before starting, periodically during therapy, and in case of side effects (eg., hypotension or worsening renal function). | | 4 | Monitor for signs and symptoms of angioedema (swelling of face, lips, tongue, or throat). | | 5 | Assess for renal insufficiency. | | 6 | Caution in patients with heart failure. |
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| additional informations | Captopril should be stored in a cool, dry place and protected from light. Avoid exceeding prescribed doses. |
| patient education | Patients should be educated on the importance of regularly monitoring blood pressure and reporting any unusual symptoms to their healthcare provider. Adherence to the prescribed regimen is vital. |
