indicated for the treatment of hypertension.
Captopril is a sulfhydryl-containing analog of proline with antihypertensive activity. Captopril competitively inhibits angiotensin converting enzyme (ACE), thereby decreasing levels of angiotensin II, increasing plasma renin activity, and decreasing aldosterone secretion. Approxiately 60-75% of an oral dose of captopril is repidly absorbed from the GI tract in fasting healthy individuals or hypertensive patients. More than 95% of a dose is excreted renally, both as unchanged (45-50%) drug and as metabolites.
Adult: Initially, 12.5mg bid or 6.25 mg bid in combination w/ a diuretic, at bedtime to avoid precipitous fall in BP, gradually increased at 2-4- wk intervals according to response. Maintenance: 25-50 mg bid. Max: 50 mg tid. Child: Neonate: Test dose: 10-50 mcg/kg (for neonates <37 wk postmenstrual age: 10 mcg/ kg), monitor BP for 1-2 hr; if tolerated give 10-50 mcg/kg 2-3 times daily, increased if needed. Max: 2 mg/kg daily in divided doses (for neonates <37 wk postmenstrual age: 300 mcg/kg daily in divided doses). 1 mth-1 2 yr: Test dose: 100 mcg/kg (max: 6.25 mg), monitor BP for 1-2 hr; if tolerated give 100-300 mcg/kg 2-3 times daily, increased if needed. Max: 6 mg/kg daily in divided doses (for 1-12 mth: Max: 4 mg/kg daily in divided doses). 12-18 yr: Test dose: 100 mcg/kg or 6.25 mg, monitorBP for 1-2 hr; if tolerated give 12.5-25mg 2-3 times daily, increased if needed. Max: 150 mg daily in divided doses. Elderly: Initially, 6.25 mg bid. Diabetic nephropathy: Adult: Proteinuria >500 rng/24 hr (in patients w/ Type 1 DM & retinopathy): 25 mg tid. May be taken w/ other anti-hypertensives if patient requires further lowering of BP. Child: Neonate: Test dose: 10-50 mcg/ kg (for neonates <37 wk postmenstrual age: 10 mcg/kg), monitor BP for 1-2 hr; if tolerated give 10-50 mcg/kg 2-3 times daily, increased if needed. Max: 2 mg/kg daily in divided doses (for neonates <37 wk postmenstrual age: 300 mcg/kg daily in divided doses). 1 mth-12 yr: Test dose: 100 mcg/kg (max: 6.25 mg), monitor BP for 1-2 hr; if tolerated give 100-300 mcg/ kg 2-3 times daily, increased if needed. Max: 6 mg/kg daily in divided doses (for 1-12 mth: Max: 4mg/kg daily in divided doses). 12-18 yr: Test dose: 100 mcg/ kg or 6.25 mg, monitor BP for 1-2 hr; if tolerated give 12.5-25 mg 2-3 times daily, increased if needed. Max: 150mg daily in divided doses.
Do not coadminister aliskiren with Captopril in patients with diabetes. Monitor renal function periodically.
Known hypersensitivity to the drug. Bilateral renal artery stenosis, hereditary angioedema; renal impairment; pregnancy.Patients on diuretics or w/ Na depletion should discontinue diuretics or increase Na intake prior to initiation of therapy. Renal impairment, SLE & other autoimmune collagen disorders & during concurrent use of immunosuppressant or leucopenic drugs, monitor WBC count & urinary protein before & during therapy. Lactation. Porphyria. Severe CHF.
Hypotension, tachycardia, chest pain, palpitations, pruritus, hyperkalaemia. Proteinuria; angioedema, skin rashes; taste disturbance, nonproductive cough, headache. Neutropenia, usually occurs w/in 3 mth of starting therapy esp in patients w/ renal dysfunction or collagen diseases. Hyperkalaemia. Anaphylactic reactions.
Captopril should not be used during the second and third trimesters of pregnancy because it may be harmful to a developing baby. It's not recommended in the first trimester unless considered essential by your doctor.Captopril Levels and Effects while Breastfeeding. Because of the low levels of captopril in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
Correction of hypertension would be of primary concern.
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
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