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Captopril (antihypertensive agent)

Written by Stephanie Nera, RPh, PharmD · Pharmacology


Updated Jun 13, 2021

Captopril is an antihypertenisve drug which works to lower blood pressure. It is an angiotensin-converting enzyme (ACE) inhibitor.

captopril

Uses

What is captopril used for?

It is used to treat high blood pressure (hypertension), congestive heart failure, kidney problems caused by diabetes, and to improve survival after a heart attack.

How should I take captopril?

Read the directions on the packaging for complete information. Check the label and expiration date.

As an oral tablet, swallow it whole without chewing, crushing, or dissolving it in water. It is best to take it at least one hour before meals.

How do I store captopril?

This product is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer. 

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using captopril?

Before using this drug, tell your doctor if you are/have:

  • Pregnant or breastfeeding.
  • Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
  • An allergy to any of the ingredients of this product.
  • Any other illnesses, disorders, or medical conditions.

Is it safe during pregnancy or breastfeeding?

ACE-inhibitors, including captopril, are contraindicated during pregnancy and breastfeeding. Studies show that these drugs can cause harm to a fetus.

This medication is pregnancy risk category D according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from captopril?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

  • Cough
  • Flushing
  • Numbness, tingling, or burning pain in your hands or feet
  • Loss of taste sensation
  • Mild skin itching or rash

More serious adverse effects that require medical attention include:

  • Lightheadedness
  • Trouble urinating
  • Shortness of breath
  • Swelling (edema)
  • Rapid weight gain
  • Chest pain or pressure
  • Pounding heartbeats or fluttering in your chest
  • High potassium (slow heart rate, weak pulse, muscle weakness, tingly feeling)
  • Sudden weakness or ill feeling
  • Fever
  • Chills
  • Sore throat
  • Painful mouth sores
  • Pain when swallowing
  • Skin sores
  • Cold or flu symptoms
  • Angioedema

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with captopril?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. 

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. 

Drugs with known interactions:

  • Aliskiren
  • Everolimus
  • Sirolimus
  • Lithium
  • ARBs (e.g. losartan, valsartan)
  • Birth control pills containing drospirenone
  • Sacubitril
  • ACE inhibitors

If you experience an adverse drug interaction, stop taking this drug and continue taking your other medication. Inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with captopril?

This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with captopril?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Kidney disease (or if you are on dialysis)
  • Liver disease
  • Diabetes
  • Marfan syndrome
  • Sjogren’s syndrome
  • Lupus
  • Scleroderma
  • Rheumatoid arthritis
  • Organ transplant

Dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

Hypertension:

Initial dose: 25 mg orally 2 to 3 times a day one hour before meals.

Maintenance dose: May increase every 1 to 2 weeks up to 50 mg orally three times a day. If blood pressure remains uncontrolled after 1 to 2 weeks at this dose, add a thiazide diuretic (loop diuretic if severe renal impairment exists) and titrate to its highest usual antihypertensive dose before further increases of captopril.

Maximum dose: 450 mg/day.

Congestive heart failure:

Initial dose: 25 mg orally three times a day (6.25 to 12.5 mg orally three times a day if hypotensive, hyponatremic, or hypovolemic).

Target maintenance dose: 50 mg orally three times a day for at least two weeks to ensure a satisfactory response.

Maximum dose: 450 mg/day.

Left ventricular dysfunction:

Initial dose: 6.25 mg orally once as early as three days post-myocardial infarction, followed by 12.5 mg orally three times a day; increase to 25 mg orally three times a day over the next several days, and then increase to target dose over the next several weeks as tolerated.

Target maintenance dose: 50 mg orally three times a day.

Diabetic nephropathy:

The recommended dose is 25 mg orally three times a day.

Hypertensive emergency:

25 mg orally 2 to 3 times a day; continue diuretic therapy and stop other antihypertensives upon initiation of this drug; may increase dose every 24 hours or less until satisfactory blood pressure or maximum dose is reached.

What is the dose for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is captopril available?

Captopril is available in the following dosage forms and strengths:

  • Tablet 25mg, 50mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

What should I do if I miss a dose?

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Disclaimer

Hello Health Group does not provide medical advice, diagnosis or treatment.

Written by

Stephanie Nera, RPh, PharmD

Pharmacology


Updated Jun 13, 2021

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