Capoten: Effective Blood Pressure and Heart Failure Management
Capoten
Capoten (captopril) is an angiotensin-converting enzyme (ACE) inhibitor medication prescribed for the management of hypertension (high blood pressure), treatment of heart failure, and improvement of survival following a myocardial infarction. It functions by relaxing blood vessels, allowing blood to flow more smoothly and the heart to pump more efficiently. This comprehensive product card provides detailed information for healthcare professionals and informed patients regarding its proper use, mechanism, and important safety considerations.
Features
- Active Ingredient: Captopril
- Drug Class: Angiotensin-converting enzyme (ACE) inhibitor
- Available Strengths: 12.5 mg, 25 mg, 50 mg, 100 mg tablets
- Administration: Oral
- Onset of Action: Within 15-60 minutes for antihypertensive effect
- Duration of Action: Dose-dependent, typically 6-12 hours
Benefits
- Effectively lowers high blood pressure, reducing long-term risk of stroke, heart attack, and kidney damage.
- Improves symptoms and survival rates in patients with congestive heart failure by decreasing cardiac workload.
- Helps protect kidney function in certain patients with diabetes (diabetic nephropathy).
- Can be used post-heart attack to improve survival and left ventricular function.
- Often allows for reduced dosage of concomitant diuretics in heart failure regimens.
- Provides a well-established safety profile with decades of clinical use and research.
Common use
Capoten is commonly prescribed for the treatment of essential hypertension, either as monotherapy or in combination with other antihypertensive agents such as thiazide diuretics. It is also a cornerstone in the management of congestive heart failure, typically used in combination with diuretics and digitalis. Additionally, it is indicated for the treatment of left ventricular dysfunction after myocardial infarction and for diabetic nephropathy in patients with type 1 diabetes mellitus and retinopathy.
Dosage and direction
Dosage must be individualized based on the patient’s clinical condition and response. For hypertension, the initial dose is usually 25 mg twice daily; if insufficient, the dose may be increased to 50 mg twice daily after one to two weeks. Maintenance doses typically range from 25 mg to 150 mg twice daily. For heart failure, start with 6.25–12.5 mg three times daily, titrating upward to a target of 50 mg three times daily as tolerated. Post-myocardial infarction dosing typically starts with 6.25 mg, then 12.5 mg three times daily, increasing to a target of 50 mg three times daily. Tablets should be taken one hour before meals for optimal absorption.
Precautions
Patients should be monitored for hypotension, especially after the initial dose and during dosage titration. Renal function and serum potassium should be assessed prior to initiation and periodically during therapy. A white blood cell count is recommended in patients with collagen vascular disease or renal impairment due to risk of neutropenia. Use with caution in patients with renal artery stenosis, as acute renal failure may occur. Angioedema has been reported with ACE inhibitors and requires immediate discontinuation and medical attention if it involves the tongue, glottis, or larynx.
Contraindications
Capoten is contraindicated in patients with a history of angioedema related to previous ACE inhibitor treatment. It should not be used in patients with hypersensitivity to captopril or any other ACE inhibitor. Concomitant use with aliskiren in patients with diabetes is contraindicated. It is also contraindicated during the second and third trimesters of pregnancy due to risk of fetal injury and death.
Possible side effect
Common side effects may include cough, taste disturbance (dysgeusia), rash, and hypotension. Less frequently, patients may experience hyperkalemia, renal dysfunction, neutropenia/agranulocytosis, angioedema, or proteinuria. Gastrointestinal effects such as nausea or vomiting may occur. Persistent dry cough is a class effect of ACE inhibitors and may necessitate discontinuation if intolerable.
Drug interaction
Capoten may interact with several medications. Concomitant use with potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium can increase the risk of hyperkalemia. NSAIDs may diminish the antihypertensive effect and increase renal risk. Diuretics can potentiate the hypotensive effect. Lithium levels may increase with concurrent use. Dual blockade of the renin-angiotensin system with ARBs or aliskiren increases risks of hypotension, hyperkalemia, and renal impairment.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed one.
Overdose
Overdose may lead to pronounced hypotension. Management should focus on supportive measures, including volume expansion with normal saline to restore blood pressure. Captopril is removed by hemodialysis. Patients should be monitored in a clinical setting with appropriate hemodynamic support.
Storage
Store at room temperature (15-30°C or 59-86°F) in a dry place, protected from light and moisture. Keep the container tightly closed and out of reach of children. Do not use after the expiration date printed on the packaging.
Disclaimer
This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personalized recommendations and before starting or changing any medication regimen. Dosage and indications may vary based on individual patient factors and regional prescribing guidelines.
Reviews
Clinical trials and decades of use have established Capoten as an effective agent in hypertension and heart failure management. Many patients experience significant improvements in blood pressure control and functional status in heart failure. The characteristic cough is a noted drawback for some individuals, occasionally leading to switching within the drug class. Overall, it remains a valuable, cost-effective option in cardiovascular therapeutics with a well-understood efficacy and safety profile.