Captopril

It is being used in moderate to severe essential hypertension, generally in combination with a diuretic and/or b blocker. It is considered safe in asthmatics & diabetics. It causes both arteriolar and vasodilatation which reduces after load & preload. Cardiac output is generally increased and heart rate is reduced.

Indications

All grades of hypertension. Congestive Heart Failure. Scleroderma crisis.

Dosage

Adults—At first, 25 milligrams (mg) two or three times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 450 mg per day. Children—Use and dose must be determined by your doctor. For heart failure: Adults—At first, 25 milligrams (mg) three times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 450 mg per day. Children—Use and dose must be determined by your doctor. For treatment after a heart attack: Adults—At first, 6.25 milligrams (mg) as a single dose, then 12.5 mg three times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 450 mg per day. Children—Use and dose must be determined by your doctor.

Contra-Indications

Pregnancy, breast feeding, aortic stenosis, renal impairment, hypersensitivity.

Special Precautions

Anaesthesia, correct sodium depletion, if any before initiating therapy. In case of concurrent use of immunosuppressant or leuko penic drugs, monitor W.B.C. counts and urinary protein before & during therapy. Bilateral renal artery stenosis-renal failure may be precipitated. Avoid concomitant use of K+ sparing diuretics. Paediatrics: Reduced dose necessary. Pregnancy: May harm the developing foetus. Lactation: Present in breast milk. Elderly: Reduced dose may be necessary.

Side Effects

Dry cough, precipitate hypotension, rashes, alteration of taste sensation, vertigo, fainting, headache, bowel upset, anaemia, granulocyto-penia and proteinuria hyperkalaemia.

Drug Interactions

With immuno suppresive drugs, risk of bone marrow depression increased. Hyperkalaemia if used with pot.sparing diuretics. Diuretics greatly enhance hypotensive action of ACE inhibitors.