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Captopril/ hydrochlorothiazide

Generic Name: captopril/hydrochlorothiazide (KAP-toe-pril/HYE-droe-KLOR-oh-THYE-a-zide)
Brand Name: Generic only. No brands available.

When used during pregnancy, captopril/hydrochlorothiazide can cause injury and even death to the developing fetus. If you become pregnant or think you may be pregnant, contact your doctor at once. If you are planning to become pregnant, talk with your doctor about other treatment options.


Captopril/ hydrochlorothiazide is used for:

Treating high blood pressure. It may also be for other conditions as determined by your doctor.

Captopril/hydrochlorothiazide is an angiotensin-converting enzyme (ACE) inhibitor and thiazide diuretic combination. The ACE inhibitor works by causing blood vessels to relax. The thiazide diuretic works by helping the kidneys eliminate extra fluid from the body. This helps to lower blood pressure.

Do NOT use captopril/ hydrochlorothiazide if:

  • you are allergic to any ingredient in captopril/hydrochlorothiazide, any other sulfonamide medicine (eg, sulfamethoxazole), or any other ACE inhibitor (eg, enalapril), including if you have a history of angioedema (swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness) caused by an ACE inhibitor
  • you are pregnant
  • you are unable to urinate
  • you are taking a medicine that contains aliskiren and you also have diabetes or kidney problems. Check with your doctor or pharmacist if you are not sure if a medicine you take contains aliskiren
  • you are taking dextran sulfate, dofetilide, or ketanserin

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: 10 Common Symptoms That Should Never Be Ignored

Before using captopril/ hydrochlorothiazide:

Some medical conditions may interact with captopril/hydrochlorothiazide. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are able to become pregnant
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of angioedema, bone marrow problems, blood vessel problems of the heart or brain, kidney disease (eg, renal artery stenosis), kidney transplant, heart problems (eg, heart failure), liver problems, diabetes, or parathyroid problems
  • if you have a history of blood electrolyte problems (eg, calcium, chloride, magnesium), an autoimmune disease (eg, rheumatoid arthritis, lupus, scleroderma), gout, asthma, or high blood cholesterol or lipid levels
  • if you are dehydrated, have high blood potassium levels, have low blood volume, have low blood sodium levels, or are on a low-salt (sodium) diet
  • if you are on dialysis, are receiving apheresis treatments, or are scheduled to have surgery or receive anesthesia
  • if you are receiving treatments to reduce sensitivity to bee or wasp stings
  • if you have recently had a certain type of nerve surgery (sympathectomy)

Some MEDICINES MAY INTERACT with captopril/hydrochlorothiazide. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Digoxin, dofetilide, or ketanserin because the risk of irregular heartbeat may be increased
  • Eplerenone, potassium preparations, potassium-sparing diuretics (eg, triamterene), salt substitutes containing potassium, or trimethoprim because the risk of high blood potassium levels may be increased
  • Everolimus or sirolimus because the risk of angioedema may be increased
  • Aliskiren or angiotensin receptor blockers (ARBs) (eg, losartan) because the risk of certain side effects (eg, kidney problems, high blood potassium levels, low blood pressure) may be increased
  • Certain gold-containing medicines (eg, sodium aurothiomalate) because flushing, nausea, vomiting, and low blood pressure may occur
  • Adrenocorticotropic hormone (ACTH), amphotericin B, barbiturates (eg, phenobarbital), beta-blockers (eg, propranolol), calcium supplements, corticosteroids (eg, prednisone), dextran sulfate, diazoxide, diuretics (eg, furosemide), monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), narcotic pain medicines (eg, codeine, fentanyl, morphine), nitrates (eg, nitroglycerin), or other medicines for high blood pressure because they may increase the risk of captopril/hydrochlorothiazide's side effects
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, celecoxib, ibuprofen, indomethacin) because they may decrease captopril/hydrochlorothiazide's effectiveness and the risk of kidney problems may be increased
  • Cholestyramine, colestipol, or salicylates (eg, aspirin) because they may decrease captopril/hydrochlorothiazide's effectiveness
  • Lithium or thiopurines (eg, azathioprine) because the risk of their side effects may be increased by captopril/hydrochlorothiazide
  • Anticoagulants (eg, warfarin), insulin or other diabetes medicines (eg, glyburide), methenamine, probenecid, or sulfinpyrazone because their effectiveness may be decreased by captopril/hydrochlorothiazide

This may not be a complete list of all interactions that may occur. Ask your health care provider if captopril/hydrochlorothiazide may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use captopril/ hydrochlorothiazide:

Use captopril/hydrochlorothiazide as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take captopril/hydrochlorothiazide by mouth on an empty stomach 1 hour before meals.
  • Captopril/hydrochlorothiazide may increase the amount of urine or cause you to urinate more often when you first start taking it. To keep this from disturbing your sleep, try to take your dose before 6 pm.
  • Captopril/hydrochlorothiazide works best if it is taken at the same time each day.
  • Continue to take captopril/hydrochlorothiazide even if you feel well. Do not miss any doses.
  • If you miss a dose of captopril/hydrochlorothiazide, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use captopril/hydrochlorothiazide.

Important safety information:

  • Captopril/hydrochlorothiazide may cause dizziness or light-headedness. These effects may be worse if you take it with alcohol or certain medicines. Use captopril/hydrochlorothiazide with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Captopril/hydrochlorothiazide may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Report any light-headedness or fainting to your doctor immediately. Your risk of light-headedness or fainting may be increased if you experience diarrhea, vomiting, or excessive sweating; if you do not drink enough fluids; or if you are on a low-salt (sodium) diet.
  • It may take up to 6 to 8 weeks to get the full benefit from captopril/hydrochlorothiazide. Do not stop using captopril/hydrochlorothiazide or change your dose of captopril/hydrochlorothiazide without checking with your doctor.
  • Tell your doctor or dentist that you take captopril/hydrochlorothiazide before you receive any medical or dental care, emergency care, or surgery.
  • Captopril/hydrochlorothiazide contains a sulfonamide called hydrochlorothiazide, which can cause certain eye problems (myopia, angle-closure glaucoma). Your risk may be increased if you are allergic to sulfonamide medicines (eg, sulfamethoxazole) or to penicillin antibiotics (eg, amoxicillin). Untreated angle-closure glaucoma can lead to permanent vision loss. If these eye problems occur, symptoms usually occur within hours to weeks of starting captopril/hydrochlorothiazide. Contact your doctor right away if you experience symptoms such as vision changes (eg, decreased vision clearness) or eye pain.
  • Your doctor may have also prescribed a potassium supplement for you. If so, follow the dosing carefully. Do not take additional potassium or change your diet to include more potassium without first checking with your doctor.
  • Check with your doctor before you use a salt substitute or a product that has potassium in it.
  • Captopril/hydrochlorothiazide may cause a dry, unproductive cough. If caused by captopril/hydrochlorothiazide, this symptom usually stops after treatment with captopril/hydrochlorothiazide is stopped.
  • Captopril/hydrochlorothiazide may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to captopril/hydrochlorothiazide. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
  • Captopril/hydrochlorothiazide may cause a serious side effect called angioedema. The risk may be higher in black patients. Contact your doctor at once if you develop swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness.
  • Captopril/hydrochlorothiazide may lower the ability of your body to fight infection. The risk may be greater if you have certain other health problems (eg, kidney problems, collagen vascular disease). Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
  • Captopril/hydrochlorothiazide may not work as well in black patients. They may also be at greater risk of side effects. Contact your doctor if your symptoms do not improve or if they become worse.
  • If you have high blood pressure, do not use nonprescription products that contain stimulants. These products may include diet pills or cold medicines. Contact your doctor if you have any questions or concerns.
  • Diabetes patients - Captopril/hydrochlorothiazide may cause the results of some tests for urine ketones to be wrong. Be sure to check blood sugar levels closely. Ask your doctor before you change your diet or the dose of your diabetes medicine.
  • Captopril/hydrochlorothiazide may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.
  • Captopril/hydrochlorothiazide may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking captopril/hydrochlorothiazide.
  • Lab tests, including blood pressure monitoring, blood potassium or other electrolyte levels, kidney function, and urine protein, may be performed while you use captopril/hydrochlorothiazide. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Captopril/hydrochlorothiazide should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Captopril/hydrochlorothiazide may cause birth defects or fetal or newborn death if you take it while you are pregnant. If you think you may be pregnant, contact your doctor right away. Captopril/hydrochlorothiazide is found in breast milk. Do not breast-feed while taking captopril/hydrochlorothiazide.

Possible side effects of captopril/ hydrochlorothiazide:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Cough; dizziness or light-headedness when sitting or standing quickly; taste changes.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness); burning, numbness, or tingling; chest pain; confusion; decrease in amount of urine produced; depression; drowsiness; eye pain; fainting; fever, chills, or persistent sore throat; joint pain; muscle pain, cramps, or tremors; numbness of an arm or leg; one-sided weakness; red, swollen, blistered, or peeling skin; restlessness; seizures; severe or persistent dizziness or light-headedness; severe or persistent nausea or vomiting; shortness of breath; slow, fast, or irregular heartbeat; slurred speech; stomach pain (with or without nausea and vomiting); sudden, severe headache or vomiting; swelling of the arms or legs; symptoms of liver problems (eg, dark urine, loss of appetite, pale stools, yellowing of the skin or eyes); unusual bruising or bleeding; unusually dry mouth; unusual thirst; unusual tiredness or weakness; vision problems (eg, blurred vision, decreased vision clearness).

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; severe or persistent dizziness or light-headedness; symptoms of blood electrolyte problems (eg, confusion; irregular heartbeat; mental or mood changes; muscle pain, weakness, or cramping; seizures; sluggishness); symptoms of dehydration (eg, dry mouth or eyes; decreased urination; fast heartbeat; nausea; restlessness; unusual thirst, tiredness, or weakness; vomiting).

Proper storage of captopril/hydrochlorothiazide:

Store captopril/hydrochlorothiazide between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Keep the bottle tightly closed. Do not store in the bathroom. Keep captopril/hydrochlorothiazide out of the reach of children and away from pets.

General information:

  • If you have any questions about captopril/hydrochlorothiazide, please talk with your doctor, pharmacist, or other health care provider.
  • Captopril/hydrochlorothiazide is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take captopril/hydrochlorothiazide or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about captopril/hydrochlorothiazide. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to captopril/hydrochlorothiazide. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using captopril/hydrochlorothiazide.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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