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Generic Name: captopril (KAP toe pril)
Brand Name: Capoten

What is captopril?

Captopril is an ACE inhibitor. ACE stands for angiotensin converting enzyme.

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

Captopril may also be used for purposes not listed in this medication guide.

What is the most important information I should know about captopril?

Do not use if you are pregnant. Stop using and tell your doctor right away if you become pregnant. Captopril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

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If you have diabetes, do not use captopril together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo, Valturna).

What should I discuss with my healthcare provider before taking captopril?

You should not use this medication if you are allergic to captopril or to any other ACE inhibitor, such as benazepril, fosinopril, enalapril, lisinopril, moexipril, perindopril, quinapril, ramipril, or trandolapril.

If you have diabetes, do not use captopril together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo, Valturna).

You may also need to avoid taking captopril with aliskiren if you have kidney disease.

To make sure captopril is safe for you, tell your doctor if you have:

  • kidney disease (or if you are on dialysis);

  • liver disease;

  • diabetes;

  • any history of heart disease; or

  • a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis.

FDA pregnancy category D. Do not use captopril if you are pregnant. Stop using this medication and tell your doctor right away if you become pregnant. Captopril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control while taking captopril.

Captopril can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using captopril.

How should I take captopril?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Captopril is usually taken 1 hour before meals. Follow your doctor's instructions.

Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking captopril.

Drink plenty of water each day while you are taking this medication.

Your blood pressure will need to be checked often, and you may need frequent blood tests.

If you need surgery, tell the surgeon ahead of time that you are using captopril. You may need to stop using the medicine for a short time.

This medication can cause false results with certain medical tests. Tell any doctor who treats you that you are using captopril.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking captopril?

Drinking alcohol can further lower your blood pressure and may increase certain side effects of captopril.

Do not use salt substitutes or potassium supplements while taking captopril, unless your doctor has told you to.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Avoid strenuous exercise without your doctor's approval if you are being treated for heart failure.

Captopril side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;

  • little or no urinating, or urinating more than usual;

  • shortness of breath (even with mild exertion), swelling, 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); or

  • sudden weakness or ill feeling, fever, chills, sore throat, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms.

Common side effects may include:

  • cough;

  • flushing (warmth, redness, or tingly feeling);

  • numbness, tingling, or burning pain in your hands or feet;

  • loss of taste sensation; or

  • mild skin itching or rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Captopril dosing information

Usual Adult Dose for 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

Usual Adult Dose for 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

-Most patients experience satisfactory clinical improvement at 50 or 100 mg orally three times a day.
-Should generally be used in conjunction with a diuretic and digitalis.

Usual Adult Dose for 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

Use: To improve survival following myocardial infarction in clinically stable patients with left ventricular dysfunction manifested as an ejection fraction of 40% or less and to reduce the incidence of overt heart failure and subsequent hospitalizations for congestive heart failure in these patients.

Usual Adult Dose for Diabetic Nephropathy:

25 mg orally three times a day

Comments: Other antihypertensives may be used in conjunction with this drug if additional blood pressure reduction is required.

Use: Treatment of diabetic nephropathy (proteinuria greater than 500 mg/day) in patients with type I insulin-dependent diabetes mellitus and retinopathy.

Usual Adult Dose for 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 other drugs will affect captopril?

Other drugs may interact with captopril, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about captopril.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 10.01. Revision Date: 2013-11-26, 1:37:18 PM.