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Captopril (Oral)

KAP-toe-pril

Oral route(Tablet)

When pregnancy is detected, discontinue captopril as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus .

Medically reviewed on Oct 31, 2018

Commonly used brand name(s)

In the U.S.

  • Capoten

Available Dosage Forms:

  • Tablet

Therapeutic Class: Antihypertensive

Pharmacologic Class: ACE Inhibitor

Uses For captopril

Captopril is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure can reduce the risk of strokes and heart attacks.

Captopril works by blocking a substance in the body that causes blood vessels to tighten. As a result, the blood vessels relax. This lowers blood pressure and increases the supply of blood and oxygen to the heart.

Captopril is also used to help treat heart failure. It is also used in some patients after a heart attack. After a heart attack, some of the heart muscle becomes damaged and weak. The heart muscle may continue to weaken as time goes by. This makes it more difficult for the heart to pump blood. Captopril may be started within the first few days after a heart attack to increase survival rate.

Captopril is also used to treat kidney problems caused by diabetes (diabetic nephropathy).

Captopril is available only with your doctor's prescription.

Before Using captopril

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For captopril, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to captopril or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of captopril in the pediatric population. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of captopril in geriatric patients. However, elderly patients are more likely to have age-related kidney problems, which may require an adjustment of dose in patients receiving captopril.

Pregnancy

Pregnancy Category Explanation
All Trimesters D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking captopril, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using captopril with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Aliskiren
  • Sacubitril

Using captopril with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Afatinib
  • Allopurinol
  • Alteplase, Recombinant
  • Amiloride
  • Azathioprine
  • Azilsartan
  • Azilsartan Medoxomil
  • Candesartan Cilexetil
  • Canrenoate
  • Digoxin
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Eplerenone
  • Eprosartan
  • Everolimus
  • Interferon Alfa-2a
  • Irbesartan
  • Lithium
  • Losartan
  • Mercaptopurine
  • Morphine
  • Morphine Sulfate Liposome
  • Nilotinib
  • Olmesartan Medoxomil
  • Oxypurinol
  • Pixantrone
  • Potassium
  • Sirolimus
  • Spironolactone
  • Telmisartan
  • Triamterene
  • Trimethoprim
  • Valsartan
  • Vincristine
  • Vincristine Sulfate Liposome

Using captopril with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Aspirin
  • Azosemide
  • Bromfenac
  • Bufexamac
  • Bumetanide
  • Bupivacaine
  • Bupivacaine Liposome
  • Capsaicin
  • Celecoxib
  • Chlorpromazine
  • Choline Salicylate
  • Clonixin
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Dipyrone
  • Droxicam
  • Ethacrynic Acid
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Flurbiprofen
  • Furosemide
  • Gold Sodium Thiomalate
  • Ibuprofen
  • Icatibant
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Morniflumate
  • Nabumetone
  • Naproxen
  • Nepafenac
  • Nesiritide
  • Niflumic Acid
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Phenylbutazone
  • Piketoprofen
  • Piretanide
  • Piroxicam
  • Proglumetacin
  • Propionic Acid
  • Propyphenazone
  • Proquazone
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sodium Salicylate
  • Sulindac
  • Tenoxicam
  • Tiaprofenic Acid
  • Tolfenamic Acid
  • Tolmetin
  • Torsemide
  • Valdecoxib

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of captopril. Make sure you tell your doctor if you have any other medical problems, especially:

  • Angioedema (swelling of the face, lips, tongue, throat, arms, or legs), history of—May increase risk of this condition occurring again.
  • Collagen vascular disease (an autoimmune disease) together with kidney disease—Increased risk of blood problems.
  • Electrolyte imbalance (eg, low sodium in the blood) or
  • Fluid imbalances (caused by dehydration, vomiting, or diarrhea) or
  • Heart or blood vessel problems (eg, aortic stenosis) or
  • Liver disease—Use with caution. May make these conditions worse.
  • Kidney problems (including patients receiving dialysis)—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of captopril

In addition to the use of captopril, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that captopril will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Take captopril on an empty stomach at least 1 hour before meals.

Dosing

The dose of captopril will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of captopril. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For high blood pressure:
      • 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.
    • For kidney problems caused by diabetes:
      • Adults—25 milligrams (mg) three times a day.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of captopril, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using captopril

It is very important that your doctor check your progress at regular visits to make sure captopril is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using captopril while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using captopril, tell your doctor right away.

You should not use captopril together with sacubitril. Do not use captopril and sacubitril/valsartan (Entresto®) within 36 hours of each other.

Captopril may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat while you are using captopril.

Call your doctor right away if you have severe stomach pain (with or without nausea or vomiting). This could be a symptom of a condition called intestinal angioedema.

Dizziness, lightheadedness, or fainting may also occur, especially when you get up suddenly from a lying or sitting position or if you have been taking a diuretic (water pill). Do not drive or do anything else that could be dangerous until you or your child know how captopril affects you. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

Check with your doctor right away if you become sick while taking captopril, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water or salt and may lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

Check with your doctor if you have a fever, chills, or sore throat. These could be symptoms of an infection resulting from low white blood cells.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Check with your doctor right away if you have bloody urine, a decrease in frequency or amount of urine, an increase in blood pressure, increased thirst, loss of appetite, lower back or side pain, nausea, swelling of the face, fingers, or lower legs, troubled breathing, unusual tiredness or weakness, vomiting, or weight gain. These could be symptoms of a serious kidney problem.

Hyperkalemia (high potassium in the blood) may occur while you are using captopril. Check with your doctor right away if you have the following symptoms: abdominal or stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, shortness of breath, or weakness or heaviness of the legs. Do not use supplements or salt substitutes containing potassium without first checking with your doctor.

Make sure any doctor or dentist who treats you knows that you are using captopril. You may need to stop using captopril several days before having surgery or medical tests.

Captopril may be less effective in black patients. Black patients also have an increased risk of angioedema (swelling of the hands, arms, face, mouth, or throat).

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, and herbal or vitamin supplements, since they may tend to increase your blood pressure.

Captopril Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

  • Chest pain
  • cloudy urine
  • fast, pounding, or irregular heartbeat or pulse

Rare

  • Arm, back, or jaw pain
  • bloody urine
  • chest discomfort
  • chest tightness or heaviness
  • decreased blood pressure
  • decreased or increased frequency or amount of urine
  • dilated neck veins
  • increased thirst
  • irregular breathing
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • loss of appetite
  • low blood pressure
  • lower back or side pain
  • nausea
  • paleness or cold feeling in the fingertips and toes
  • sweating
  • swelling of the face, fingers, feet, or lower legs
  • tingling or pain in the fingers or toes when exposed to cold temperatures
  • troubled breathing
  • unusual tiredness or weakness
  • vomiting
  • weight gain

Incidence not known

  • Bleeding gums
  • bloody, black, or tarry stools
  • blurred vision
  • chills
  • confusion
  • cough
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • high fever
  • painful or difficult urination
  • pale skin
  • pinpoint red spots on the skin
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • swollen glands
  • unusual bleeding or bruising

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

  • Change in taste
  • feeling of warmth
  • itching skin
  • loss of taste
  • rash
  • redness of the face, neck, arms, and occasionally, upper chest

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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