Brand Name: Apo-Capto (CAN), Capoten, Gen-Captopril (CAN), Novo-Captopril (CAN), Nu-Capto (CAN)
Pregnancy Category C (first trimester), Pregnancy Category D (second, third trimesters)
Drug classes: Antihypertensive, Angiotensin-converting enzyme (ACE) inhibitor
Blocks ACE from converting angiotensin I to angiotensin II, a powerful vasoconstrictor, leading to decreased blood pressure, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synthesis also may be involved in the antihypertensive action.
· Treatment of hypertension alone or in combination with thiazide-type diuretics
· Treatment of CHF in patients unresponsive to conventional therapy; used with diuretics and digitalis
· Treatment of diabetic nephropathy
· Treatment of left ventricular dysfunction after MI
· Unlabeled uses: management of hypertensive crises; treatment of rheumatoid arthritis; diagnosis of anatomic renal artery stenosis, hypertension related to scleroderma renal crisis; diagnosis of primary aldosteronism, idiopathic edema; Bartter's syndrome; Raynaud's syndrome
· Allergy to captopril; impaired renal function; CHF; salt/volume depletion, lactation, pregnancy.
Tachycardia, angina pectoris, MI, Raynaud's syndrome, CHF, hypotension in salt/volume depleted patients, Rash, pruritus, pemphigoid-like reaction, scalded mouth sensation, exfoliative dermatitis, photosensitivity, alopecia, Gastric irritation, aphthous ulcers, peptic ulcers, dysgeusia, cholestatic jaundice, hepatocellular injury, anorexia, constipation, Proteinuria, renal insufficiency, renal failure, polyuria, oliguria, urinary frequency, Neutropenia, agranulocytosis, thrombocytopenia, hemolytic anemia, pancytopenia, Cough, malaise, dry mouth, lymphadenopathy
· Increased risk of hypersensitivity reactions with allopurinol
· Decreased antihypertensive effects with indomethacin
· Increased captopril effects with probenecid
Interaction with Food:
· Decreased absorption of captopril with food
· Administer 1 hr before or 2 hr after meals.
· Alert surgeon and mark patient's chart with notice that captopril is being taken; the angiotensin II formation subsequent to compensatory renin release during surgery will be blocked; hypotension may be reversed with volume expansion.
· Monitor patient closely for fall in BP secondary to reduction in fluid volume (excessive perspiration and dehydration, vomiting, diarrhea); excessive hypotension may occur.
· Reduce dosage in patients with impaired renal function.