Captopril

Details About Generic Salt ::  Captopril 

Main Medicine Class:: Cardiovascular System   Sub Medicine Class ::  Anti Hypertensives

4D. ANTI-HYPERTENSIVES in 4. CARDIOVASCULAR SYSTEM
CAPTOPRIL
ACEI | ANTI-HYPERTENSIVE
also comes under 4A. Drugs for Cardiac Failure & Shock in 4. Cardiovascular System
PK: A: 60%-75%; reduced 30%-40% by food E: Urine

Indications & Dose: DIABETIC NEPHROPATHY PO Adult 25mg TID Child 12–18 yr: 100µg/kg or 6.25mg as test dose, if tolerated administer 12.5–25mg BID/TID, max 150mg/day in divided doses | HEART FAILURE Combination therapy PO Adult Initially 6.25-12.5mg TID in conjunction with cardiac glycoside & diuretics. Target dose 50mg TID Child Neonate: Initially 10–50µg/kg (test dose) if tolerated 10–50µg/kg BID/TID, max 2mg/kg/ day in divided doses, 1 month–12yr: 100µg/kg (test dose), if tolerated 100–300µg/kg BID/TID, max 6mg/kg/day in divided doses, 12–18 yr: 100µg/kg (test dose), if tolerated 12.5–25mg BID/TID max 150mg/day in divided doses | HYPERTENSION PO Adult Initially 12.5-25mg BID/TID, may be increased to 12.5-25 mg/dose at 1-2wks up to 50mg TID, max 150mg TID Child Neonate: Initially 10–50µg/kg (test dose) if tolerated 10–50µg/kg BID/TID, max 2mg/kg/ day in divided doses, 1 month–12yr: 100µg/kg (test dose), if tolerated 100–300µg/kg BID/TID, max 6mg/kg/day in divided doses, 12–18 yr: 100µg/kg (test dose), if tolerated 12.5–25mg BID/TID max 150mg/day in divided doses | Acute PO Adult 12.5-25 mg, may be repeat if needed | LEFT VENTRICULAR DYSFUNCTION AFTER MI PO Adult Initially 6.25mg followed by 12.5mg TID, then 25mg TID, target dose 50mg TID

Contra: Hypersensitivity, history of angioedema with ACE inhibitor, aortic stenosis/outflow tract obstruction

Precautions: renovascular disease/suspected renovascular disease, HF, patients who are likely to be sodium/water depleted, renal/hepatic impairment, hypovolemia, hypertrophic cardiomyopathy, cardiac/cerebrovascular insufficiency, SLE, black patients with HTN, elderly, children

ADR: Serious: angina pectoris, tachycardia, hypotension, blood disorders, renal failure, hyperkalemia, eosinophilic pneumonitis, angioedema, Others: headache, dizziness, drowsiness, fatigue, weakness, insomnia, sinusitis, nausea, diarrhea, anorexia, proteinuria, erectile dysfunction, decreased libido, gynecomastia, cough, asthma, dyspnea, rash, altered taste, fever

DDI: Serious Phenothiazines causes additive hypotensive effect, Azathioprine causes anemia & leucopenia, Loop diuretics/Diuretics causes hyponatremia & reversible acute renal failure, Bupivacaine causes severe hypotension & bradycardia, Probenecid decreases renal clearance of drug, Coumarins/Aspirin reduces antihypertensive effect & renal failure, Antacids reduces bioavailability of drug, Lithium toxicity occurs

Diet: 1h before/2h after food

Monitor: BUN, electrolytes, Secr, BP,CBC with DC (in renal impairment and/or collagen vascular disease patients)

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