Captopril, tablets 25 mg 40 pcs

Captopril is an angiotensin-converting enzyme (ACE) inhibitor
The mechanism of antihypertensive action is associated with competitive inhibition of ACE activity, which leads to a decrease in the rate of conversion of angiotensin I to angiotensin II, which is a powerful vasoconstrictor.

The decrease in angiotensin II concentration results in a secondary increase in plasma renin activity by eliminating the negative feedback of renin release and directly reducing aldosterone secretion. In addition, captopril appears to influence the kinin-callicrein system by inhibiting the breakdown of bradykinin.

With its vasodilator effect, it reduces total peripheral vascular resistance (postload), pulmonary capillary congestion pressure (preload) and pulmonary vascular resistance; it increases cardiac minute volume and exercise tolerance.

Long-term use decreases severity of left ventricular myocardial hypertrophy, prevents progression of heart failure and slows development of left ventricular dilatation.

Lowering tone of renal tubular arterioles, thus improving intra-column hemodynamics and preventing the development of diabetic nephropathy.

Indications

Arterial hypertension (including renovascular), chronic heart failure (as part of combined therapy), left ventricular dysfunction after myocardial infarction in clinically stable patients.

Diabetic nephropathy in insulin-dependent diabetes mellitus.

Active ingredient

Composition

1 tablet contains 25 mg of captopril.

How to take, the dosage

The starting dose of Captopril is 6.25 mg or 12.5 mg 3 times a day; if necessary, the dose is increased to 25 mg 3 times a day. The maximum daily dose is 150 mg.

Adults: 25 mg three times a day, thereafter depending on tolerance gradually increase to 100 mg three times a day. The standard dosage is 50-100 mg three times a day, and the maximum daily dose is 450 mg. In heart failure, it is prescribed together with diuretics and/or in combination with foxglove drugs (to avoid initial excessive BP decrease, the diuretic is cancelled or the dose is reduced before administration of captopril).
Children: 0.15 mg/kg/day in three or four doses.

Interaction

Hypotensive effect is weakened by indomethacin and other. NSAIDs, including selective COX-2 inhibitors (Na+ retention and decreased Pg synthesis), especially against the background of low renin concentration, and estrogens (Na+ retention).

Combination with thiazide diuretics, vasodilators (minoxidil), increases the hypotensive effect.

Combination with potassium-saving diuretics, K+ preparations, potassium supplements, salt substitutes (contain significant amounts of K+) increases the risk of hyperkalemia.

Delays excretion of Li+ preparations, increasing its concentration in the blood.

The administration of captopril while taking allopurinol or procainamide increases the risk of Stevens-Johnson syndrome and neutropenia.

In concomitant use of ACE inhibitors and gold drugs (sodium aurothiomalate), a symptom complex including facial hyperemia, nausea, vomiting, and decreased BP has been described.

Insulin and other oral hypoglycemic drugs – risk of hypoglycemia.

The use of captopril in patients receiving immunosuppressants (including azathioprine or cyclophosphamide) increases the risk of hematological disorders.

Special Instructions

Do not use simultaneously with potassium-saving diuretics and other drugs that increase the concentration of potassium in the blood (because of the risk of hyperkalemia).

Contraindications

Captopril is contraindicated in patients with hypersensitivity to this drug or to other angiotensin-converting enzyme inhibitors (patients who developed angioedema during treatment with another ACE inhibitor), GI disorders, immunological diseases, pregnancy, lactation.

Side effects

Cardiovascular system and blood (hematopoiesis, hemostasis): orthostatic hypotension, tachycardia, neutropenia, agranulocytosis.

Gastrointestinal system disorders: nausea, anorexia, taste disorders, dry mouth.

Mechanical disorders: electrolyte imbalance (especially in patients with renal failure), hyponatremia (with simultaneous use of diuretics).

Allergic reactions: skin rash, itching, erythema, urticaria, photosensitization, vasomotor edema.

Others: dry cough.

Overdose

Symptoms: pronounced BP decrease.

Treatment: lay the patient with the lower extremities elevated; measures aimed at restoring BP (increase of the circulatory volume, including intravenous infusion of 0.9% NaCl solution), symptomatic therapy. Hemodialysis may be used in adults; peritoneal dialysis is ineffective.

Similarities