Captopril - instructions for use: how to take for blood pressure

Composition and release form

The active ingredient of the drug is captopril. Additional ingredients included in the drug include lactose, corn starch, silicon dioxide, etc.

The product is produced in the form of tablets. The dosage varies depending on the manufacturer. On sale you can find tablets that contain 12.5, 25, 50, 100 mg of the active ingredient.

Why is Captopril contraindicated for pregnant women?

Pregnancy and Captopril are incompatible.
The active component of the drug easily overcomes the barrier between tissues and blood, penetrates the placenta and has a toxic effect on the unborn baby. The negative side of the impact of Captopril on the formation of serious defects in fetal development has been proven. His guilt in suppressing the child’s viability is noted. With the onset of pregnancy, you should definitely stop taking Captopril if you have high blood pressure. The drug substance passes into breast milk, so the drug is contraindicated in breastfeeding. If a nursing woman has taken a Captopril tablet, it is better to transfer the child to artificial feeding.

Pharmacological action and pharmacokinetic properties

Captopril tablets are classified as ACE inhibitors. Drugs in this group block the transformation of angiotensin I to angiotensin II. Due to this, the synthesis of aldosterone decreases. This action leads to a decrease in total peripheral vascular resistance. Due to this, blood pressure and the load on the heart are reduced.

Plasma renin activity has no effect on the hypotensive effect. A decrease in pressure is observed with normal or reduced hormone levels. This is due to the effect on the renin-angiotensin system.

Long-term use of the drug provokes a decrease in myocardial hypertrophy and resistive arterial walls. In addition, the medicine has the following types of effects:

• reduces platelet aggregation;
• stimulates coronary and renal blood flow;
• increases blood supply to the myocardium;
• reduces the level of sodium ions in people suffering from heart failure;
• reduces the degradation of bradykinin and increases the production of prostaglandin.

A decrease in pressure after the use of Captopril does not lead to the appearance of symptoms of reflex tachycardia and causes a decrease in myocardial oxygen demand. When treating heart failure, the correct dosage of the drug does not affect blood pressure.

After taking the substance, symptoms of hypertension disappear within 1-1.5 hours. The duration of the effect depends on the dosage. It may take several weeks to achieve the required parameters.

The drug is absorbed quite quickly. Absorption is at 75%. If you take Captopril with food, this figure decreases to 35-45%. Bioavailability is 35-40%.

Approximately 25-30% of the drug binds to the protein components of blood plasma. When used orally, the maximum concentration of the drug in the blood is 114 ng/ml. This result is achieved after 0.5-1.5 hours.

Metabolism of the drug occurs in the liver. Approximately 95% of the drug leaves the body through the kidneys. In its original form, 40-50% is excreted, the rest is in the form of metabolites. The half-life of the drug takes 3 hours.

In chronic kidney failure, the medication may accumulate. In this case, the half-life can be from 3.5 to 32 hours.

How does Captopril work?

Due to the fact that the drug significantly reduces blood pressure and reduces the load on the heart muscle, it is widely used to treat arterial hypertension and hypertension. Also, its effectiveness is obvious in the treatment of diseases of the cardiovascular system, in the process of rehabilitation after myocardial infarction. It is also important to understand not only what Captopril helps with, but also how it works.

The drug "Captopril" suppresses the activity of the enzyme that regulates the conversion of angiotensins. For this reason, the medication is classified as an ACE inhibitor. When taking the drug, the body does not produce an enzyme that has a strong vasoconstrictor effect and increases blood pressure (BP). Without it, the vessels of the circulatory system retain their shape, and the pressure is normal. Regular use of the drug ensures constant indicators within the permissible norm. With elevated blood pressure after taking Captopril, the levels decrease to a maximum after 60 - 90 minutes. To achieve a stable therapeutic effect, the drug must be taken for 1 to 2 months.

The expansion of the lumen of blood vessels ensures stable functioning of the heart muscle and reduces the load on the heart: it needs less effort to pump blood. "Captopril", no matter what it is used for, significantly increases the physical capabilities of a person with heart problems. Those who have previously suffered a myocardial infarction or have a history of other diseases of the cardiovascular system can better tolerate emotional stress and physical activity when taking Captopril.

What is noteworthy: when the drug is taken for heart failure, the adjusted dosage does not affect blood pressure. But it is also worth noting that due to increased blood flow in the kidneys, the medicine is effective in diabetic nephropathy.

"Captopril" is used for high blood pressure as an independent remedy, as well as in complex treatment with other antihypertensive drugs. Unlike other drugs with similar effects, the medication does not retain sodium in the body, and fluid accumulation does not occur. This allows, when treating hypertension, not to resort to additional stimulation with diuretics, but to cope with edema and congestive processes without problems. How effective a remedy is can be determined by already starting to use it in therapy.

Indications for use

Many people are interested in what Captopril tablets are used for and what are the rules for their use. Key indications for taking this drug include the following:

• hypertension, including renovascular form;
• chronic heart failure - in this case the medicine is included in combination therapy.

Video on the topic

How are Captopril and Capoten taken for hypertension? What is more effective: Capoten or Captopril? How long can you take these medications? Answers in the video:

The information on the MyMedNews.ru website is for reference and general information, collected from publicly available sources and cannot serve as a basis for making a decision on the use of medications in the course of treatment.

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Contraindications

The use of Captopril for high blood pressure is not always acceptable. The main contraindications to the use of the product include the following:

1. Angioedema, including hereditary form. The drug should not be used if there is a history of this disorder, which appeared after taking other ACE inhibitors.
2. Serious kidney damage. Contraindications include stenosis of the renal arteries, azotemia, the primary form of hyperaldosteronism, and the condition after a kidney transplant.
3. Aortic stenosis, development of mitral stenosis. Also, the drug should not be used if there are other barriers to the removal of blood from the left ventricle.
4. Serious liver damage.
5. Cardiogenic shock.
6. Arterial hypotension.
7. Pregnancy and lactation.
8. Age up to 18 years.
9. High sensitivity to Captopril and other drugs in this category.

The medicine is prescribed with extreme caution for complex autoimmune pathologies, including systemic lupus erythematosus and scleroderma. Limitations also include cerebral ischemia, diabetes mellitus, and suppression of blood circulation in the bone marrow. Caution should be observed in case of cardiac ischemia, in old age, and when limiting sodium in the diet.

Captopril: what do these tablets treat?

Captopril is a drug that lowers blood pressure and blocks angiotensin-converting enzyme. In addition, it has a vasodilating effect and prevents the development of kidney dysfunction in diabetes mellitus, or more precisely, in its insulin-dependent form.

The highest concentration of the drug occurs half an hour after taking it (it all depends on the meal). It is excreted through the kidneys. By the way, this drug tends to pass into breast milk!

Indications for the use of this remedy are:

• Increased blood pressure, which was caused by various reasons;
• Impaired functioning of the left ventricle after a heart attack (but provided that the patient’s condition is stable);
• Chronic functional failure of the heart;
• Kidney disorders in insulin-dependent diabetes mellitus.
• It is imperative to know that captopril, despite its relative safety, has a number of side effects, which include:
• Impaired functioning of the nervous system (general weakness in the body, headaches, dizziness, increased fatigue, spontaneous muscle contractions);
• Disruption of the hematopoietic system (decrease in hemoglobin level, increase in the number of agranulocytes, decrease in the number of neutrophils, decrease in the number of platelets);
• Impaired functioning of the cardiovascular system (decreased pressure when changing body position, increased heart rate);
• Impaired metabolic processes (impaired acidity (to the acidic side), increased levels of potassium ions);
• Disorders of the digestive system (decreased or complete loss of appetite, disturbances in stool, taste perception, nausea, abdominal pain, increased liver enzymes, bilirubin, bile stagnation, inflammation of the liver, pancreas);
• Impaired functioning of the urinary system (increased concentrations of urea and creatinine in the blood plasma, formation of protein in the urine);
• Respiratory disorders (formation of dry cough).

Contraindications for captopril include the following:

• The patient has not reached 18 years of age;
• Hypersensitivity or individual intolerance to the drug or its individual components;
• Pregnancy and lactation period. During pregnancy, taking captopril is strictly prohibited, and during lactation - only in isolated cases and only under the condition of complete refusal to breastfeed the child.
• There have been no cases of drug overdose currently recorded.

Instructions for use

Captopril can only be prescribed by a doctor. The daily dosage is selected individually depending on clinical indications. Take the medicine 1 hour before meals.

For chronic heart failure, Captopril should be included in combination therapy. If there are no results from using diuretics, you should first take 6.25 mg 2-3 times a day.

Gradually (2 week interval) the volume is increased to the average maintenance level - 25 mg 2-3 times a day. If this amount is not enough, the dosage is increased. However, this must be done at intervals of 2 weeks.

When using Captopril for the treatment of arterial hypertension, initially use 25 mg twice a day. If the desired effect is not achieved, the dosage is gradually increased. This should be done every 2-4 weeks.

If Captopril is used, at what pressure levels should the dosage be changed? Maintenance volume for moderate hypertension - 25 mg twice a day. Sometimes a larger dosage is required, but it should not exceed 50 mg once, taken twice a day. In difficult cases, take 50 mg of the medicine three times a day. The maximum daily volume is 150 mg.

If renal function is impaired, it is recommended to adjust the dosage of the drug. If creatinine clearance is at least 30 ml/min, the daily volume can be 75-100 mg.

In more complex cases, the initial dosage is 12.5-25 mg per day. If necessary, increase the dosage over a long period of time. However, in any case, the drug should be used in a smaller dose than usual.

Important: For elderly patients, the amount of the drug is selected individually. Treatment should begin with 6.25 mg twice daily. Doctors recommend maintaining the dosage at this level.

Captopril: at what pressure, instructions for use, price, reviews and analogues

The article describes the medical drug Captopril, instructions for its use, release forms, pharmacological properties of the drug, indications for use, composition, possible side effects on the human body and other aspects of this drug.

The drug Captopril is a universal drug that lowers blood pressure. It is used to urgently reduce blood pressure, to prevent diabetes and oncology.

Because the drug is dispensed in pharmacies only with a doctor’s prescription - only the doctor determines the dosage for the patient. Self-medication is strictly prohibited.

Captopril belongs to the group of ACE inhibitors. Its action is to narrow the lumen of blood vessels and increase the release of aldosterone in the adrenal cortex. Long-term use of the drug reduces myocardial hypertrophy and the amount of sodium in the body, which is good for people with chronic heart disease.

It begins to act within 15 minutes (put under the tongue), which makes it possible to stop a hypertensive crisis and complications of high blood pressure. When taken orally, the active substance is absorbed into the stomach and takes effect within an hour. Do not take the medicine with meals, because the process of exposure to the drug slows down.

Composition and release form of the drug Captopril

The medication consists of the active substance of the same name – captopril, which is part of the group of ACE inhibitors. Excipients to improve medication intake: lactose, starch (dry), castor oil, etc.

The drug is available exclusively in the form of tablets in blisters of 10 pieces of different dosages - 12.5 mg, 25 mg, 50 mg. The box can contain 2 or 4 blisters.

pharmachologic effect

Pharmacological action of the drug Captopril

The drug, an angiotensin-converting enzyme inhibitor (ACEI), makes it difficult to change inactive angiotensin I to angiotensin II, which tends to narrow the lumens of the body’s blood vessels. Taking the drug reduces the content of angiotensin II in the body and thereby reduces blood pressure. Reduces the resistance of blood vessels to the force of blood flow.

After oral administration, more than 75% of the substance is absorbed into the gastrointestinal tract. Eating reduces the active absorption of the drug by 40%.

Doctor of Medical Sciences, Professor Emelyanov G.V.:

I have been treating hypertension for many years. According to statistics, in 89% of cases, hypertension results in a heart attack or stroke and death. Currently, approximately two thirds of patients die within the first 5 years of disease progression.

The next fact is that it is possible and necessary to reduce blood pressure, but this does not cure the disease itself.

The drug acts on the cause of the disease, making it possible to completely get rid of hypertension. In addition, within the framework of the federal program, every resident of the Russian Federation can receive it for FREE

.

Indications for use

First of all, the drug Captopril is prescribed to reduce blood pressure, prevent the onset of a hypertensive crisis, in cases of chronic heart disease.

The indication for prescribing the drug may be a systolic pressure of 140 mmHg. in people who, at such indicators, feel symptoms of a hypertensive crisis.

It is worth remembering that a hypertensive crisis (a sharp rise in pressure to 160 per 100 mm Hg or higher) requires immediate medical attention.

Captopril is also used in cases of:

• Acute renal failure.
• Increased blood pressure for no specific reason.
• Type 1 diabetes mellitus.
• Post-mortem myocardial infarction.
• Disorders of the ventricles of the heart.

Important! An agronomist from Barnaul with 8 years of experience in hypertension found an old recipe, set up production and released a product that will once and for all save you from problems with blood pressure... Read more...

Methods of application

Depending on the indication for which the medicine is prescribed, the doctor determines the dosage. Self-administration of the drug is prohibited. Captopril is taken an hour before meals for best effect.

To localize a hypertensive crisis, Captopril is taken one tablet under the tongue every 20 minutes. The maximum dose is 3 tablets. This helps to quickly lower blood pressure and improve the patient’s well-being. In cases of heart pain, nitroglycerin is added to Captopril, the dose of Captopril is reduced to 2 tablets to prevent a decrease in blood pressure.

In case of hypertension, the drug is prescribed in a volume of 25 mg 2 times a day. To achieve the desired effect, the dosage of the drug is increased in stages every 2-4 weeks. Depending on the severity of hypertension, the following is prescribed:

1. Mild or moderate degree - 2 tablets of 12.5 mg 2 times a day. Daily max. dose – 100 mg.
2. Severe - 50 mg 3 times a day. Daily dose – 150 mg.

When treating heart diseases, 6.25 mg is prescribed 2-3 times a day, gradually increasing the dose (not earlier than after 2 weeks). The average dosage is 25 mg 2-3 times a day. The dose is also gradually increased.

The maximum possible daily dose is 150 mg of the active substance. Therapy for myocardial infarction: take 3 tablets 3 times a day, the dose is gradually reduced.

During the acute course of the disease, taking the drug is contraindicated to avoid worsening the patient's condition.

For older people, the dosage of Captopril is selected individually, but not more than 6.25 mg 2 times a day.

The medicine can be used to quickly lower blood pressure. If the pressure readings reach 145 to 105 or higher, you need to take 1 tablet. Repeated administration of another tablet after 40 minutes is acceptable if the pressure has not decreased during this time.

The drug Captopril is taken as a preventive measure for high blood pressure.

The dosage of the drug is determined exclusively by a specialist. Self-medication can lead to headaches, nausea, lethargy, and drowsiness.

If side effects occur after taking the minimum dose of the medicine, you should stop taking it immediately.

Contraindications

Captopril is not recommended for use in the following cases:

1. Narrowing of the lumen of blood vessels.
2. Myocardopathy.
3. Swelling of the skin, face, limbs.
4. Primary hyperaldosteronism (Conn's syndrome).
5. Pregnancy and lactation period.
6. Children under 18 years of age.
7. When driving vehicles and mechanisms that require concentration.
8. Individual intolerance to individual components of the drug.
9. Arterial hypotension.
10. The period after kidney transplantation.

Pregnancy . The use of the drug is contraindicated. If the course of treatment is started earlier than the expected start of pregnancy, then during the period of pregnancy it is necessary to replace Captopril with another drug that is safer for the health of the mother and child.

Lactation period . Taking the drug during breastfeeding is contraindicated. The active substance is excreted into breast milk and can affect the hemodynamics of the child. During treatment with the drug, the child should be transferred to artificial feeding.

Children . Taking the drug for children under 18 years of age is not advisable. In case of emergency, the doctor determines the dosage, which differs from the standard one.

Depending on the child’s body weight, a daily dose of 1-1.5 mg per 1 kilogram of weight is prescribed.

Side effects

This drug has a large list of side effects that appear throughout the entire course of treatment with the drug. Doctors recommend that the first days of treatment be carried out under the constant supervision of specialists in order to monitor the body’s reaction to the active substance.

Surgical intervention in the human body while taking the medicine is prohibited. Anesthesia has a negative effect on blood pressure and can sharply lower it.

The appearance of jaundice also requires immediate refusal to take Captopril.

Alcoholic drinks are not compatible with treatment with Captopril.

Captopril affects the results of urine tests for acetone. It is better to take this test some time after the end of the course of treatment.

In rare cases, the drug may increase the level of potassium in the blood of a person who has diabetes or kidney failure.

Captopril has the following side effects:

• Tachycardia.
• Head pain, dizziness.
• Drowsiness, lethargy, loss of performance.
• Bronchospasm, pulmonary edema.
• Deterioration of vision.
• Rash, itching and other redness of the skin.
• Dry mouth.
• Attacks of dry cough.
• Loss of appetite.
• Changes in taste sensations.
• Abdominal pain, diarrhea.

The manifestation of at least one of the above symptoms requires immediate discontinuation of the drug and contacting your doctor to replace the drug with another.

Overdose with Captopril

An overdose of Captopril provokes downward jumps in blood pressure and thromboembolic complications. It is necessary to put the person in a horizontal position and the symptoms will go away in a couple of hours.

special instructions

Before starting a course of treatment, the body's water balance should be at a normal level. Throughout treatment, it is necessary to monitor kidney function. Sometimes it is possible to release protein into the urine, which will go away within a month without additional measures. The level of protein in the urine should not exceed 1000 mg per day, otherwise another drug is selected for treatment.

Treatment is carried out under close medical supervision in the following cases:

• Inflamed or dilated blood vessels.
• Diffuse disorders in connective tissues.
• Taking immunosuppressants.
• Kidney disorders.

Also, before starting treatment, the patient undergoes a general blood test, and every two weeks for 3 months of treatment, as well as after the end of treatment. If the level of leukocytes in the blood decreases to 1 g per liter of blood or less, then the drug is replaced with another.

In order to avoid a sharp decrease in blood pressure, the patient is stopped taking all diuretics. If symptoms of arterial hypotension appear, a person should take a horizontal position and slightly raise his legs.

Caution must be exercised when treating with drugs that interfere with the synthesis of uric acid or have a membrane-stabilizing effect.

In patients with kidney disease, taking Captopril increases the chance of developing proteinuria.

Taking Captopril during hemodialysis requires not using membranes with high conductivity to avoid pseudo-allergic reactions.

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In cases of swelling of the subcutaneous tissue, skin or mucous membranes, it is necessary to discontinue the drug and examine the patient. If your face is swollen, you should take antihistamines. In case of swelling of the throat, adrenaline is immediately administered intravenously.

Interaction with other drugs

The combined use of diuretics and vasodilators enhances the hypotensive effect of Captopril.

Nonsteroidal anti-inflammatory drugs, estrogens and clonidine reduce the hypotensive effect of Captopril.

An increase in potassium concentration occurs when Captopril is taken simultaneously with diuretics that conserve potassium.

Taking insulin and hypoglycemic drugs has a potential risk of glycemia during treatment with Captopril.

Analogues of the drug Captopril

Depending on the manufacturer, there are analogues of Captopril:

• Captopril Hexal.
• Captopril Sandoz.
• Captopril AKOS.
• Captopril Alkaloid.
• Captopril Credopharm.
• Captopril STI.
• Captopril UBF.
• Captopril Ferein.
• Captopril Norton.
• Captopril Egis.

In accordance with the active substance, analogues are distinguished:

• Kapoten.
• Kaptopres.
• Alkadil.
• Blockordil.
• Vero Captopril.

Kaptopres Blockordil Capoten

All drugs have their own area of ​​effect. Only a doctor can select the necessary medicine and its dosage depending on the patient’s health condition, his age, and the presence of other diseases.

Price

The average cost of Captopril in pharmacies is 20 rubles. for 20pcs per package. Dispensed only with a doctor's prescription.

Reviews

Valentin, 42 years old:

Captopril helped with a hypertensive crisis. The blood pressure dropped instantly from 166 to 143. I recommend it as an emergency aid.

Svetlana, 27 years old:

My grandmother is hypertensive and her doctor prescribed captopril. She has been taking it for 4 years and has not encountered any side effects during this time.

Anna, 53 years old:

Taking captopril in its pure form did not suit me very well, but in combination with diuretics it is much more effective. It probably depends on the characteristics of the body.

Source: https://odavlenii.com/preparaty/kaptopril/

Side effects

In some cases, the drug Captopril provokes unwanted side effects. These include the following:

1. If the cardiovascular system is damaged, there is a risk of developing tachycardia and orthostatic hypotension. The drug can also provoke the appearance of peripheral edema.
2. From the respiratory system, a dry cough and spasms in the bronchi may occur. In severe cases, pulmonary edema develops.
3. Allergic reactions can manifest themselves in the form of angioedema, which affects the face, mucous membranes, larynx, and limbs.
4. When the digestive organs are damaged, a reversible taste disorder and a feeling of dryness in the mouth occur. In rare cases, patients complain of diarrhea, abdominal pain, and gum hyperplasia. In difficult situations, hepatitis develops.
5. Dermatological pathologies manifest themselves in the form of rashes, which are accompanied by a feeling of itching and an increase in body temperature. Some people experience skin flushing and increased sensitivity to ultraviolet radiation.
6. If the nervous system is damaged, headaches, increased drowsiness, dizziness, and blurred vision may appear.
7. Malfunctions of the urinary system, such as impaired renal function,
   proteinuria.

Important: If unwanted reactions occur, you should stop taking the medication and consult a doctor. The specialist will adjust the dosage or select another remedy.

Side effects

Like any drug, Captopril tablets have their own contraindications, which should be familiarized with before starting treatment. Side effects can be observed in various systems and affect the functioning of internal organs. They occur against the background of various disorders, as well as due to an overdose of Captopril. To avoid this, you need to know exactly how many tablets of the drug to take.

Nervous system

A number of characteristic and general side effects are observed on the part of the sensory organs and nervous system:

• severe fatigue;
• dizziness;
• migraine;
• insomnia;
• clouding of mind;
• convulsions;
• numbness in the limbs;
• deterioration of visual function;
• impaired perception of taste and smell.

The cardiovascular system

A drug to lower blood pressure can greatly reduce blood pressure levels and cause hypotension. While taking it, sudden surges in pressure may also occur when the body position changes. An incorrectly selected dosage of Captopril or individual characteristics can lead to the development of acute heart failure or myocardial infarction. You may also experience rapid heartbeat, arrhythmia, and poor circulation in the blood vessels of the brain, which can lead to a stroke. Particularly life-threatening side effects include:

• cardiogenic shock;
• pulmonary embolism.

No less dangerous are changes in the composition of the blood, when, while taking Captopril, fluctuations in the concentration of platelets, eosinophils, neutrophils and basophils occur.

Respiratory system

Bronchospasm or shortness of breath may occur. The development of rhinitis, pneumonia and bronchitis is also often observed.

Digestive system

Taking any tablet drugs is associated with a load on the digestive tract. Disorders of taste perception, gastric ulcers, gastritis, inflammation of the tongue, dry mouth and a metallic taste may occur. But flatulence, bloating, stomach pain, nausea or vomiting also often occur.

urinary system

The development of acute renal failure is possible, and an increase in fluid waste is also observed. According to the results of control tests, protein is often detected in the urine during treatment.

External manifestations

Side effects occasionally occur on the skin in the form of rashes, redness and dermatitis. But herpes zoster, alopecia, and toxic necrolysis can also develop. In case of allergies to active or excipients, urticaria, Quincke's edema or anaphylactic shock develop.

In addition to all of the listed manifestations, pain or aches in the joints, increased body temperature, and sepsis may occur. Since treatment with Captopril is a long process, it is important to do control tests. If changes in the composition of the blood or fluctuations in biochemical parameters are detected, the dosage of the drug should be reconsidered, and if your health worsens, stop taking the medication altogether.

Overdose

If the recommended dosage of the drug is exceeded, there is a risk of unwanted reactions. These include the following:

• sudden decrease in blood pressure;
• state of shock;
• bradycardia;
• angioedema;
• stupor;
• thromboembolism;
• kidney failure;
• changes in water and electrolyte balance;
• circulatory disorders in the brain;
• myocardial infarction.

To cope with the symptoms of an overdose, you need to completely eliminate the use of the medicine and rinse your stomach. After this, lay the patient on a flat surface and begin measures aimed at replenishing blood volume and electrolytes. For this, intravenous administration of saline, plasma substitutes and other substances is indicated.

Symptomatic treatment should also be carried out, which is aimed at maintaining the normal functioning of internal organs. For this purpose, adrenaline is used, which helps increase blood pressure, an artificial pacemaker, and antihistamines. If necessary, hemodialysis can be performed.

Captopril - instructions for use, description, composition, price, reviews and analogues of tablets

Captopril is rightfully considered the most popular remedy for hypertension. Regular use can maintain blood pressure levels within normal limits.

Let's take a closer look at the drug, which has become an indispensable assistant in providing emergency care at home during a hypertensive crisis.

Varieties, release form and composition

Captopril is available in several types of tablets for oral use.

Varieties of the drug are distinguished by the addition of the manufacturer's abbreviation to the main name. For example:

• Captopril-Vero;
• AKOS;
• Akri;
• Aegis;
• Ros;
• Sar;
• STI;
• UBF;
• FPO;
• Ferein and others.

The manufacturer is given the right to modify the composition of the drug, leaving the main substance unchanged, diversifying the list with auxiliary components. This gives reason to study the indications for use in detail in order to avoid side effects.

Instructions for use

Most readers are interested in the questions: at what pressure and how to take Captopril? It should be taken at high blood pressure an hour before meals. In this case, it is not allowed to crush the tablets: chew or bite. The drug should be swallowed in its original form with plenty of water.

The dosage of the drug is determined by the attending physician individually.

When starting therapy with minimal doses, monitoring the effective effect of the drug is necessary. Blood pressure is checked using a tonometer every 30 minutes.

If necessary, the amount of the drug is increased to the maximum allowable dose of 300 mg/day.

It should be noted that increasing the dosage increases the risk of side effects that can lead to undesirable consequences.

General provisions and dosages

Sublingual application

The drug begins to act only 60 minutes after administration. To provide emergency assistance for high blood pressure, Captopril is dissolved by placing the tablet under the tongue. Within 15 minutes the effect of the drug is noticeable.

Use during pregnancy and breastfeeding

According to clinical studies in animals, the drug has a toxic effect on the developing fetus. Taking the medicine starting from the 13th week led to death and provoked developmental defects. Based on the above, the use of the drug at the first signs of pregnancy requires immediate discontinuation.

The active substance included in the composition tends to penetrate into mother's breast milk, and therefore, if it is necessary to take the drug, the newborn is transferred to artificial feeding.

Impact on the ability to operate machinery

Due to the peculiarity of Captopril to cause dizziness when taking it, work activities associated with increased attention, as well as those requiring a high reaction speed, are not recommended. Driving a car is not recommended.

Overdose

An independent increase in the dose of the drug provokes a sharp decrease in blood pressure. An overdose threatens the patient with cerebrovascular accident and can lead to thromboembolic complications, collapse or myocardial infarction.

In order to prevent irreversible reactions in the patient’s body if the dosage is exceeded, emergency assistance should be provided immediately. For this purpose, the patient should be laid down and given a drug that raises blood pressure until the ambulance arrives. Qualified doctors will continue symptomatic therapy in the hospital, which sometimes requires hemodialysis.

Analogs

The pharmaceutical industry has developed two types of Captopril analogues:

• containing a similar amount of the main active ingredient;
• containing a substitute for the active substance with a similar spectrum of action.

The first group of generics containing Captopril includes:

• Angiopril-25;
• Blockordil;
• Kaptopres;
• Alkodil;
• Kapoten.

The second group of generic Captopril consists of ACE inhibitors:

• Accupro;
• Amprilan;
• Arentopres;
• Bagopril;
• Hypernik;
• Dapril;
• Diropress;
• Zonixem;
• Irumed;
• Coverex;
• Metiapril and some others.

Capoten or Captopril?

Since both drugs contain the same active substance, the above-mentioned drugs are synonymous drugs. According to the instructions for use, they have a similar mechanism of therapeutic effect on the body and exhibit similar side effects.

Therefore, the choice of drug and preference for one over another depends only on subjective reasons.

Interaction with other drugs

Captopril should not be combined with medications that increase potassium levels in the blood. These include potassium-sparing diuretics - Veroshpiron, Spironolactone. Also included in this category are potassium compounds such as Panangin and Asparkam, heparin, and salt substitutes containing potassium.

The medicine can enhance the effect of hypoglycemic drugs - Gliclazide, Metformin, etc. Therefore, with such combinations, you need to monitor your blood glucose levels. Captopril also enhances the effect of analgesics and anesthetics.

Diuretics, antidepressants, vasodilators, antipsychotics lead to an increase in the hypotensive effect of Captopril. When combining such drugs there is a risk of a severe drop in blood pressure.

When combining Captopril with nitrates, it is recommended to reduce the amount of the latter. These include Nitroglycerin, Sodium nitroprusside and other agents.

When combined with non-steroidal anti-inflammatory drugs, the effectiveness of Captopril is reduced. This should be taken into account when using Aspirin, Nimesulide, Ibuprofen and other similar drugs.

Captopril can increase the level of lithium and digoxin in the blood. Therefore, the combination of the drug with lithium preparations can lead to signs of intoxication of the body.

The combination of Captopril with Procainamide, Allopurinol and immunosuppressants increases the risk of neutropenia, which manifests itself as a decrease in the volume of leukocytes in the blood. This combination also increases the risk of Stevens-Johnson syndrome.

Taking Captopril against the background of desensitizing therapy increases the risk of anaphylactic reactions. A similar effect is observed in combination with Estramustine and gliptins.

The use of Captopril with gold preparations provokes nausea and vomiting. Also, this combination can cause facial skin flushing and decreased blood pressure.

Taking Captopril in combination with hypoglycemic drugs and insulin increases the possibility of developing hypoglycemia.

Undesirable effects

Headache is one of the signs of a side effect.
A pharmacological agent can provoke some unpleasant manifestations from various body systems. If such symptoms appear, you should temporarily stop taking the pills and consult your doctor as soon as possible. List of possible adverse events during therapy with Captopril:

• paresthesia - “goosebumps”, tingling;
• orthostatic hypotension - a sharp drop in blood pressure when changing body position;
• headache, drowsiness, dizziness;
• insomnia;
• lack of coordination;
• attacks of tachycardia;
• swelling of the hands and feet;
• changes in the ratio of blood elements;
• chest pain;
• hot flashes;
• bronchospasm;
• dry cough and shortness of breath;
• dry mouth;
• abdominal discomfort;
• poor appetite;
• stool failures;
• bile stagnation;
• pain in joints and muscles;
• frequent urination;
• skin rashes and itching;
• photosensitivity;
• chills and fever.

Use in pediatrics

It is not recommended to treat children with Captopril, since the effectiveness and safety of using the drug in pediatric practice have not been studied. If it is impossible to do without the drug, the dosage is selected depending on the child’s weight. Experts recommend using 1-2 mg per 1 kg of body weight per day.

Features of application

7 days before the start of therapy, antihypertensive drugs are stopped. Constant monitoring of blood pressure, as well as the concentration of potassium, urea, and creatinine in the blood plasma is necessary. If the water-electrolyte balance is impaired or creatinine clearance <40 ml/min, dosage adjustment may be necessary. If fulminate necrosis or intrahepatic cholestasis develops, the dose is interrupted.

During pregnancy and lactation

Pregnant and breastfeeding women should avoid taking it. If necessary, stop breastfeeding.

Is the drug suitable for children?

Not used to treat children under 18 years of age.

In old age

In old age it should be used with caution. Dosage adjustment may be required.

For impaired renal function

Use is contraindicated after kidney transplantation and in the presence of bilateral renal artery stenosis. The drug is not prescribed to patients with severe renal impairment.

For liver dysfunction

For porphyria, the drug is not prescribed.

Effect on concentration

The drug reduces concentration.

special instructions

When treating with Captopril, you need to follow a number of recommendations:

1. If a dose is missed, take the usual dose next time. The volume of the drug should not be increased.
2. Before starting treatment, it is necessary to restore fluid volume and electrolyte levels in the blood. These indicators may be impaired due to the use of diuretics, severe diarrhea or vomiting.
3. During therapy, you need to monitor your kidney function. In 20% of cases, proteinuria occurs during the use of the drug, which is accompanied by the appearance of protein impurities in the urine. Usually this condition goes away on its own. If the protein content exceeds 1000 mg per day, treatment with Captopriom will have to be abandoned.
4. Within 3 months of therapy you need to take a blood test. This must be done every 2 weeks. If the leukocyte volume decreases to 1 G/l, the drug should be discontinued.

Drug interactions

Before use, it is necessary to study the interaction with other medications.

With other drugs

General anesthetics, antihypertensive drugs, clonidine and antipsychotics enhance the hypotensive effect. NSAIDs, estrogens, antacids, and sympathomimetic drugs can weaken the antihypertensive effect. Dairy products, potassium-containing medications, potassium-sparing diuretics, and cyclosporine can lead to an increase in the concentration of potassium in the blood. Concomitant use of immunosuppressive drugs, cytostatics and Allopurinol is contraindicated.

When performing hemodialysis using high-performance membranes, the risk of developing anaphylactic shock increases.

Alcohol compatibility

Alcohol enhances the antihypertensive effect. Joint use is contraindicated.

Approximate price in Russia

The price of Captopril depends on the dosage. On average, 20 tablets of 20 mg cost about 10 rubles.

Captopril is an effective drug that helps to quickly reduce blood pressure. To get the desired results, this remedy should only be used under the supervision of a cardiologist.

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Ivan Grekhov

Graduated from the Ural State Medical University with a degree in General Medicine. General practitioner

Indications for prescribing the drug

Many patients ask what Captopril helps with without carefully reading the instructions for use. The official instructions provide the following indications for prescribing the tablets:

• arterial hypertension;
• heart failure;
• nephropathy due to diabetes mellitus;
• rehabilitation period after myocardial infarction.

For arterial hypertension, the drug can be prescribed for monotherapy or as part of complex treatment, for example, in combination with diuretics. The decision to prescribe the drug and draw up a treatment regimen for hypertension remains with the doctor and depends, first of all, on the value of blood pressure. Combination therapy is used in the presence of one or more risk factors for complications of hypertension; monotherapy with captopril may be indicated for moderate increases in blood pressure. In case of stage 1 hypertension, when the pressure value does not exceed 140-150 mmHg, taking a potent drug in the vast majority of cases is not advisable.

For heart failure aggravated by high blood pressure, Captopril tablets are prescribed to eliminate symptoms. This medicine is used in relatively short courses, along with other drugs to normalize myocardial function.

In case of nephropathy due to diabetes mellitus, Captopril helps improve intraglomerular hemodynamics, which reduces the risks of rapid progression of kidney pathology.

Captopril is used in the treatment of acute myocardial infarction. In this case, the drug must be taken within the first 24 hours after the heart attack. The course of therapy is usually not long and takes about 4 weeks. The drug is indicated to reduce the risk of developing a recurrent heart attack, reduce the likelihood of a hypertensive crisis and ensure a smooth decrease in blood pressure in patients who have suffered a heart attack.

In all of these cases, the decision to prescribe Captopril should be made only by the attending physician. The medicine is unsafe and requires careful selection of the dosage regimen.

Cost and analogues

When prescribing Captopril, the price will depend on the manufacturer of the drug. Thus, the Russian drug costs about 25 rubles for 40 tablets, and the Italian Captopril Sandoz costs 150 rubles for a package of 40 tablets.

A complete analogue of the drug is Capoten tablets. If it is necessary to replace Captopril, analogues should be selected from drugs of the same group, but with a different substance in the composition. These include:

• Accupro;
• Diroton;
• Lisinopril;
• Renitek;
• Zokardis.

The decision to replace the drug with an analogue should be made by the attending physician.