Captopril

The usual starting dose of captopril depends on the condition for which you are taking Captopril.

For treating high blood pressure, the usual starting dose is 25 mg taken by mouth 2 or 3 times a day. After 1 or 2 weeks, your doctor may increase your dose, depending on side effects and how well the medication is working for you. The dose of captopril to control blood pressure does not usually go above 50 mg 3 times daily. The maximum dose of captopril is 450 mg daily given in 3 equally divided doses.

For treating heart failure, the usual starting dose is 25 mg taken by mouth 2 or 3 times a day. After 1 or 2 weeks, your doctor may increase your dose, depending on side effects and how well the medication is working for you. The dose of captopril to treat heart failure does not usually go above 50 mg to 100 mg given 3 times daily. The maximum dose of captopril is 450 mg daily given in 3 divided doses.

After a heart attack, the usual starting dose is 12.5 mg taken by mouth, 3 times a day. This dose will be increased gradually, to the recommended daily dose of 50 mg taken 3 times a day.

When treating Kidney Disease caused by diabetes, the recommended dose is 25 mg taken by mouth, 3 times daily. If this dose does not adequately lower blood pressure, other medications will be used in addition to captopril. Captopril should be taken 1 hour before meals.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Captopril exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Captopril at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause unusual tiredness; it may alter your sense of taste; on occasion, it may cause a dry cough - contact your pharmacist or doctor if it becomes bothersome. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Captopril is available as 12.5 mg, 25 mg, 50 mg, and 100 mg tablets.

Do not take this medication if you:

• are allergic to captopril or any ingredients of the medication
• are pregnant
• have experienced angioedema (a serious allergic reaction that causes the area around the face, throat, and tongue to swell) after taking any of the class of medications known as ACE inhibitors (e.g., captopril, Enalapril, Fosinopril, Lisinopril, etc.)
• have diabetes or kidney disease and are taking Aliskiren

There may be an interaction between captopril and any of the following:

• Abiraterone
• acetylsalicylic acid (Asa)
• Aldesleukin
• aliskiren
• Allopurinol
• alpha blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• alpha agonists (e.g., Clonidine, methyldopa)
• amifostine
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, lisdexamphetamine)
• angiotensin receptor blockers (ARBs; e.g., candasartan, Irbesartan, Losartan)
• antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hyd
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• asunaprevir
• Azathioprine
• barbiturates (e.g., butalbital, pentobarbital Phenobarbital)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• brimonidine
• Bupropion
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• Canagliflozin
• Celecoxib
• certain selective serotonin reuptake inhibitors (SSRIs; e.g., Sertraline, Paroxetine, Fluoxetine)
• chloroquine
• Cimetidine
• Cinacalcet
• ciprofloxacin
• Cobicistat
• Darifenacin
• delavirdine
• diazoxide
• Diphenhydramine
• diuretics (water pills; e.g., Furosemide, hydrochlorothiazide, triamterene)
• Dronedarone
• drospirenone
• Duloxetine
• Eplerenone
• Everolimus
• “gliptin” diabetes medications (DPP-IV inhibitors; e.g., Linagliptin, Saxagliptin, Sitagliptin)
• grass pollen allergen extract
• Guanfacine
• Heparin
• certain HIV protease inhibitors (e.g., darunavir, indinavir, ritonavir)
• imatinib
• iron dextran complex
• isoniazid
• ketoconazole
• levodopa
• lithium
• low-molecular-weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• medications that increase potassium levels (e.g., potassium supplements, Spironolactone, Amiloride, triamterene, and salt substitutes containing potassium)
• Metformin
• Methadone
• Methylphenidate
• Minoxidil
• Mirabegron
• narcotic medications (e.g., Codeine, Morphine)
• Nilotinib
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., Diclofenac, Ibuprofen, Naproxen)
• Obinutuzumab
• other angiotensin converting enzyme inhibitors (ACEIs; enalapril, Ramipril)
• peginterferon alfa-2b
• Pentoxifylline
• phosphodiesterase-5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• Pregabalin
• quinidine
• quinine
• Ropinirole
• sacubitril
• Sirolimus
• sodium phosphates
• Temsirolimus
• terbinafine
• Ticlopidine
• Tizanidine
• tolcapone
• Tolvaptan
• Tranylcypromine
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• Trimethoprim
• Yohimbine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Captopril. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Captopril.

Angioedema: Angioedema (a serious allergic reaction that causes the area around the throat and tongue to swell) may occur with the use of ACE inhibitors, including captopril. This occurs for about 1 in 1,000 people. If you experience swelling of the face, tongue, or throat, stop taking captopril at once and seek immediate medical attention. People who have had angioedema caused by other substances may be at increased risk of angioedema while taking an ACE inhibitor.

Cough: People taking captopril may develop a dry, persistent cough that usually disappears only after stopping or lowering the captopril dose. Be sure to tell your doctor of any cough that does not seem to be related to a usual cause.

Fluid and electrolyte levels: Increases in blood levels of potassium occur for a small percentage of people who take captopril. This rarely causes problems, but your doctor should monitor your potassium levels. People with kidney disease or diabetes are at a higher risk of having increased blood potassium while taking captopril.

Infection: Captopril can reduce the number of cells that fight infection in the body (white blood cells). Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.

Report any signs of infection, such as sore throat or fever, to your doctor.

Kidney function: Changes in kidney function have been seen in certain people taking Captopril. The use of diuretics (water pills) or aliskiren may further increase the risk of kidney problems for those already at risk for this problem. If you have kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Captopril, and whether any special monitoring is needed.

Let your doctor know if you notice any decrease in urine output or increased swelling of the lower limbs, which suggests an accumulation of fluid due to decreased urination.

Liver function: Changes in liver function have occurred in people with or without preexisting liver problems during treatment with this medication. In most cases, the changes were reversed when the medication was stopped. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Low blood pressure: Occasionally, blood pressure drops too low after taking captopril. This usually happens after the first or second dose or when the dose is increased. It is more likely to occur for those who take aliskiren or water pills, have a salt-restricted diet, are on dialysis, are suffering from diarrhea or vomiting, or have been sweating excessively and not drinking enough liquids. Get up slowly when rising from a sitting or lying down position. If low blood pressure causes you to faint or feel lightheaded, contact your doctor.

Excessive sweating and lack of fluid intake may lead to an excessive fall in blood pressure because of reduced fluid in your blood vessels. Vomiting or diarrhea may also lead to a fall in blood pressure. Consult your doctor if you feel your blood pressure is too low.

Surgery: If you are scheduled to have any type of surgery, inform all the doctors involved in your care that you are taking captopril.

Pregnancy: ACE inhibitors such as captopril may cause severe harm or death to the developing baby if taken by the mother during pregnancy. Captopril should not be used during pregnancy. If you become pregnant while taking Captopril, contact your doctor immediately.

Breast-feeding: Small amounts (1%) of captopril are passed from the mother to the infant in breast milk. The effect of this amount on the breast-fed child has not been determined. Talk to your doctor about whether you should breast-feed while taking Captopril.

Children: The safety and effectiveness of using Captopril have not been established for children.

This medication is typically used twice a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. You should take this medication at approximately the same time each day. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication should not be taken with food. It is best taken on an empty stomach, one hour before or 2 hours after a meal.