Captopril is an angiotensin converting enzyme (ACE) inhibitor prescribed for treating high blood pressure, heart failure, and for preventing kidney failure due to high blood pressure and diabetes. Captopril is available under the following different brand names: Capoten and Captoril.

Captopril is used alone or in combination with other medications to treat high blood pressure and heart failure.

Dizziness, lightheadedness, or loss of taste may occur as your body adjusts to the medication. Dry cough may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Captopril works by opening your blood vessels. This allows blood to flow more easily and decreases how hard your heart has to pump. These effects lower your blood pressure levels, improve your heart’s ability to pump blood, and improve blood flow in your kidneys.

If you have diabetes, do not use captopril together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo). You may also need to avoid taking captopril with aliskiren if you have kidney disease.

Assessment

1. Monitor BP and pulse frequently during initial dose adjustment and periodically during therapy.
2. Heart Failure: Monitor weight and assess patient routinely for resolution of fluid overload (peripheral edema, rales/crackles, dyspnea, weight gain, jugular venous distention).

Captopril caused a decrease in heart rate in 18 patients but an increase in 2 patients. In the remaining 68, heart rate did not change. As a whole captopril caused a significant decrease in blood pressure without compensatory increase in heart rate.

Captopril was withdrawn in 3 patients for not achieving satisfactory BP control and/or because of side effects. It is concluded that captopril is safe and effective in the long-term treatment of hypertension, however, majority of the patients with severe forms of hypertension required double or multiple combinations.

Captopril is an FDA-approved medication used in the management of hypertension, left ventricular dysfunction after myocardial infarction, and diabetic nephropathy. Off-label indications include acute hypertensive crisis and Raynaud phenomenon.

In most patients, the antihypertensive effect began about 15 to 30 minutes after oral administration of captopril; the peak effect was achieved after 60 to 90 minutes. The maximum reduction in blood pressure of a defined captopril dose was generally visible after three to four weeks.

Taking potassium supplements, potassium-containing salt substitutes (No Salt, Morton Salt Substitute, and others), or large amounts of high-potassium foods (such as bananas and other fruit) at the same time as taking ACE inhibitors could cause life-threatening problems.

Captopril is best given on an empty stomach, half an hour before food, to increase effectiveness. Usually your child will be given a test dose of Captopril under medical supervision before commencing regular dosing. This is to ensure that Captopril doesn’t cause very low blood pressure.

Captopril is rarely used today. As Professor Poole-Wilson explains, better once-daily ACE inhibitors have come along that are easier for patients to use within the cocktail of drugs they may need to control their blood pressure or heart failure.

Captopril, the first ACE inhibitor approved for human use was developed based on the structure of a bradykinin potentiating peptide isolated from the venom of the Brazilian pit viper, Bothrops jararaca [10].

To the Editor. —Cough is increasingly reported as a potential side effect of angiotensin-converting enzyme inhibitors. Cases of cough have been reported with enalapril as well as with captopril therapy.

Blood pressure drugs. Angiotensin-converting enzyme (ACE) inhibitors, which are commonly prescribed for high blood pressure and heart failure, are known to cause chronic cough in some people.

Angiotensin Converting Enzyme (ACE) Inhibitors These high blood pressure medications block formation of a hormone that causes blood vessels to narrow, so vessels relax. ACE inhibitors may cause these side effects: A dry, hacking cough that doesn’t go away.