Detailed Drug Information:

DRUG CLASS AND MECHANISM: Captopril is an ACE (angiotensinconverting enzyme) inhibitor. ACE is an enzyme in the body which isimportant for the formation of angiotensin II. Angiotensin II causesconstriction of arteries in the body, thereby elevating blood pressure.ACE inhibitors such as captopril lower blood pressure by inhibiting theformation of angiotensin II, thus relaxing the arteries. Relaxing thearteries not only lowers blood pressure, but also improves the pumpingefficiency of a failing heart and improves cardiac output in patients withheart failure.

PREPARATIONS: tablets: 12.5 mg, 25 mg, 50 mg, 100 mg.

STORAGE: Tablets should be stored at room temperature in atightly closed container.

PRESCRIBED FOR: Captopril can be used alone in treating highblood pressure. Its blood pressure lowering effect can be further enhancedby the addition of a diuretic (water pill) medication. Capozide is anexample of a medication that combines the effect of captopril with adiuretic (water pill). By reducing resistance in the arteries, captoprilcan be useful in the treatment of congestive heart failure. In treatingheart failure, captopril usually supplements conventional treatment, including a diuretic and digoxin (Lanoxin). After a heart attack,captopril has been found to be effective in improving functioning of thedamaged heart. It is also used to treat kidney disease associated withdiabetes.

DOSING: Should be taken on an empty stomach one hour beforemeals.

DRUG INTERACTIONS: Captopril should not be taken by people witha known allergy to ACE inhibitors. Swelling of the facial tissues and eventhe upper airways has been reported with ACE inhibitors on very rareoccasions, and can lead to serious breathing difficulties. Captopril caninteract with diuretics (water pills) and other blood pressure medicinesto cause an excessive drop in blood pressure, which can cause symptoms ofweakness, dizziness, and lightheadedness. Impairment of kidney functionhas been reported with ACE inhibitors, especially in patients with severeheart failure or pre-existing kidney disease. Combining captopril withpotassium supplements, potassium containing salt substitutes, andpotassium-conserving diuretics such as amiloride (Moduretic),spironolactone (Aldactone), and triamterene (Dyazide, Maxzide), can leadto dangerously high blood levels of potassium. Indomethacin (Indocin) andpossibly other anti-inflammatory medications may decrease the bloodpressure lowering effect of captopril.

In rare instances, low white blood cell counts have been reported withthe use of captopril. Low white blood cells increase the patient's risk ofinfections. Anticancer drugs or chloramphenicol taken with captopril canincrease the chance of having a low blood cell count. When taken withlithium, captopril can increase lithium to toxic levels in the blood. Safeuse in children is not established. It is not habit forming.

PREGNANCY: ACE inhibitors, including captopril, can be harmfulto the fetus and should not be taken by pregnant women.

NURSING MOTHERS: It is also avoided in nursing mothers.

SIDE EFFECTS: Captopril is generally well tolerated and sideeffects are usually mild and transient. A dry, persistent cough has beenreported with the use of captopril and other ACE inhibitors. Coughingresolves after discontinuing the medication. Other side effects are rareand include abdominal pain, constipation, diarrhea, dizziness, fatigue,headache, loss of taste, loss of appetite, nausea and vomiting, easybruising or bleeding, chest pain, chills, difficulty breathing, severedizziness or fainting, fever, numbness or tingling in the hands or feet,rash, and a sore or swollen throat. In rare instances, liver dysfunctionand skin yellowing (jaundice) have been reported with ACE inhibitors.