Why teeth become exposed and how to treat them. Treatment of exposed gums

ACE inhibitor. Drug Kapoten reduces the formation of angiotensin II from angiotensin I. A decrease in the content of angiotensin II leads to a direct decrease in the release of aldosterone. At the same time, OPSS, blood pressure, post- and preload on the heart decrease. Dilates arteries more than veins. Causes a decrease in the degradation of bradykinin (one of the effects of ACE) and an increase in the synthesis of Pg. The hypotensive effect does not depend on the activity of plasma renin; a decrease in blood pressure is observed at normal and even reduced concentrations of the hormone, which is due to the effect on the tissue renin-angiotensin system. Strengthens coronary and renal blood flow. At long-term use reduces the severity of hypertrophy of the myocardium and the walls of resistive arteries. Improves blood supply to ischemic myocardium. Reduces platelet aggregation. Helps reduce Na+ content in patients with CHF. At doses of 50 mg/day, it exhibits angioprotective properties against microvasculature vessels and helps slow the progression of chronic renal failure in diabetic nephroangiopathy. A decrease in blood pressure, unlike direct vasodilators (hydralazine, minoxidil, etc.), is not accompanied by reflex tachycardia and leads to a decrease in myocardial oxygen demand. In case of heart failure, in an adequate dose it does not affect blood pressure. Maximum reduction in blood pressure after oral administration observed after 60-90 minutes. The duration of the hypotensive effect is dose-dependent and reaches optimal values within a few weeks.

Indications for use

For mild/moderate hypertension - as additional means when treated with thiazide diuretics in patients who do not respond effectively to treatment with thiazide drugs alone. Severe hypertension when standard treatment fails.

Kapoten indicated for the treatment of congestive heart failure. The drug should be used together with diuretics and, where necessary, digitalis preparations.

Directions for use

Hypertension
Treatment with Kapoten should be carried out using the lowest effective dose, which should be selected according to the needs of the patient.

Mild/moderate hypertension
For mild/ moderate degree hypertension Kapoten should be used as an adjunct to thiazide diuretic treatment. The starting dose is 12.5 mg twice daily. The usual maintenance dose is 25 mg twice daily and can be increased in stages over 2 to 4 weeks until the desired response is achieved, up to a maximum dose of 50 mg twice daily.

Severe hypertension
For severe hypertension, the starting dose is 12.5 mg twice daily. The dose can be increased in stages up to a maximum dose of 50 mg three times a day. Capoten can be used together with other antihypertensive drugs, however, the dose of such drugs should be selected individually. Usually the daily dose should not be exceeded Capoten, equal to 150 mg/day.

Heart failure
Treatment with Capoten should be started under close medical supervision. Kapoten should be prescribed when treatment with a diuretic (such as furosemide 40-80 mg or equivalent) fails to relieve symptoms. An initial dose of 6.25 mg or 12.5 mg may minimize the temporary drop in blood pressure. The possibility of this effect can be reduced by stopping or reducing the dose of the diuretic, if possible, before starting treatment with Capoten. The usual maintenance dose is 25 mg two or three times a day, and the dose can be increased in stages, once every two weeks at least, until a satisfactory response is obtained. The usual maximum daily dose is 150 mg. Capoten should be prescribed in combination with a diuretic and, when necessary, with digitalis.

Elderly patients
The dose should be adjusted depending on changes in blood pressure and maintained at the minimum level necessary to achieve sufficient results. Since renal function may be limited in elderly patients, and dysfunction of other organs may also be observed, a small dose should be used at the beginning of treatment. Capoten.

Children
Kapoten not recommended for the treatment of mild/moderate hypertension in children. Available experience of use in newborns, especially premature infants; is limited. Since renal function in newborns is not equivalent to that in older children or adults, Capoten should be used when patients are under medical supervision. The initial dose should be 0.3 mg per kg body weight per day up to a maximum dose of 6 mg/kg body weight per day in divided doses. The dose should be selected individually, depending on the patient’s response to treatment and distributed into 2-3 doses throughout the day.

Patients with impaired renal function
Capoten is not recommended for use in patients with impaired renal function. When its use is clinically indicated in severely hypertensive patients with impaired renal function, the dose may need to be lower to ensure adequate blood pressure control. The dose can be adjusted to the patient's response, but sufficient time must pass between dose changes. In such patients, the drug of choice is a loop diuretic rather than a thiazide-type diuretic.
Capoten is easily removed from the body using hemodialysis.

Side effects

Blood
Neutropenia, anemia, thrombocytopenia.

Kidneys
Proteinuria, increased content blood urea, as well as creatinine, increased serum potassium and acidosis.

Cardiovascular system
Hypotension, tachycardia.

Availability side effects on captopril is mainly related to renal function, since the drug is excreted from the body primarily through the kidneys. The dose should not exceed the amount necessary to achieve an adequate result, and it should be reduced in patients with impaired renal function.

Leather
Rashes, usually itchy. As a rule, they are mild, temporary, and macular-papular in nature. IN in rare cases- nature of urticaria. In some cases, the rash is associated with fever, and some patients developed angioedema. Itching, hot flashes, vesicular rashes and photosensitivity have been reported.

Gastrointestinal tract
Reversible and usually self-limiting disturbances in the sense of taste have been reported. Weight loss may occur due to loss of taste. Stomatitis resembling aphthous ulcers has been reported. Increased liver enzyme activity has been reported in some patients. In rare cases, hepatocellular damage and cholestatic jaundice have been reported. Stomach irritation and abdominal pain may occur.

Other
Hand paresthesias have been reported serum sickness, cough, bronchospasm and lymphadenopathy.

Contraindications

History of hypersensitivity to captopril.

Precautions
The patient's examination should include assessment of renal function before initiation of treatment and at appropriate intervals thereafter. Patients with impaired renal function should not usually be treated with captopril. Capoten should not be used in patients with aortic stenosis or obstructive defects in the blood outflow tract from the heart.

Hypotension
After the first doses of the drug, some patients may experience symptomatic hypotension.

In most cases, symptoms are relieved simply when the patient moves to a lying position. In patients with severe forms of renin-dependent hypertension (eg, renovascular hypertension) or in the presence of severe congestive heart failure receiving large doses diuretic, excessive hypotensive reactions were usually observed within one hour after taking the initial dose Capoten. In such patients, discontinuation of diuretic treatment or noticeable decrease diuretic dose for 4-7 days before starting treatment Kapoten, reduces the likelihood of such an effect. If you start treatment with Capoten with small doses (6.25 mg or 12.5 mg), the duration of the possible hypotensive effect is reduced. In some patients, infusion saline solution can give positive effect. The development of hypotension after taking the first dose does not eliminate the need for subsequent dose adjustment of Capoten.

Effects on the kidneys
Proteinuria in patients with previous normal function kidneys are rarely observed. When proteinuria is present, it is usually observed in patients with severe hypertension and indications of pre-existing kidney disease. Some of these patients have nephrotic syndrome. In patients with indications of pre-existing kidney disease, it is recommended to measure protein in the urine monthly during the first nine months of treatment.

Blood
Neutropenia/agranulocytosis, thrombocytopenia and anemia have been reported in patients receiving Capoten. In patients with normal renal function in the absence of other complicating factors, neutropenia is observed in rare cases.
Kapoten should not be used routinely in patients with pre-existing renal impairment, collagen vascular disease, patients being treated with immunosuppressive drugs, allopurinol or procainamide, or a combination of these complicating factors, since neutropenia is almost exclusively associated with patients in this group. Some of these patients may develop serious infections, which in some cases do not respond to intensive antibiotic treatment. If Capoten is used in such patients, it is recommended to carry out a count before starting treatment. shaped elements white blood, including determination of the differential blood count every two weeks during the first three months of treatment Kapoten and periodically thereafter. During treatment, all patients should be instructed to report any sign of infection, e.g. sore throat, an increase in temperature when a differential count of white blood elements is carried out. Capoten and other prescribed drugs should be discontinued if neutropenia is observed (neutrophils less than 1000/mm3) or there is a suspicion of it. In most patients, the number of neutrophils quickly returns to normal after stopping Capoten.

Surgery/anesthesiology
In patients exposed to large surgical operations or during anesthesia with drugs that cause hypotension, captopril will block the formation of angiotensin II caused by compensatory secretion of renin. This may lead to hypotension, which can be corrected by volume replacement.

Clinical chemistry
Capoten can give false positive test in urine for acetone.

Pregnancy

Capoten has been shown to have a lethal effect on rabbit and sheep fetuses. Toxic effect it was not detected on the fetus in hamsters or rats.
Capoten is contraindicated for use during pregnancy and should not be used in women childbearing age unless they are protected by effective contraception.

Since captopril is excreted into human milk, Capoten should not be used in nursing women.

Interaction with other drugs

Diuretics potentiate the antihypertensive effect of Capoten. Potassium-sparing diuretics (triamterene, amiloride, and spironolactone) or potassium supplements may result in marked increases in serum potassium concentrations.

When taken simultaneously with indomethacin, a decrease in the antihypertensive effect may be observed. This is also likely to be observed with the use of other non-steroidal anti-inflammatory drugs.

Capoten has been reported to have a synergistic effect with peripheral vasodilators such as minoxidil. Knowledge of this interaction may help avoid initial hypotensive reactions.

It is believed that the antihypertensive effect of Capoten may be delayed when patients receiving clonidine are switched to Kapoten.

Neutropenia and/or Stevens-Johnson syndrome have been reported in patients receiving Capoten in combination with allopurinol or procainamide. Although no causal relationship has been identified, these combinations should be used with caution, especially in patients with impaired renal function.

The use of azathioprine and cyclophosphamide has been associated with blood dyscrasias in patients with renal failure, who simultaneously took Capoten.

The excretion of Capoten through the kidneys is reduced in the presence of probenecid.

Overdose

In case of overdose, blood pressure should be monitored and if hypotension develops, volume replacement is the treatment of choice. Captopril is removed from the body by dialysis.

Release form

Boxes of blister packs containing 40 tablets of 25 mg each.
Boxes of blister packs containing 40 tablets of 50 mg each.

Storage conditions

Store at room temperature.
Dispensed from pharmacies with a doctor's prescription.

Synonyms

Captopril

Compound

1-[(2S)-3-mercapto-2-methyl-propionyl]-L-proline.
Tablets contain 25 mg or 50 mg captopril.

Basic parameters

Name:	CAPOTEIN

Article publication date: 05/02/2017

Article updated date: 12/18/2018

From this article you will learn everything important information about Capoten tablets: what and how they help. For what diseases are they prescribed, what symptoms do they help relieve.

Capoten is an angiotensin-converting enzyme inhibitor (). Its main effect is to reduce blood pressure.

The drug has side effects and contraindications, so take it only as prescribed by your treating cardiologist or therapist.

These tablets are prescribed to patients suffering from the following diseases:

Capoten for hypertension

The tablets help to significantly reduce blood pressure due to two mechanisms:

Do not allow blood vessels to narrow. The drug blocks the enzyme that converts angiotensin 1 into angiotensin 2. Angiotensin 2 is a substance that constricts blood vessels, which increases blood pressure. Since blocking the angiotensin-converting enzyme does not produce the same amount of angiotensin 2, blood pressure does not increase.
. This effect is achieved by increasing the level of bradykinin, prostaglandin E 2 and nitric oxide in the blood - bioactive substances that reduce vascular tone and dilate them.

Mechanism of action ACE inhibitors

Thanks to this mechanism of action, Capoten not only prevents pressure from rising, but also reduces it if it has already risen.

This drug is especially effective for hypertension caused by kidney disease. With kidney pathologies, their production of renin increases - a substance that, when combined with angiotensin produced by the liver, forms angiotensin 1. And angiotensin 1 is converted into angiotensin 2 under the action of angiotensin-converting enzyme. Angiotensin 2 causes an increase in blood pressure; renin, angiotensin and angiotensin 1 themselves do not have this effect. Capoten, by blocking angiotensin-converting enzyme, prevents an increase in the level of angiotensin 2.

However, this does not help much with kidney disease itself. This medication only treats hypertension caused by kidney diseases, and by reducing pressure relieves excessive load on the kidneys. If you stop taking the pills, high blood pressure will make itself felt again. To completely get rid of nephrogenic hypertension, it is necessary to treat the underlying kidney disease, and take an ACE inhibitor as an addition to the main therapy - as symptomatic treatment high blood pressure.

Capoten for chronic heart failure

How and why the drug helps with chronic heart failure:

Lower blood pressure if it is elevated (mechanism this effect described in the previous section).
Relieve swelling. Capoten reduces the level of the adrenal hormone aldosterone, which reduces sodium retention and, accordingly, water retention in the body.
Reduce shortness of breath and warn. Thanks to a decrease in pressure in the small (pulmonary) circle.
. Due to the dilation of blood vessels and an increase in the volume of blood emitted by the heart.

Dilated and spasmodic artery

Kapoten after a heart attack

It is not used in acute phase disease, but only when the patient is already in a stable condition. Usually the product can be taken 3 days after suffered a heart attack.

Tablets are needed to prevent heart failure caused by necrosis of a portion of the myocardium. They improve blood circulation, prevent blood stagnation in the small and big circles, as well as edema, increase the ejection fraction of the left ventricle.

Kapoten also prevents a recurrent heart attack, as it dilates blood vessels, including coronary ones, and normalizes blood supply to the heart muscle.

Capoten for diabetic nephropathy

Diabetic nephropathy is damage to the blood vessels of the kidneys that occurs against the background of diabetes.

For this pathology, the drug is prescribed to improve blood circulation in the kidneys by relieving vascular spasm. And also to lower blood pressure, increased due to kidney damage.

Taking an ACE inhibitor for diabetic nephropathy significantly improves the prognosis: reduces the risk of needing hemodialysis or a kidney transplant.

Hypertension affects 20-30% of the population, and with age the figure increases to 50-60%. Today, this is the most common CVD disease.

Develops gradually, fraught with serious consequences: irreversible damage the most important organs: heart, blood vessels, brain, fundus and kidneys.

On late stages Coordination is impaired, weakness appears in the limbs, vision deteriorates, memory is significantly reduced, and intelligence is significantly reduced. This disease can cause a stroke or heart attack.

To treat hypertension, medication alone is not enough. The patient will have to reconsider his lifestyle: establish healthy eating, quit smoking and alcohol, and do physical exercise. The pressure increases various reasons. Clinical studies showed that with mild and moderate hypertension, as well as during a hypertensive crisis, the drug kapoten helps well and is easily tolerated by patients.

Kapoten – medicinal product, used to treat hypertension, is an ACE inhibitor. The active ingredient is captopril (25 mg per tablet). The medicine blocks the converting enzyme angiothesin, which increases blood pressure. Thanks to the action of capoten, the production of aldosterone by the adrenal glands, which also increases blood pressure, is reduced. The drug promotes vasodilation and excretion from the body excess liquid, reducing pressure in the pulmonary circulation and the right ventricle of the heart.

The drug Copoten is available in the form of white tablets with a cream tint, square in shape with rounded edges. Dosage tablets 25 mg, 50 mg in blisters of 14 tablets, 1-4 blisters in a cardboard package. Manufacturer: JSC KhFK AKRIKHIN, Russia. Cost: in Moscow 110-130 rubles. (pack of 14 pcs.), 160-180 rub. (pack of 28 pcs.), 230-250 rubles (40 pcs.); in Ukraine average price 160-280 UAH.

The tablet is quickly absorbed into the gastrointestinal tract (about 75%) and begins to act after 10 minutes, full effect occurs within 1-1.5 hours, therapeutic effect lasts 6 hours. It is excreted from the body by the kidneys and urine.

Pharmacological action

The drug (ACE inhibitor) produces hypotensive effect, interferes with the production of angiotensin II, reducing its tendency to narrow arterial and (to a lesser extent) venous vessels.

The active substance is captopril, excipients: starch, lactose, stearic acid, MCC. Store at 15-25 O C, shelf life 3 years. Dispensed by prescription. Read more: appointmenthood instructions his application and at what pressureyou need to drink it.

Indications for use and doses

Treatment is carried out under the supervision of a physician; dosages and administration schedule are developed individually for each patient. The cause of hypertension should be determined and whether the patient has any contraindications.

Capoten is prescribed for complex therapy diseases:

myocardial infarction;
arterial hypertension;
heart failure;
nephropathy due to diabetes of the 1st degree.

The main purpose of taking capoten is to stabilize high blood pressure.

A Arterial hypertension (AH) is an increase in pressure, has three degrees of development:

optimal pressure – 120/80;
normal – 120-130/80-85;
increased – 130-139/85-89;
1st degree hypertension – 140-159/90-99;
2nd degree hypertension – 160-179/100-109;
Stage 3 hypertension – above 180/above 110.

How to take Capoten

The medicine should be taken orally after meals 2-3 times a day. The initial dosage per dose is 12.5 mg, the doctor can increase the dose per dose to 25-50 mg, taking into account the severity of the disease, but not more than 150 mg per day.

During a hypertensive crisis, take one 25 mg tablet, which lowers blood pressure within 10-20 minutes. If insufficient effect is achieved, you can take another tablet after 1-2 hours. When taking the tablet under the tongue and then dissolving it, the effect of the medicine is more active and faster. But during resorption, a burn to the mucous membrane may occur, so care must be taken.

Usually from Capoten pressure is taken 2-3 times a day as prescribed by a doctor (25 mg per day). In some cases (with mild and average shape hypertension), one dose per day is prescribed to maintain optimal pressure. The main thing is not to exceed permissible dose(50 mg in 2 doses)! The patient's age should be taken into account. For older people, the prescribed dose should be slightly lower. In general, this drug is rarely prescribed to patients over 65 years of age.

Take the medicine daily. The course of therapy usually lasts from several weeks to a month. If sudden surges in pressure continue, you should immediately consult a cardiologist, as this may be due to a serious reason (pathology of blood vessels and heart).

When taking capoten and alcohol simultaneously, blood pressure may drop significantly and hypotension may provoke headache, nausea and vomiting.

Contraindications

Use the hood when high blood pressure it is forbidden:

the patient has pathologies that impede the outflow of blood (aortic stenosis);
2-sided renal artery stenosis;
liver or kidney dysfunction;
hyperkalemia;
age under 18;
pregnancy and breastfeeding;
angioedema;
after kidney transplant
intolerance to the components included in the drug;

Side effects

Capoten is used in complex therapy in combination with other drugs: diuretics, antihypertensive medications, calcium receptor blockers.

The following side effects may occur when taking the drug:

orthostatic hypotension (low blood pressure);
tachycardia;
peripheral edema;
dry cough, bronchospasm;
swelling of the lungs, face, extremities, mucous membranes of the larynx, tongue, lips;
hyperkalemia, hyponatremia, high concentration of nitrogen in the urine;
rash accompanied by itching, flushing of the face, sometimes fever;
dry mouth, taste disturbance, gum hyperplasia;
anemia, neutropenia, thrombocytopenia;
ataxia, drowsiness, headaches, dizziness, blurred vision;
rarely abdominal pain, diarrhea.

Combination of capoten with other medications

The hood is compatible with Concor, their simultaneous use is allowed. But it’s better to have a capoten in the first aid kit to stop an attack in case of hypertensive crisis rather than drinking all the time. Regular use of Concor is sufficient to maintain normal blood pressure.

Perindopril is also an ACE inhibitor, both drugs are identical. And there is no point in combining them in complex therapy. You need to choose one of them, perindopril is less popular and common, but it can also be used to treat hypertension.

Physiotensom - blood pressure tablets, used for regular use (usually in the morning and evening) for hypertension to maintain normal blood pressure. Capoten is used to quickly lower blood pressure, as emergency assistance. Pressure surges often occur at the beginning of treatment for hypertension.

Amlodipine is used in complex therapy. He often enters combination drugs. If the blood pressure rises sharply during therapy, a Capoten tablet (placed under the tongue) quickly reduces it.

Nifedipine (blocker calcium channels) can be taken instead of Capoten during a hypertensive crisis, sharp jump pressure. A tablet placed under the tongue begins to act within a few minutes. This remedy is also used in complex therapy of hypertension.

Analgin at arterial hypertension It is not recommended to take it either together with Capoten or separately. These drugs do not combine well and give a lot side effects. Today, analgin is attributed negative impacts on the body than positive ones.

Analogues and substitutes

Dilaprel is available as gelatin capsules with powdery contents. Active ingredient– ramipril. Used to treat arterial hypertension and heart failure. It is recommended to take in the morning, regardless of meals, with water.

The starting dose is 2.5 mg. If the blood pressure does not normalize within 3 weeks, the doctor may increase the dose to 5 mg per day. If this dose does not produce results, increase to 10 mg per day. Treatment should be carried out under constant monitoring attending physician.

Prenesa - a drug (group of inhibitors) reduces peripheral vascular resistance, blood pressure, increases cardiac output. The medicine improves renal and cardiac blood flow, increases the elasticity of the arteries, and reduces the load on the myocardium. Can be taken to prevent cardiovascular complications after a heart attack. The composition of 1 tablet of the drug Prenesa 2 mg includes: active substance– perindopril – 2 mg and additional substances. Available in the form of tablets in blisters of 10 pcs.

Diroton (Lisinopril) reduces precardiac resistance without affecting the heart rate, enhances eye and cardiac blood flow, and produces a vasodilator effect. It is used for mono- and complex therapy of hypertension and concomitant cardiovascular pathologies. Available by prescription in the form of tablets 5, 10, 20 mg. Active ingredient: lisinopril

Enap (Slovenia, KRKA company). Available in the form of tablets and solutions (for injection). The tablet contains 2.5, 5, 10 or 20 mg of enalapril maleate. Used to treat cardiovascular diseases. It works effectively, the quality is high, and side effects are extremely rare.

Lipril (ACE inhibitor) - the drug has the same indications for use and similar side effects. The active ingredient is lisinopril (lisinopril dihydrate), available in tablet form. It is usually taken once a day, at the same time in the morning, regardless of meals. The initial dose is 5 mg, but do not exceed the permissible maximum dose of 40 mg/day.

Capoten and captopril are almost similar in composition and effect on the body. Used in the treatment of hypertension and heart failure.

Capozide is prescribed if capoten does not give the desired result. Capozide contains captopril and diuretics: 50 mg of captopril and 25 mg of hydrochlorothiade, which enhances the effect of reducing pressure. Its action time is longer, so you can drink it once a day.

All drugs reduce blood pressure and are quite effective, each has certain contraindications. Kapoten is one of the best. Such medicines You cannot take it on your own, it can worsen your condition. Overdose can lead to sad consequences. A sharp drop in pressure is very dangerous for health and even life. If this happens, the person may lose consciousness and will need quick help doctors

The need for prescription, dose, schedule of administration, as well as the choice of drug is determined by the doctor. Its task is to take into account the accompanying chronic diseases and all the risks when selecting drugs for complex therapy.

He must observe the patient's response to the initial dose of the drug, reduce or increase it. Treatment takes place under the close attention of doctors to avoid the development of complications.

ACE inhibitor

Active ingredient

Release form, composition and packaging

Pills white to off-white in color, square with rounded edges, biconvex with a cross-shaped notch on one side and the word "SQUIBB" and the number "452" embossed on the other, with characteristic odor; Light marbling is allowed.

Excipients: microcrystalline cellulose - 40 mg, corn starch - 7 mg, stearic acid - 3 mg, lactose monohydrate - 25 mg.

10 pcs. - blisters (4) - cardboard packs.
14 pcs. - blisters (2) - cardboard packs.
14 pcs. - blisters (4) - cardboard packs.

Pharmacological action

ACE inhibitor. Suppresses the formation of angiotensin II and eliminates it vasoconstrictor effect on arterial and venous vessels.

Reduces peripheral vascular resistance, afterload, and lowers blood pressure. Reduces preload, reduces pressure in the right atrium and pulmonary circulation.

Reduces the release of aldosterone in the adrenal glands.

The maximum hypotensive effect is observed within 60-90 minutes after oral administration. The degree of blood pressure reduction is the same in the patient's standing and lying position.

The effectiveness and safety of captopril in children have not been established. The literature describes limited experience with the use of captopril in children. Children, especially neonates, may be more susceptible to developing hemodynamic side effects. There have been cases of excessive, prolonged and unpredictable increases in blood pressure, as well as associated complications, including oliguria and convulsions.

Pharmacokinetics

Suction

When taken orally, it is quickly absorbed from the gastrointestinal tract. Cmax in the blood is reached approximately 1 hour after administration. The bioavailability of captopril is 60-70%. Simultaneous use food slows down the absorption of the drug by 30-40%.

Distribution

Binding to blood proteins is 25-30%.

Removal

T1/2 is 2-3 hours. The drug is excreted from the body mainly in the urine, up to 50% unchanged, the rest in the form of metabolites.

Indications

- arterial hypertension, incl. renovascular;

— chronic failure(consisting of combination therapy);

— dysfunction of the left ventricle after myocardial infarction in a clinically stable condition;

— diabetic nephropathy against the background of type 1 diabetes mellitus (with albuminuria >30 mg/day).

Contraindications

- history of angioedema (Quincke's edema) associated with the use of ACE inhibitors;

- hereditary/idiopathic angioedema;

- severe renal dysfunction;

- severe liver dysfunction;

- refractory hyperkalemia;

- bilateral stenosis renal arteries or stenosis of the artery of a single kidney with progressive azotemia;

— condition after kidney transplantation;

- stenosis of the aortic mouth and similar obstructive changes that impede the outflow of blood from the left ventricle;

- simultaneous use with aliskiren and aliskiren-containing drugs in patients with diabetes mellitus or impaired renal function (GFR less than 60 ml/min);

- lactose intolerance, lactase deficiency and glucose-galactose malabsorption syndrome;

- pregnancy;

- lactation period ( breastfeeding);

- age under 18 years (efficacy and safety have not been established);

— increased sensitivity to the components of the drug and other ACE inhibitors.

WITH caution the drug should be prescribed for severe autoimmune diseases connective tissue(including SLE, scleroderma); inhibition of bone marrow hematopoiesis (risk of developing neutropenia and agranulocytosis); cerebral ischemia; diabetes mellitus(increased risk of developing hyperkalemia); primary hyperaldosteronism; IHD; conditions accompanied by a decrease in blood volume (including vomiting, diarrhea); arterial hypotension; impaired renal and/or liver function; chronic heart failure; performing surgery/general anesthesia; patients on hemodialysis; patients on a sodium-restricted diet; when performing hemodialysis using high-strength membranes (for example, AN69), desensitizing therapy, LDL apheresis; simultaneous use potassium-sparing diuretics, potassium preparations, potassium-containing substitutes, lithium preparations, allopurinol, procainamide (risk of developing neutropenia, agranulocytosis); elderly patients (dose adjustment required); black patients.

Dosage

The drug is taken orally 1 hour before meals. The dosage regimen is set individually.

At arterial hypertension The initial dose is 12.5 mg (1/2 tablet 25 mg) 2 times a day. If necessary, the dose is increased gradually (with an interval of 2-4 weeks) until the optimal effect is achieved. At mild and moderate arterial hypertension the maintenance dose is 25 mg 2 times/day; maximum dose is 50 mg 2 times/day. At severe arterial hypertension The initial dose is 12.5 mg (1/2 tablet 25 mg) 2 times a day. The dose is gradually increased to a maximum daily dose of 150 mg (50 mg 3 times a day).

At chronic heart failure The initial daily dose is 6.25 mg (1/4 tablet 25 mg) 3 times a day. If necessary, the dose is increased gradually (at intervals of at least 2 weeks). The maintenance dose is 25 mg 2-3 times/day. The maximum daily dose is 150 mg. If diuretic therapy was carried out before prescribing Capoten, it is necessary to exclude the presence of a pronounced decrease in the content of electrolytes and bcc.

At dysfunction of the left ventricle after myocardial infarction in patients who are in a clinically stable condition, the use of the drug Capoten can be started within 3 days after myocardial infarction. The initial dose is 6.25 mg/day (1/4 tablet 25 mg), then daily dose can be increased to 37.5-75 mg in 2-3 doses (depending on drug tolerance) up to a maximum of 150 mg/day.

At diabetic nephropathy the drug is prescribed in a dose of 75-100 mg, divided into 2-3 doses. At type 1 diabetes mellitus with microalbuminuria(albumin clearance 30-300 mg/day) the dose of the drug is 50 mg 2 times/day. For proteinuria more than 500 mg/day, the drug is effective at a dose of 25 mg 3 times/day.

Patients with moderate renal impairment (creatinine clearance ≥ 30 ml/min/1.73 m2) Capoten is prescribed at a dose of 75-100 mg/day. At severe violations renal function (KR)<30 мл/мин/1.73 м 2) the initial dose is no more than 12.5 mg/day (1/2 tablet 25 mg). In the future, if necessary, the dose is gradually increased (at fairly large intervals), but a smaller than usual daily dose of the drug is used.

Elderly patients the dose is selected individually. It is recommended to start treatment with a dose of 6.25 mg (1/4 tablet 25 mg) 2 times a day and, if possible, maintain it at this level.

If necessary, loop diuretics are additionally prescribed rather than thiazide diuretics.

Side effects

Determination of the frequency of adverse reactions: often (≥1/100,<1/10); нечасто (≥1/1000, <1/100), редко (≥1/10 000, <1/1000), очень редко (<1/10 000).

From the cardiovascular system: uncommon - tachycardia or arrhythmia, angina pectoris, palpitations, orthostatic hypotension, excessive decrease in blood pressure, Raynaud's syndrome, flushing of the face, pallor; very rarely - cardiac arrest, cardiogenic shock.

From the respiratory system: often - dry non-productive cough, shortness of breath; very rarely - bronchospasm, eosinophilic pneumonitis, rhinitis, pulmonary edema.

For the skin and subcutaneous tissues: often - itching of the skin, with or without rashes, skin rashes, alopecia.

Allergic reactions: uncommon - angioedema of the extremities, face, lips, mucous membranes, tongue, pharynx and larynx; rarely - angioedema of the intestine; very rarely - urticaria, Stevens-Johnson syndrome, erythema multiforme, photosensitivity, erythroderma, pemphigoid reactions, exfoliative dermatitis, allergic alveolitis, eosinophilic pneumonia.

From the nervous system: often - drowsiness, dizziness, insomnia; uncommon - headache, paresthesia; rarely - ataxia; very rarely - confusion, depression, cerebrovascular accidents, including stroke and syncope, blurred vision.

From the hematopoietic system: very rarely - neutropenia, agranulocytosis, pancytopenia, lymphadenopathy, eosinophilia, thrombocytopenia, anemia (including aplastic and hemolytic forms).

From the immune system: very rarely - increased titer of antinuclear antibodies, autoimmune diseases.

From the digestive system: often - nausea, vomiting, irritation of the gastric mucosa, abdominal pain, diarrhea, constipation, taste disturbance, dry oral mucosa, dyspepsia; infrequently - anorexia; rarely - stomatitis, aphthous stomatitis; very rarely - glossitis, gastric ulcer, pancreatitis, gingival hyperplasia, impaired liver function and cholestasis (including jaundice), increased activity of liver enzymes, hepatitis (including rare cases of hepatonecrosis), hyperbilirubinemia.

From the musculoskeletal system: very rarely - myalgia, arthralgia.

From the urinary system: rarely - renal dysfunction (including renal failure), polyuria, oliguria, frequent urination; very rarely - nephrotic syndrome.

From the reproductive system: very rarely - impotence, gynecomastia.

Other: infrequently - peripheral edema, chest pain, increased fatigue, feeling of general malaise, asthenia; rarely - hyperthermia.

Laboratory indicators: very rarely - proteinuria, eosinophilia, hyperkalemia, hyponatremia, increased levels of urea nitrogen, bilirubin and creatinine in the blood, decreased hematocrit, decreased hemoglobin, leukocytes, platelets, hypoglycemia.

Overdose

Symptoms: a sharp decrease in blood pressure, shock, stupor, bradycardia, water and electrolyte imbalance, renal failure.

Treatment: gastric lavage, administration of adsorbents and sodium sulfate within 30 minutes after taking the drug, administration of a 0.9% solution or other plasma-substituting drugs (the patient should first be transferred to a horizontal position with a low head, then measures should be taken to replenish the blood volume), hemodialysis. In case of bradycardia or pronounced vagal reactions, administration of atropine. The use of an artificial pacemaker may be considered. Peritoneal dialysis is not effective in removing captopril from the body.

Drug interactions

In patients taking diuretics, Capoten may potentiate the hypotensive effect. Strict restriction of table salt intake (salt-free diets) and hemodialysis also have a similar effect. Typically, an excessive decrease in blood pressure occurs within the first hour after taking the first prescribed dose of Capoten.

Vasodilators (for example, nitroglycerin) in combination with Capoten should be used in the lowest effective doses due to the risk of excessive reduction in blood pressure.

Caution should be exercised when using the drug Capoten (without or with a diuretic) and drugs that affect the sympathetic nervous system (for example, ganglion blockers, alpha-blockers).

When using the drug Capoten and indomethacin together (and possibly other NSAIDs, for example), a decrease in the hypotensive effect may be observed, especially in arterial hypertension accompanied by low renin activity. In patients with risk factors (elderly age, hypovolemia, concomitant use of diuretics, impaired renal function), simultaneous use of NSAIDs (including COX-2 inhibitors) and ACE inhibitors (including captopril) can lead to deterioration of renal function, including acute renal failure. Usually, renal dysfunction in such cases is reversible. Renal function should be periodically checked in patients taking Capoten and NSAIDs.

When treating with Capoten, potassium-sparing diuretics (for example, triamterene, spironolactone, amiloride), potassium supplements, potassium supplements, salt substitutes (contain significant amounts of potassium ions) should be prescribed only for proven hypokalemia, because their use increases the risk of developing hyperkalemia.

With the simultaneous use of ACE inhibitors (especially in combination with diuretics) and lithium preparations, it is possible to increase the lithium content in the blood serum, and, consequently, the toxicity of lithium preparations. Serum lithium levels should be periodically determined.

When insulin and oral hypoglycemic agents, such as sulfonylureas, are used simultaneously with ACE inhibitors, including Capoten, an excessive decrease in blood glucose concentrations is possible. It is necessary to monitor the concentration of glucose in the blood at the beginning of therapy with Capoten and, if necessary, adjust the dose of the hypoglycemic drug.

Dual blockade of the RAAS caused by the simultaneous use of ACE inhibitors and angiotensin II receptor antagonists or aliskiren and aliskiren-containing drugs was associated with an increased incidence of side effects such as arterial hypotension, hyperkalemia, and decreased renal function (including acute renal failure).

The use of Capoten in patients receiving allopurinol or procainamide increases the risk of developing neutropenia and/or Stevens-Johnson syndrome.

The use of Capoten in patients receiving immunosuppressants (for example, cyclophosphacine or azathioprine) increases the risk of developing hematological disorders.

Special instructions

Before starting, as well as regularly during treatment with Capoten, renal function should be monitored. In patients with chronic heart failure, Capoten should be used under close medical supervision.

When using ACE inhibitors, a characteristic non-productive cough is observed, which ceases after discontinuation of ACE inhibitor therapy.

In rare cases, when using ACE inhibitors, a syndrome is observed that begins with the appearance of cholestatic jaundice, turning into fulminant hepatonecrosis, sometimes with a fatal outcome. The mechanism of development of this syndrome is unknown. If a patient receiving ACE inhibitor therapy develops jaundice or a marked increase in liver enzymes, treatment with ACE inhibitors should be discontinued and the patient should be monitored.

Some patients with kidney disease, especially those with severe renal artery stenosis, experience increases in serum urea nitrogen and creatinine concentrations after lowering blood pressure. This increase is usually reversible after discontinuation of therapy with Capoten. In these cases, it may be necessary to reduce the dose of Capoten and/or discontinue the diuretic.

During long-term use of the drug Capoten, approximately 20% of patients experience an increase in the concentration of urea and creatinine in the blood serum by more than 20% compared to the norm or the initial value. In less than 5% of patients, especially with severe nephropathy, treatment discontinuation is required due to an increase in creatinine concentration.

The use of dual blockade of the RAAS caused by the simultaneous use of ACE inhibitors and angiotensin II receptor antagonists or aliskiren and aliskiren-containing drugs is not recommended, as it has been associated with an increased incidence of side effects such as arterial hypotension, hyperkalemia, decreased renal function (including acute renal failure). If the simultaneous use of ACE inhibitors and angiotensin II receptor antagonists (dual blockade of the RAAS) is necessary, then treatment should be carried out under the supervision of a physician and with constant monitoring of renal function, electrolyte levels in the blood, and blood pressure.

In patients with arterial hypertension, when using the drug Capoten, severe arterial hypotension is observed only in rare cases; the likelihood of developing this condition increases with increased loss of fluid and salts (for example, after intensive treatment with diuretics), in patients with heart failure or on dialysis. The possibility of a sharp decrease in blood pressure can be minimized by first withdrawing (4-7 days before) the diuretic or increasing the intake of sodium chloride (approximately a week before starting treatment), or by prescribing the drug Capoten at the beginning of treatment in low doses (6.25-12.5 mg /day).

The drug should be prescribed with caution to patients on a low-sodium or salt-free diet (increased risk of hypotension and hyperkalemia).

An excessive decrease in blood pressure may occur in patients during major surgical operations, as well as when using anesthetics that have a hypotensive effect. In such cases, to correct low blood pressure, measures to increase blood volume are used.

Excessive reduction in blood pressure due to the use of antihypertensive drugs may increase the risk of myocardial infarction or stroke in patients with coronary artery disease or cerebrovascular disease. If arterial hypotension develops, the patient should be placed in a horizontal position with a low headboard. IV administration of 0.9% sodium chloride solution may be required.

Caution should be exercised when using ACE inhibitors in patients with mitral/aortic stenosis/hypertrophic obstructive cardiomyopathy; in case of cardiogenic shock and hemodynamically significant obstruction, the use of the drug is not recommended.

Neutropenia/agranulocytosis, thrombocytopenia and anemia have been reported in patients taking ACE inhibitors. Neutropenia is rare in patients with normal renal function and no other abnormalities. In renal failure, simultaneous use of the drug Capoten and allopurinol led to neutropenia.

The drug Capoten should be used very carefully in patients with autoimmune connective tissue diseases, those taking immunosuppressants, allopurinol and procainamide, especially in the presence of pre-existing renal dysfunction. Due to the fact that the majority of fatal cases of neutropenia during the use of ACE inhibitors developed in such patients, their blood leukocyte count should be monitored before starting treatment, in the first 3 months - every 2 weeks, then every 2 months.

In all patients, the number of leukocytes in the blood should be monitored monthly in the first 3 months after starting therapy with Capoten, then every 2 months. If the number of leukocytes is below 4000/μl, a repeat general blood test is indicated; below 1000/μl, the drug is stopped while monitoring the patient continues. Typically, restoration of the number of neutrophils occurs within 2 weeks after discontinuation of the drug Capoten. In 13% of cases of neutropenia, death was noted. In almost all cases, fatal neutropenia was observed in patients with connective tissue diseases, renal or heart failure, while taking immunosuppressive drugs, or a combination of both of these factors.

When using ACE inhibitors, proteinuria may occur, mainly in patients with impaired renal function, as well as when using the drug in high doses. In most cases, proteinuria when using the drug Capoten disappeared or its severity decreased within 6 months, regardless of whether the drug was stopped or not. Renal function tests (blood urea nitrogen and creatinine concentrations) in patients with proteinuria were almost always within normal limits. In patients with kidney disease, the protein content in the urine should be determined before starting treatment and periodically throughout the course of therapy. In some cases, against the background of the use of ACE inhibitors, incl. the drug Capoten, an increase in potassium content in the blood serum is observed. The risk of developing hyperkalemia when using ACE inhibitors is increased in patients with renal failure and diabetes mellitus, as well as those taking potassium-sparing diuretics, potassium supplements, or other drugs that cause an increase in potassium levels in the blood (for example, heparin). The simultaneous use of potassium-sparing diuretics and potassium supplements should be avoided. In addition, when using ACE inhibitors simultaneously with thiazide diuretics, the risk of hypokalemia cannot be excluded, therefore, in such cases, regular monitoring of potassium levels in the blood during therapy should be carried out.

When performing hemodialysis in patients receiving ACE inhibitors, the use of dialysis membranes with high permeability (for example, AN69) should be avoided, since in such cases the risk of developing anaphylactoid reactions increases. Anaphylactoid reactions have also been observed in patients undergoing LDL apheresis with dextran sulfate. The use of either a different class of antihypertensive drugs or a different type of dialysis membrane should be considered.

In rare cases, during therapy with ACE inhibitors, life-threatening anaphylactoid reactions were observed in patients undergoing desensitization with hymenoptera venom (bees, wasps). In such patients, these reactions were prevented by temporarily stopping ACE inhibitor therapy. Particular care should be taken when desensitization is performed in such patients.

If angioedema develops, the drug is discontinued and careful medical observation is carried out until the symptoms disappear completely. Angioedema of the larynx can be fatal. If the swelling is localized on the face, special treatment is usually not required (antihistamines can be used to reduce the severity of symptoms); if the swelling spreads to the tongue, pharynx or larynx and there is a threat of developing airway obstruction, epinephrine (adrenaline) should be immediately administered subcutaneously (0.3-0.5 ml in a dilution of 1:1000). In rare cases, patients after taking ACE inhibitors experienced angioedema of the intestine, which was accompanied by abdominal pain (with or without nausea and vomiting), sometimes with normal values of C-1-esterase activity and without previous facial edema. Intestinal edema should be included in the differential diagnosis of patients with complaints of abdominal pain when using ACE inhibitors.

In representatives of the Negroid race, cases of the development of angioedema were noted with a higher frequency compared to representatives of the Caucasian race.

ACE inhibitors are less effective in blacks than in Caucasians, which may be due to the higher prevalence of low renin activity in blacks.

In patients with diabetes mellitus receiving hypoglycemic agents (oral hypoglycemic agents or insulin), glycemic levels should be carefully monitored, especially during the first month of therapy with ACE inhibitors.

When undergoing major surgery or when using general anesthesia agents that have a hypotensive effect, patients taking ACE inhibitors may experience an excessive decrease in blood pressure. In these cases, it is possible to increase the BCC.

When using the drug Capoten, a false-positive reaction may occur when analyzing urine for acetone.

Impact on the ability to drive vehicles and operate machinery

During the treatment period, it is necessary to refrain from driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions, because Dizziness may occur, especially after taking the initial dose.

Pregnancy and lactation

The use of the drug Capoten is contraindicated during pregnancy.

The drug Capoten should not be used in the first trimester of pregnancy. There have been no adequate controlled studies of the use of ACE inhibitors in pregnant women. The limited available data on the effects of the drug in the first trimester of pregnancy indicate that the use of ACE inhibitors does not lead to fetal malformations associated with fetotoxicity. Epidemiological data demonstrating a risk of teratogenicity after exposure to ACE inhibitors in the first trimester of pregnancy have not been convincing, but some increase in risk cannot be excluded. If the use of an ACE inhibitor is considered necessary, patients planning pregnancy should be switched to alternative antihypertensive therapy that has an established safety profile for use during pregnancy.

It is known that long-term exposure of the fetus to ACE inhibitors in the second and third trimesters of pregnancy can lead to disruption of its development (decreased renal function, oligohydramnios, delayed ossification of the skull bones) and the development of complications in the newborn (such as renal failure, arterial hypotension, hyperkalemia) . If the patient received the drug Capoten in the second and third trimesters of pregnancy, it is recommended to conduct an ultrasound examination to assess the condition of the skull bones and fetal kidney function.

The use of ACE inhibitors during pregnancy can cause developmental disorders (including arterial hypotension, neonatal hypoplasia of the skull bones, anuria, reversible or irreversible renal failure) and fetal death. If the fact of pregnancy is established, the use of the drug Capoten should be discontinued as soon as possible.

Approximately 1% of a given dose of captopril is found in breast milk. Due to the risk of serious adverse reactions in the child, breastfeeding should be stopped or therapy with Capoten should be discontinued in the mother during the period of breastfeeding.

Use in old age

WITH caution The drug should be prescribed to elderly patients (dose adjustment required).

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Storage conditions and periods

The drug should be stored out of reach of children, in a dry place at a temperature not exceeding 25°C. Shelf life - 5 years.

In this article you can read the instructions for use of the drug Kapoten. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Capoten in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Kapoten analogues in the presence of existing structural analogues. Use for the treatment of arterial hypertension and the reduction of high blood pressure in adults, children, as well as during pregnancy and lactation.

Kapoten- ACE inhibitor. Active ingredient: Captopril. Suppresses the formation of angiotensin 2 and eliminates its vasoconstrictive effect on arterial and venous vessels.

Reduces peripheral vascular resistance, afterload, and lowers blood pressure. Reduces preload, reduces pressure in the right atrium and pulmonary circulation.

Reduces the release of aldosterone in the adrenal glands.

Pharmacokinetics

When taken orally, the bioavailability of captopril is 60-70%. Simultaneous food intake slows down the absorption of the drug by 30-40%. The drug is excreted from the body mainly through urine, up to 50% unchanged.

Indications

arterial hypertension, incl. renovascular;
chronic heart failure (as part of combination therapy);
dysfunction of the left ventricle after myocardial infarction in a clinically stable condition;
diabetic nephropathy due to type 1 diabetes mellitus (with albuminuria >30 mg per day).

Release forms

Tablets 25 mg and 50 mg.

Instructions for use and dosage

Capoten is prescribed orally 1 hour before meals. The dosage regimen is set individually.

For arterial hypertension, the initial dose is 12.5 mg 2 times a day. If necessary, the dose is increased gradually (with an interval of 2-4 weeks) until the optimal effect is achieved. For mild and moderate arterial hypertension, the average therapeutic dose is 25 mg 2 times a day; the maximum dose is 50 mg 2 times a day. For severe arterial hypertension, the initial dose is 12.5 mg 2 times a day. The dose is gradually increased to a maximum daily dose of 150 mg (50 mg 3 times a day).

For chronic heart failure, Capoten is prescribed in cases where the use of diuretics does not provide an adequate effect. The initial dose is 6.25 mg 3 times a day. If necessary, the dose is increased every 2 weeks. Maintenance dose - 25 mg 2-3 times a day. The maximum daily dose is 150 mg.

In cases of left ventricular dysfunction after myocardial infarction in patients who are in a clinically stable condition, the use of Capoten can be started within 3 days after myocardial infarction. The initial dose is 6.25 mg per day, then the daily dose can be increased to 37.5-75 mg in 2-3 doses (depending on the tolerability of the drug) up to a maximum of 150 m per day.

For diabetic nephropathy, the daily dose is from 75 mg to 100 mg, divided into 2-3 doses. For insulin-dependent diabetes mellitus with microalbuminuria (albumin clearance 30-300 mg per day), the dose of the drug is 50 mg 2 times a day. With a total protein clearance of more than 500 mg per day, the drug is effective at a dose of 25 mg 3 times a day.

For elderly patients, the dose is selected individually. It is recommended to start treatment with the lowest therapeutic dose of 6.25 mg 2 times a day and, if possible, maintain it at this level.

If necessary, loop diuretics are additionally prescribed rather than thiazide diuretics.

Side effect

orthostatic hypotension;
tachycardia;
peripheral edema;
dry cough (usually disappears after discontinuation of the drug);
bronchospasm;
pulmonary edema;
angioedema of the extremities, face, lips, mucous membranes, tongue, pharynx or larynx;
headache, dizziness;
paresthesia;
drowsiness;
visual impairment;
hyperkalemia, hyponatremia;
neutropenia, agranulocytosis, thrombocytopenia, anemia;
taste disturbance;
dry mouth;
stomatitis;
stomach ache;
diarrhea.

Contraindications

angioedema (hereditary or associated with a history of ACE inhibitor use);
severe renal dysfunction;
severe liver dysfunction;
hyperkalemia;
bilateral renal artery stenosis or stenosis of the artery of a single kidney with progressive azotemia;
condition after kidney transplantation;
stenosis of the aortic mouth and similar obstructive changes that impede the outflow of blood from the left ventricle;
pregnancy;
lactation period (breastfeeding);
age under 18 years;
hypersensitivity to the drug and other ACE inhibitors.

Use during pregnancy and breastfeeding

The drug is contraindicated for use during pregnancy and lactation.

Special instructions

With long-term use of Capoten, approximately 20% of patients experience an increase in urea and creatinine in the blood serum by more than 20% compared to the norm or the initial value. In less than 5% of patients, especially with severe nephropathy, treatment discontinuation is required due to an increase in creatinine concentration.

In patients with arterial hypertension, when using Capoten, severe arterial hypotension is observed only in rare cases; the likelihood of developing this condition increases with increased loss of fluid and salts (for example, after intensive treatment with diuretics), in patients with heart failure or on dialysis.

The possibility of a sharp decrease in blood pressure can be minimized by first withdrawing (4-7 days before) the diuretic or increasing the intake of sodium chloride (approximately a week before starting treatment), or by prescribing Capoten at the beginning of treatment in small doses (6.25-12.5 mg per day). day).

In the first 3 months. therapy, the number of blood leukocytes should be monitored monthly, then once every 3 months. In patients with autoimmune diseases, the number of leukocytes in the first 3 months. Treatment should be monitored every 2 weeks, then every 2 months. If the number of leukocytes is less than 4000/μl, a general blood test is indicated; if less than 1000/μl, the drug is stopped.

In some cases, against the background of the use of ACE inhibitors, incl. Kapoten, there is an increase in the concentration of potassium in the blood serum. The risk of developing hyperkalemia when using ACE inhibitors is increased in patients with renal failure and diabetes mellitus, as well as those taking potassium-sparing diuretics, potassium supplements, or other drugs that cause an increase in the concentration of potassium in the blood (for example, heparin). The simultaneous use of potassium-sparing diuretics and potassium supplements with Capoten should be avoided.

When performing hemodialysis in patients receiving Capoten, the use of dialysis membranes with high permeability (for example, AN 69) should be avoided, since in such cases the risk of developing anaphylactoid reactions increases.

If angioedema develops, the drug is discontinued and careful medical observation is carried out. If the swelling is localized on the face, special treatment is usually not required (antihistamines can be used to reduce the severity of symptoms); if the swelling spreads to the tongue, pharynx or larynx and there is a risk of developing airway obstruction, 0.5 ml of a 0.1% solution of epinephrine (adrenaline) should be immediately administered.

When taking Capoten, a false-positive reaction may occur in a urine test for acetone.

Capoten should be prescribed with caution to patients on a low-salt or salt-free diet, because in this case, the risk of developing arterial hypotension increases.

If symptomatic arterial hypotension occurs after taking Capoten, the patient should take a horizontal position with legs elevated.

Use in pediatrics

The safety and effectiveness of the drug in children and adolescents under 18 years of age have not been established.

Impact on the ability to drive vehicles and operate machinery

Drug interactions

Diuretics and vasodilators (for example, minoxidil) enhance the antihypertensive effect of the drug Capoten.

Indomethacin and other NSAIDs may reduce the antihypertensive effect of Capoten.

Concomitant use of Capoten with potassium-sparing diuretics (triamterene, amiloride and spironolactone) or potassium supplements can lead to hyperkalemia.

The simultaneous use of lithium salts and Capoten may lead to an increase in the concentration of lithium in the blood serum.

During the simultaneous use of Capoten with allopurinol and procainamide, neutropenia and/or Stevens-Johnson syndrome may occur.

When used simultaneously with Capoten, immunosuppressants (for example, azathioprine and cyclophosphamide) increase the risk of developing hematological disorders.

Analogues of the drug Capoten

Structural analogues of the active substance:

Alkadyl;
Angiopril-25;
Blockordil;
Vero-Captopril;
Captopril;
Captopril Sandoz;
Captopril-AKOS;
Captopril-Acri;
Captopril-Ferein;
Katopil;
Epsitron.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.