Square shaped blood pressure tablets. What are the symptoms of an overdose of Capoten?

One of the most commonly used drugs for persistent increases in blood pressure is Capoten. This drug is not a new pharmacology and belongs to the group of ACE inhibitors. It is used for first aid during hypertensive crises and treatment of acute attacks of hypertension. How exactly to take Capoten, the instructions for use, at what pressure, will tell you.

One of the most commonly used drugs for persistent increases in blood pressure is "Capoten"

Properties of the drug

The tablets dissolve in the gastrointestinal tract. The bioavailability of the active component of the drug is 65%. The product is not recommended to be used with meals, because the presence of food in the digestive tract slows down the absorption of the active component by 30%. The therapeutic effect begins 10 minutes after consuming the capsule. But the maximum concentration of the active substance in the blood is achieved after 1.5 hours. The hypotensive effect lasts 6 hours.

The active component of the capsules is excreted from the body mainly by the kidneys (up to 90%). In this case, almost half of the substance comes out unchanged.

Features of the composition and form of release

The main active ingredient of the drug is captopril. The drug is produced in one pharmacological form - square tablets of white (sometimes with a slight beige tint) color. There are two types of dosage of the active substance - 25 and 50 mg. In addition to the main component, the tablets contain additional inactive components:

starch (most often corn);
lactose;
cellulose.

Capsules are packaged in blisters of 14 pieces. One cardboard package contains 28 tablets.

Corn starch is included in this medicine

Therapeutic effect

The medicine reduces the pressure and load during the work of the heart muscle. The therapeutic effect of the drug is due to the ability of the active substance to block the transition of the enzyme angiotensin I to a new form - angiotensin II (it narrows the lumen of the veins and provokes an increase in blood pressure). After the enzyme stops being produced, the following changes occur in the patient’s body:

the lumen of the veins remains dilated, as a result of which the tonometer readings and the workload on the heart are reduced;
if you regularly take Capoten for blood pressure, the upper and lower values remain within the acceptable values. Most patients are interested in how many days of therapy it takes to achieve stable results. Cardiologists emphasize that a persistent decrease in tonometer readings is achieved after 6 weeks of therapy;
While taking the medication, patients do not experience swelling of the soft tissues, so there is no need to take additional diuretics.

Captopril increases the lumen of arteries to a greater extent, rather than venous vessels. And when treating ischemia, it improves blood supply to the affected areas of the heart muscle.

Captopril increases arterial lumen to a greater extent

Instructions for use

Before starting a course of treatment with Capoten, the instructions for use at what pressure and pathologies recommend different dosage regimens. Therapy begins with a minimum amount (12.5 mg of captopril), increasing the amount of medication weekly to the required individual maintenance level. For each pathology this level is different. For example, a standard treatment regimen for hypertension looks like this:

start taking ½ part of a tablet (12.5 mg of active ingredient) 2 times a day;
if Capoten does not cause adverse reactions, but this dosage is not enough to maintain stable tonometer readings, after 2 weeks it is doubled - take 1 tablet 2 times a day;
in the initial and middle stages of hypertension, it is enough to take 25 mg of the active substance at a time every 12 hours. If symptoms of arterial hypertension of the third or fourth degree appear (blood pressure higher than 170/100), the dosage is gradually increased to 50 mg of the active component per use.

Capsules must not be crushed or cracked. They are swallowed whole, washed down with a small amount of liquid;

Capsules must not be crushed or bitten

food reduces the absorption of the active substance by the mucous membranes of the stomach, so it is recommended to take the drug on an empty stomach;
How to take Capoten correctly for high blood pressure, if you need to stop an attack and quickly reduce your tonometer readings? Cardiologists recommend placing the capsule under the tongue without swallowing it. Blood pressure decreases after 10–15 minutes. And the duration of action of the medicine is 5 hours.

The maximum permissible daily dose of the drug is 300 mg of captopril. Using the drug in higher doses is considered inappropriate - the therapeutic effect will not increase, but the side effects will only become more pronounced.

Indications for use

This drug is prescribed to patients with the following pathologies:

hypertension of various origins;
chronic heart failure (as one of the drugs in complex therapy);
impaired functioning of the left ventricle, observed in people who have had a heart attack;
nephropathy observed in diabetics.

For hypertension, "Capoten" is prescribed

A plan for how to take Capoten for high blood pressure is drawn up by your attending physician. The dosage and schedule for using capsules are completely individual and directly depend on the clinical picture of the pathology and the presence of concomitant diseases.

Contraindications for use

Like all antihypertensive drugs, Capoten has a number of contraindications. People with the following pathologies should not take the medicine:

disruption of blood outflow (circulation) resulting from narrowing of the aortic lumen;
renal failure;
liver dysfunction;
renal artery stenosis;
increased potassium levels in the body;
the period of bearing and breastfeeding a child;
childhood, adolescence;
individual sensitivity to the components of the product.

There are a number of relative contraindications to treatment with the drug, during which the doctor determines how to take Capoten for high blood pressure and constantly monitors the patient’s well-being. These include:

ischemia of the cerebral arteries;
elderly age;
a hemodialysis procedure necessary for autoimmune muscle diseases.

If a hypertensive person has a condition that provokes a decrease in the volume of circulating blood (diarrhea, vomiting, hyperhidrosis), the use of capsules is temporarily stopped until the person’s well-being stabilizes. For this, symptomatic therapy is used. During the course of treatment, hypertensive patients must constantly monitor blood pressure levels and the biochemical composition of the blood. As practice shows, 20% of patients experience an increase in blood urea concentration by 15% of normal. Sometimes, poor laboratory test results require discontinuation of capsule therapy.

Older people should not take this drug

Features of treatment during pregnancy

The medicine is not used to correct blood pressure in pregnant women. Experiments conducted on animals have shown that taking captopril in 85% of cases leads to fetal death. What to do if conception occurred during a course of capsule treatment? The woman is transferred to treatment with relatively safe medications and the state of intrauterine development of the embryo is assessed.

During lactation, you should not take Capoten to treat hypertension. There is no data on what concentration of the active substance is in breast milk and how exactly it will affect the baby’s well-being.

During lactation, you should not take Capoten for the treatment of hypertension.

Drug interactions with other medications

Different active ingredients contained in drugs from different groups enhance or weaken the effect of captopril. Therefore, to draw up a regimen for taking capsules, the cardiologist must know what concomitant medications the patient is taking:

Diuretics and vasodilators enhance the hypotensive effect of Capoten.
Nonsteroidal anti-inflammatory drugs, for example, Indomethacin, reduce the effect of the active substance on the body.
When taking capsules simultaneously with diuretics that do not remove potassium (Triamterene), hyperkalemia may develop.
The simultaneous use of Capoten and immunosuppressants (Azathioprine, Cyclophosphamide) increases the likelihood of hematological dysfunctions of the body.

Most men are interested in drug interactions between the drug and potency stimulants. "Capoten" is one of the few antihypertensive medications that do not affect sexual desire in men. Therefore, there is no data on such drug interactions.

"Indomethacin" reduces the effect of the active substance on the body

Side effects

In most cases, the drug is well tolerated by the body. Mild side effects may occur at the very beginning of therapy and with prolonged use of capsules. Most often observed:

heart rhythm disturbance (tachycardia);
dry cough, less often – swelling and spasm of the bronchi;
the appearance of soft tissue swelling. Often - lips, lower extremities. Rarely – swelling of the tongue, mucous membranes of the larynx;
there is the appearance of dermatitis, a feeling of itching of the skin;
drowsiness, fatigue;
headache, which is sometimes accompanied by dizziness;
disruption of digestive processes (constipation, diarrhea, cramping pain in the stomach).

Headache, which is sometimes accompanied by dizziness

As patient reviews show, taking the drug does not affect the ability to drive. The exception is exacerbation of side effects.

Rare cases of drug overdose have been recorded. Mainly due to hypertensive patients violating the recommended capsule use regimen. The main symptoms of an overdose are a sharp decrease in blood pressure to a critically low level. You cannot take measures on your own in such cases. The patient should lie face down and wait for an ambulance. Treatment consists of using drugs with the opposite effect of Capoten.

Kapoten: instructions for use and reviews

Capoten is a drug with an antihypertensive effect.

Release form and composition

Capoten is produced in the form of tablets: square with rounded edges, from white with a creamy tint to white, biconvex with a cross-shaped notch on one side, on the other - with the number “452” and the embossed word “SQUIBB”, with a characteristic odor; light marbling is acceptable (in bottles of 40 pcs., 1 bottle in a cardboard box; in blisters of 10, 14, 15 pcs., 1-4 blisters in a cardboard box).

1 tablet contains:

Active substance: captopril – 25 or 50 mg;
Auxiliary components: microcrystalline cellulose, stearic acid, corn starch, lactose.

Pharmacological properties

Pharmacodynamics

Captopril, the active substance of Capoten, is an ACE inhibitor (angiotensin-converting enzyme). As a result of therapy, the formation of angiotensin II is suppressed and its vasoconstrictor effect on the venous and arterial vascular systems is eliminated.

Main effects of Kapoten:

decrease in preload, decrease in pressure in the right atrium and pulmonary circulation;
decrease in TPVR (total peripheral vascular resistance), afterload, decrease in blood pressure;
decreased secretion of aldosterone in the adrenal glands.

The development of the maximum hypotensive effect is observed within 60–90 minutes after oral administration. The decrease in blood pressure is equally pronounced in standing and lying positions.

In children, the effectiveness/safety of captopril therapy has not been established. Children, especially newborns, may be more susceptible to hemodynamic adverse reactions. There are reports of excessive, unpredictable and prolonged increases in blood pressure, as well as complications associated with it, including seizures and oliguria.

Pharmacokinetics

When taken orally, captopril is rapidly absorbed from the gastrointestinal tract. Cmax (maximum concentration) in blood plasma is achieved in approximately 60 minutes. The bioavailability of captopril is from 60 to 70%. When taken simultaneously with food, the absorption of the drug slows down by 30–40%.

Captopril binding to blood proteins is 25–30%.

T1/2 (half-life) ranges from 2 to 3 hours. Excretion is carried out mainly through urine; a smaller part (up to 50%) is unchanged, a large part is in the form of metabolites.

Indications for use

Arterial hypertension, including renovascular;
Left ventricular dysfunction after myocardial infarction (in patients in a clinically stable condition);
Chronic heart failure (simultaneously with other drugs);
Diabetic nephropathy in patients with type 1 diabetes mellitus (with albuminuria >30 mg per day).

Contraindications

Severe functional disorders of the liver and kidneys;
Hyperkalemia;
Quincke's edema (hereditary or associated with a history of use of angiotensin-converting enzyme inhibitors);
Arterial stenosis of a solitary kidney with progressive azotemia or bilateral renal artery stenosis;
Conditions after kidney transplantation, aortic stenosis and other obstructive changes that impede the outflow of blood;
Pregnancy and lactation;
Hypersensitivity to the components of the drug (currently or in history, including to other angiotensin-converting enzyme inhibitors).

The safety and effectiveness of Capoten in children have not been studied.

Instructions for use of Capoten: method and dosage

Capoten tablets are taken orally.

The dosage regimen is determined by the indications.

For arterial hypertension, the doctor selects the dose of Capoten individually. The drug must be taken in the minimum effective dose.

The initial dose for mild to moderate hypertension is 12.5 mg 2 times a day, maintenance dose is 25 mg 2 times a day. If necessary, the dose can be increased every 2-4 weeks. The usual effective therapeutic dose is 50 mg 2 times a day.

The initial dose for severe hypertension is 12.5 mg 2 times a day. Gradually, the daily dose is increased to a maximum of 150 mg (3 times a day, 50 mg). When using Capoten simultaneously with other antihypertensive drugs, it is recommended to select the dose individually.

Treatment of heart failure should begin under the supervision of a doctor. As a rule, an initial dose of 6.25 mg 3 times a day maximizes the effect of transient hypotension. The maintenance dose is usually 25 mg 2-3 times a day. If necessary, the dose is increased every 2 weeks (maximum 150 mg).

After a myocardial infarction, the use of Capoten can be started after 3 days. The drug is prescribed at an initial dose of 6.25 mg 3 times a day with a gradual (over several weeks) increase in a single dose to 25 mg. If necessary, the dose can be gradually increased to a maximum of 50 mg 3 times a day.

If symptomatic hypotension develops, a dose reduction may be required. According to indications, Capoten can be used simultaneously with other drugs, for example, thrombolytics, beta-blockers and acetylsalicylic acid.

The recommended daily dose for diabetic nephropathy is 75-100 mg 2-3 times a day. For patients with insulin-dependent diabetes with microalbuminuria (with albumin excretion of 30-300 mg per day), Capoten is prescribed 50 mg 2 times a day. If the total protein clearance is more than 500 mg per day, the drug should be taken 25 mg 3 times a day. If necessary, simultaneous use with other antihypertensive drugs is possible: beta-blockers, diuretics, vasodilators or centrally acting drugs.

The daily dose of Capoten for moderate or mild renal impairment (with creatinine clearance of at least 30 ml/min/1.73 m²) is 75-100 mg 2-3 times a day. The initial daily dose for severe renal impairment (with creatinine clearance less than 30 ml/min/1.73 m²) is no more than 25 mg (12.5 mg 2 times a day). If the drug is insufficiently effective, the dose is slowly increased every 7-14 days until the therapeutic effect occurs, but it should be lower than the maximum daily dose (by reducing the single dose or increasing the interval between doses of the drug). If necessary, additional loop diuretics (not thiazide-type diuretics) should be used.

For elderly patients, the dose of Capoten is selected individually. It is recommended to start therapy with a minimum therapeutic dose, which should not be further increased.

Side effects

During the use of Capoten, side effects may occur that develop with varying frequency:

Nervous system and sensory organs: dizziness, headache, paresthesia, ataxia, visual impairment, drowsiness;
Organs of the gastrointestinal tract: taste disturbance (is reversible, goes away on its own), aphthous stomatitis, dry mouth, increased activity of liver enzymes; rarely - hepatitis, abdominal pain, gum hyperplasia, diarrhea, hyperbilirubinemia, increased levels of hepatic transaminases in the blood plasma;
Cardiovascular system and blood (hemostasis, hematopoiesis): tachycardia, orthostatic hypotension, peripheral edema;
Respiratory system: bronchospasm, dry cough, pulmonary edema;
Hematopoietic system: in rare cases - agranulocytosis, anemia, thrombocytopenia, neutropenia (in patients with normal renal function (with creatinine clearance<1,6 мг/дл) при отсутствии других осложняющих факторов развитие нейтропении наблюдалась только в 0,02% случаях); положительный тест на антитела к ядерному антигену;
Skin: rash (maculopapular, mild, disappears within a few days after lowering the dose), usually accompanied by itching and in rare cases an increase in body temperature; flushing of the face, bullous and vesicular rashes, photosensitivity, erythema (including Stevens-Johnson syndrome);
Water and electrolyte balance: hyponatremia (most often develops when following a salt-free diet with the simultaneous use of diuretics), hyperkalemia (most likely in patients with renal failure), proteinuria, acidosis, increased blood urea nitrogen and creatinine;
Allergic reactions: angioedema of the mucous membranes, extremities, lips, face, tongue, larynx or pharynx.

Overdose

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

Therapy: gastric lavage, use of adsorbents and sodium sulfate for 30 minutes after taking Capoten, administration of a 0.9% solution of sodium chloride or other plasma-substituting drugs (the patient must first be transferred to a horizontal position with a low head, then measures are taken to replenish the volume circulating blood), hemodialysis. In case of pronounced vagal reactions or bradycardia, atropine is administered. It is possible to use an artificial pacemaker. To remove captopril from the body, peritoneal dialysis is ineffective.

special instructions

Before starting therapy, as well as regularly while taking Capoten, it is necessary to monitor kidney function. In patients with chronic heart failure, the drug should be used under close medical supervision.

During long-term treatment, an increase in creatinine and urea in the blood serum may be observed.

In patients with arterial hypertension, when using Capoten, severe arterial hypotension is observed only in isolated cases; the likelihood of developing this condition increases with excessive loss of salts and fluids (for example, after intensive diuretic therapy), in patients on dialysis, or in patients with heart failure.

The possibility of a sharp decrease in blood pressure can be minimized if diuretics are discontinued 4-7 days in advance or the sodium chloride intake is increased in advance (7 days in advance). This can also be achieved by prescribing small doses of Capoten (6.25-12.5 mg per day) at the beginning of treatment.

In the first 3 months of treatment, you need to monitor the number of blood leukocytes monthly, then once every 3 months. In patients with autoimmune diseases, in the first 3 months of treatment, the number of leukocytes must be monitored every 14 days, then every 2 months. If the number of leukocytes is less than 4000/μl, a general blood test is indicated; if the number is less than 1000/μl, therapy should be interrupted.

The risk of developing hyperkalemia when using Capoten is increased in patients with renal failure and diabetes mellitus, as well as in patients taking potassium supplements, potassium-sparing diuretics or other drugs that increase the concentration of potassium in the blood (for example, heparin). The simultaneous use of potassium supplements and potassium-sparing diuretics with Capoten should be avoided.

If angioedema develops, Capoten should be discontinued and careful medical observation should be carried out. If swelling is localized on the face, as a rule, no special therapy is carried out (antihistamines may be prescribed to reduce the severity of symptoms). When swelling spreads to the tongue, larynx or pharynx, there is a risk of developing airway obstruction. In this case, immediate administration of 0.5 ml of a 0.1% solution of adrenaline (epinephrine) may be required.

Capoten tablets should be taken with caution by patients who follow a salt-free or low-salt diet, since in this case the risk of developing arterial hypotension increases.

If symptomatic arterial hypotension develops after taking Capoten, the patient should take a horizontal position and raise his legs.

During therapy, a false-positive reaction may occur when testing urine for acetone.

Impact on the ability to drive vehicles and complex mechanisms

Patients taking Capoten should refrain from driving vehicles and performing other potentially hazardous activities that require increased concentration and rapid psychomotor reactions (due to the likelihood of developing dizziness, especially after taking the initial dose).

Use during pregnancy and lactation

According to the instructions, Capoten is not prescribed during pregnancy/lactation.

Epidemiological data indicating a risk of teratogenicity following first-trimester exposure to ACE inhibitors are inconclusive, but some increase in the likelihood cannot be excluded. If ACE inhibitor therapy is considered necessary, patients planning pregnancy should be switched to an alternative antihypertensive drug with an established safety profile for use during pregnancy.

It was found that the effect of long-term therapy with ACE inhibitors on the fetus in the 2nd–3rd trimesters of pregnancy can cause disruption of its development (in the form of decreased renal function, oligohydramnios, slow ossification of the skull bones) and complications in the newborn (including renal failure, arterial hypotension, hyperkalemia ). In cases where the patient took Capoten during this period, an ultrasound examination is indicated to assess the state of the function of the fetal kidneys and skull bones.

The use of ACE inhibitors during pregnancy can cause developmental disorders (including arterial hypotension, neonatal hypoplasia of the skull bones, anuria, reversible/irreversible renal failure) and fetal death. If the fact of pregnancy is established, Capoten is canceled.

About 1% of the taken dose of captopril passes into breast milk. Given the risk of developing serious side effects in the child, breastfeeding should be stopped or the mother should stop taking Capoten for this period.

Use in childhood

Therapy with Capoten is contraindicated in patients under 18 years of age (experience with use is limited).

For impaired renal function

severe renal impairment: Capoten is contraindicated;
renal failure: therapy should be carried out under medical supervision.

For liver dysfunction

severe liver dysfunction: Capoten is contraindicated;
liver failure: therapy should be carried out under medical supervision.

Use in old age

Therapy with Capoten in elderly patients should be carried out under medical supervision (correction of the dosage regimen is necessary).

Drug interactions

When Capoten is used simultaneously with certain medications, undesirable effects may occur:

Ganglion blockers, diuretics, adrenergic blockers: increased hypotensive effect of Capoten;
Potassium-sparing diuretics (spironolactone, amiloride, triamterene) or potassium dietary supplements: a marked increase in serum potassium concentrations;
Clonidine, indomethacin and other non-steroidal anti-inflammatory drugs: decreased antihypertensive effect of Capoten;
Procainamide, allopurinol: development of neutropenia and/or Stevens-Johnson syndrome (the causal relationship is not clear);
Immunosuppressants (cyclophosphamide, azathioprine): increased risk of developing hematological disorders;
Probenecid: decreased excretion of captopril through the kidneys;
Lithium salts: an increase in the concentration of lithium in the blood serum, which increases the risk of developing toxic and side effects of lithium preparations.

Analogs

Analogs of Capoten are: Captopril, Captopril-STI, Captopril-AKOS, Captopril Sandoz, Kaposide, Accupro, Berlipril, Diroton, Zocardis, Lisinocol.

Terms and conditions of storage

Store in a dry place, out of reach of children, at temperatures up to 25 °C.

Shelf life – 5 years.

Catad_pgroup ACE inhibitors

Capoten tablets - official* instructions for use

*registered by the Ministry of Health of the Russian Federation (according to grls.rosminzdrav.ru)

Registration number:

P N013055/01

Active substance:

Captopril

Dosage form:

pills

Compound:

1 tablet contains:

Aactive substance: captopril in terms of 100% substance - 25 mg;

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

Description:

Tablets are white to off-white in color with a characteristic odor, 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. Light marbling is allowed.

Pharmacotherapeutic group:

Angiotensin converting enzyme inhibitor (ACE inhibitor) ATX:
C.09.A.A.01

Pharmacodynamics:

The drug Capoten® is an angiotensin-converting enzyme (ACE) inhibitor. Suppresses the formation of angiotensin II and eliminates its vasoconstrictive effect on arterial and venous vessels.

Reduces total peripheral vascular resistance, reduces 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 reduction in blood pressure is the same when the patient is in the “standing” and “lying” positions.

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 seizures.

Pharmacokinetics:

When taken orally, it is rapidly absorbed from the gastrointestinal tract, the maximum concentration in the blood plasma is observed approximately 1 hour after administration. The bioavailability of captopril is 60-70%. Simultaneous food intake slows down the absorption of the drug by 30-40%. The connection with blood plasma proteins is 25-30%. The half-life is 2-3 hours. The drug is excreted from the body primarily by the kidneys, up to 50% unchanged, the rest in the form of metabolites.

Indications for use

Arterial hypertension, including renovascular;

Chronic heart failure (as part of combination therapy);

Left ventricular dysfunction after myocardial infarction in a clinically stable condition;

Diabetic nephropathy due to type 1 diabetes mellitus (with albuminuria more than 30 mg/day).

Contraindications

Hypersensitivity to captopril, any other component of the drug or other ACE inhibitors;

History of angioedema (Quincke's edema) associated with the use of ACE inhibitors and hereditary/idiopathic angioedema);

Severe liver and/or kidney dysfunction;

Refractory hyperkalemia;

Bilateral renal artery stenosis, stenosis of the artery of a single kidney with progressive azotemia;

Condition after kidney transplantation;

Stenosis of the aortic mouth and similar changes that impede the outflow of blood from the left ventricle;

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

Pregnancy;

Breastfeeding period;

Age up to 18 years (efficacy and safety have not been established);

Lactose intolerance, lactase deficiency and glucose-galactose malabsorption syndrome.

Carefully:

Severe autoimmune connective tissue diseases (including systemic lupus erythematosus, scleroderma);

Inhibition of bone marrow hematopoiesis (risk of developing neutropenia and agranulocytosis);

Cerebral ischemia;

Diabetes mellitus (increased risk of developing hyperkalemia);

Patients on hemodialysis;

Diet with limited salt;

Primary hyperaldosteronism;

Cardiac ischemia;

Conditions accompanied by a decrease in circulating blood volume (including vomiting, diarrhea);

Old age (dose adjustment required);

Surgery/general anesthesia, hypotension, use in black patients, renal and/or liver dysfunction, chronic heart failure, hemodialysis using high-flux membranes (eg, AN69®), desensitization therapy, low-density lipoprotein (LDL) apheresis, simultaneous use of potassium-sparing diuretics, potassium preparations, potassium-containing substitutes and lithium, simultaneous use of immunosuppressants, allopurinol, procainamide (risk of developing neutropenia, agranulocytosis).

Pregnancy and lactation:

The use of 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 increased 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 to ACE inhibitors on the fetus 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 Capoten® during 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, anuria, reversible or irreversible renal failure) and fetal death. If pregnancy is established, the use of 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.

Directions for use and doses

Inside, an hour before meals. The dosage regimen is set individually.

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

For the treatment of chronic heart failure. 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. The initial daily dose is 6.25 mg (1/4 tablet of 25 mg) 3 times a day. In the future, if necessary, the dose is gradually increased (at intervals of at least 2 weeks). The average maintenance dose is 25 mg 2-3 times a day, and the maximum is 150 mg per day.

In cases of left ventricular dysfunction after myocardial infarction in For 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 (1/4 tablet of 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 mg per day. day.

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

Patients with impaired renal function at moderate degree of renal impairment (creatinine clearance (CC) of at least 30 ml/min/1.73 m2), the drug Capoten® can be prescribed at a dose of 75-100 mg/day. For more severe renal dysfunction (creatinine clearance less than 30 ml/min/1.73 m2), the initial dose should be no more than 12.5 mg/day (1/2 tablet but 25 mg); in the future, if necessary, at sufficiently long intervals, the dose of Capoten® is gradually increased, but a lower than usual daily dose of the drug is used.

In old age the dose of the drug is selected individually; it is recommended to start therapy with a dose of 6.25 mg (1/4 tablet of 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

The frequency of adverse reactions is understood as: often - ? 1/100,<1/10, нечасто- ?1/1000, <1/100, редко- ?1/10000, < 1/1000, очень редко - < 1/10000.

From the cardiovascular system:

uncommon - tachycardia or arrhythmia, angina pectoris, palpitations, orthostatic hypotension, peripheral edema, marked decrease in blood pressure, Raynaud's syndrome, flushes of blood to the facial skin, 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.

Allergic reactions:

often - itching of the skin, with or without rashes, skin rashes, alopecia;

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 central 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 organs:

very rarely - neutropenia, agranulocytosis, pancytopenia, lymphadenopathy, eosinophilia, thrombocytopenia, anemia (including aplastic and hemolytic forms), increased titer for 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 organs:

very rarely - impotence, gynecomastia.

Other:

infrequently - 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 administration, administration of 0.9% sodium chloride solution or other plasma-substituting solutions (first lay the patient down, elevate the legs and then carry out measures 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.

Interaction

In patients taking diuretics, the drug Capoten® may potentiate the hypotensive effect. A similar effect also occurs restriction of table salt intake (salt-free diets), hemodialysis. Typically, an excessive decrease in blood pressure occurs within 1 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 co-prescribing Capoten® (without or with a diuretic) and l medications that affect the sympathetic nervous system(for example, ganglion blockers, alpha blockers).

When using the drug Capoten® and indomethacin (and possibly other non-steroidal anti-inflammatory drugs, such as acetylsalicylic acid) a decrease in the hypotensive effect may be observed, especially with arterial hypertension accompanied by low renin activity. In patients with risk factors (elderly age, hypovolemia, concomitant use of diuretics, impaired renal function), concomitant use of non-steroidal anti-inflammatory drugs (including cyclooxygenase-2 inhibitors) and ACE inhibitors (including
captopril), can lead to deterioration of kidney function, up to acute renal failure. Usually, renal dysfunction in such cases is reversible. Renal function should be periodically monitored in patients taking Capoten® and non-steroidal anti-inflammatory drugs.

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

With 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. Lithium and serum levels should be periodically determined.

ACE inhibitors, including
captopril, may potentiate the hypoglycemic effect insulin and hypoglycemic agents for oral administration, such as sulfonylurea derivatives.

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 renin-angiotensin-aldosterone system (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 hypotension, hyperkalemia, and decreased renal function (including acute renal failure).

allopurinol or procainamide, increases the risk of developing neutropenia and/or Stevens-Johnson syndrome.

The use of the drug Capoten® in patients taking 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, it is used under close medical supervision.

When taking ACE inhibitors, a characteristic non-productive cough is observed, which stops after discontinuation of therapy with ACE inhibitors. In rare cases, when taking 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 therapy with ACE inhibitors develops jaundice or there is a marked increase in the activity of 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 upon 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 serum urea and creatinine concentrations by more than 20% compared to the norm or baseline 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 renin-angiotensin-aldosterone system (RAAS) caused by the simultaneous use of ACE inhibitors and angiotensin II receptor antagonists or aliskiren and aliskiren-containing drugs is not recommended, since 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 ARA II (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 small doses (6, 25-12.5 mg/day).

Prescribe with caution to patients on a low-salt or salt-free diet (increased risk of developing arterial hypotension) and hyperkalemia. An excessive decrease in blood pressure may occur in patients during major surgical operations, as well as when using general anesthesia agents that have a hypotensive effect. In such cases, to correct low blood pressure, measures are taken to increase the volume of circulating blood.

Excessive reduction in blood pressure due to antihypertensive medications may increase the risk of myocardial infarction or stroke in patients with coronary heart disease or cerebrovascular disease. If arterial hypotension develops, the patient should take a horizontal position with legs elevated. Intravenous administration of 0.9% sodium chloride solution may be required.

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

Neutropenia/agranulocytosis, thrombocytopenia and anemia have been reported in patients taking ACE inhibitors. In patients with normal renal function and in the absence of other disorders, neutropenia is rare. In case of 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, in those taking immunosuppressants, allopurinol and
procainamide, especially in the presence of pre-existing renal impairment. Due to the fact that the majority of fatal cases of neutropenia due to 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, death was observed in patients with connective tissue diseases, renal or heart failure, while taking immunosuppressants, 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 high doses of drugs. In most cases, proteinuria when taking 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 high-permeability dialysis membranes (for example, AN69) should be avoided, since in such cases the risk of developing anaphylactoid reactions increases. Anaphylactoid reactions have also been reported in patients undergoing low-density lipoprotein removal (apheresis) procedures.
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 while taking ACE inhibitors.

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

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.

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

During 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. And in these cases, you can increase the volume of circulating blood.

When taking the drug Capoten®, a false-positive reaction may occur when testing urine for acetone.

Effect on ability to drive:

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.

Release form:

Tablets 25 mg.

Package:

10 or 14 tablets per blister pack.

4 blister packs of 10 tablets each or 2 or 4 blister packs of 14 tablets each, together with instructions for use, are placed in a cardboard pack.

Storage conditions:

In a dry place, at a temperature not exceeding 25°C.

Keep out of the reach of children.

Best before date:

Do not use the drug after the expiration date.

Conditions for dispensing from pharmacies:

On prescription

Registration Certificate Holder:

Owner of the Registration Certificate: AKRIKHIN KhFK, OJSC

Manufacturer

AKRIKHIN HFC, JSC Russia

The drug "Capoten" is a drug that is an inhibitor of the angiotensin-digesting enzyme and is a synthetic medicine. It contains the active element captopril and excipients such as lactose and corn starch. Basically, in case of cardiac dysfunction, the drug "Capoten" is prescribed. What exactly is it used for? Let's find out in the article.

Release form

The medicine is produced in the form of square, biconvex white tablets. Each tablet contains 25 mg captopril. One blister contains 10 or 14 tablets. There are 2 or 4 blisters in a pack.

The drug "Capoten": what is it used for?

The medication is prescribed for conditions such as:

diabetic nephropathy, which develops due to diabetes mellitus (type 1);
post-infarction period with impaired functioning of the left ventricle;
arterial hypertension (including renovascular).

The drug "Capoten" is one of the means of combination therapy.

pharmachologic effect

You can do this in a relatively short time if you take this medicine (Capoten is prescribed quite often for blood pressure). At the same time, the myocardial oxygen demand decreases, and the development of tachycardia does not occur. The maximum therapeutic effect is usually achieved after an hour. The optimal value can be achieved with long-term use of the medication after several weeks. For diabetic nephropathy, the use of the drug helps slow down the development of kidney pathology.

Contraindications to the use of the medication

We have found out why Capoten tablets are prescribed, now we will look into the contraindications to the use of this drug. The medicine is not prescribed if the patient has the following conditions:

The drug cannot be used in pediatrics and children under 18 years of age, since the necessary clinical trials have not been conducted.

The drug "Capoten" is used with caution in the following conditions:

primary hyperaldosteronism;
severe autoimmune connective tissue diseases;
inhibition of bone marrow hematopoiesis (as agranulocytosis and neutropenia may develop);
coronary heart disease or cerebral ischemia;
following a salt-free or low-salt diet;
in old age.

Instructions for use

The drug "Capoten", no matter what it is prescribed for, is taken an hour before eating. The dose of the medicine is determined individually and depends on the type and severity of the disease.

The initial dose for hypertension is 12.5 mg, take the medicine 2 times a day. The dose is gradually increased, the interval between increases can be several weeks. For moderate hypertension, take 2 tablets of the medication twice a day, the maximum you can take is 4 tablets. In severe forms, the initial dose is 12.5 mg twice a day, gradually increasing the amount to the maximum dose - three times a day, 2 tablets.

For CHF, medication is prescribed if there is no positive effect from taking diuretics. Initially, take 6.25 mg up to three times a day, after that - 25 mg three times a day, the maximum dose for 24 hours is 6 tablets. It is recommended to increase the dose every 2 weeks.

In the post-infarction period, in a stable state, take 6.25 mg per day. You can gradually increase the dose to the maximum.

For diabetic nephropathy, take up to 3-4 tablets per day, divide the specified amount into 2-3 doses.

For moderate or mild renal dysfunction, take 75-100 mg per day, for severe form - 2 tablets per day.

Those who have used the drug "Capoten" for blood pressure leave mostly positive reviews. However, this is only subject to compliance with all doctor’s instructions.

Side effects

The drug "Capoten" may have side effects, which manifest themselves:

orthostatic hypotension, tachycardia;
bronchospasm or pulmonary edema;
angioedema of the mucous membranes, lips, tongue, face, larynx, pharynx, extremities;
drowsiness, headache, ataxia, blurred vision, dizziness;
agranulocytosis, neutropenia, thrombocytopenia, anemia.

Finally

After reading this article, you learned more about the drug "Capoten": what it is used for, how to use it correctly, possible side effects. Before using the medicine, be sure to consult a specialist.

For dizziness, circulatory problems, and heart failure, doctors prescribe Capoten - instructions for use of which will help you understand the peculiarities of its use. The medication has an antihypertensive effect and is available by prescription, so the patient should be aware of possible contraindications and side effects. Read more about them in the instructions for use.

Capoten tablets

According to the pharmacological classification, Capoten belongs to the drugs inhibitors of angiotensin-converting enzyme (ACE). The active ingredient in the composition is captopril. Capoten is prescribed for blood pressure, heart failure and heart disease. The instructions for use of the drug indicate all methods of administration, dosage and consequences of overdose.

Compound

The medicine Capoten is available in only one tablet form. The detailed composition is shown in the table:

Pharmacodynamics and pharmacokinetics

The active component captopril suppresses the production of angiotensin, which has a vasoconstrictor effect on arteries and veins. Reduces total peripheral vascular contraction (TPV), afterload, and blood pressure. Reduces preload, pressure inside the right atrium and pulmonary circulation. An additional effect is to reduce the production of aldosterone by the adrenal glands.

The maximum hypotensive effect is achieved one and a half hours after taking Capoten. The effectiveness and safety of use in children have not been established; oliguria and seizures are possible. The medication is absorbed in the stomach, reaching maximum concentration after an hour. Bioavailability is 60-70%, decreasing by a third with food intake. Captopril binds to plasma proteins by 25-30%, the half-life of the substance is 2-3 hours. Metabolites are excreted in the urine.

Indications for use

According to the instructions for use, Capoten blood pressure tablets are prescribed for the following indications:

Arterial hypertension of the renovascular type.
Chronic heart failure.
Decreased left ventricular function after therapy for myocardial infarction.
Diabetic nephropathy.
Use with caution in severe autoimmune connective tissue diseases, impaired liver and kidney function, and bone marrow circulation.
If Capoten is prescribed to elderly patients undergoing hemodialysis, following a sodium-restricted diet, using potassium-sparing diuretics, immunosuppressants, lithium preparations, doctors should monitor their condition.

How to take Capoten

According to the instructions for use, the drug is taken orally one hour before meals. The regimen, course and dosage of Capoten are prescribed individually:

If left ventricular function is impaired after a heart attack, treatment begins three days after the attack. The initial dose of Capoten is 6.25 mg/day (a quarter of a tablet), then increases to 37.5-75 mg, divided into 2-3 doses. The maximum dosage is 150 mg/day.
For diabetic severe nephropathy, the dose is 75-100 mg, divided into 2-3 doses. For diabetes mellitus, the dosage is reduced to 50 mg/day twice a day. For proteinuria, a dose of 25 mg three times a day is effective.
For elderly patients, the dose is set individually. Treatment of hypertension with Capoten begins with 6.25 mg twice a day.

For heart failure

According to the instructions, if the patient suffers from heart failure, the initial daily dose of Capoten is 6.25 mg three times a day. As prescribed, the dosage is increased gradually at intervals of two weeks. The maintenance dose is 25 mg 2-3 times a day, the maximum daily dose is 150 mg. Caution should be observed during simultaneous treatment with diuretics; it is important to exclude a decrease in electrolyte levels.

How to take Capoten for high blood pressure

For arterial hypertension, the initial dose is 12.5 mg twice a day. As prescribed by the doctor, it is increased at intervals of 0.5-1 month until the desired effect is achieved. Mild and moderate hypertension requires a maintenance dose of 25 mg 2 times a day, a maximum dose of 50 mg 2 times a day. In severe cases, drink 12.5 mg twice a day, gradually increasing the dosage of Capoten to 150 mg, divided into three doses.

Kidney diseases

At a moderate stage of renal dysfunction, Capoten is taken at a dose of 75-100 mg/day. If the dysfunction is severe, the initial dosage cannot be more than 12.5 mg/day. After positive results, the dose can be gradually increased (observing large intervals - they are prescribed by the doctor), but the daily dosage is used less than the usual one.

How to take Capoten: under the tongue or drink

The instructions recommend taking the tablets with water. To get rid of high blood pressure, it is important to keep the same intake time every day, an hour before meals. The medication can be combined with loop diuretics. In exceptional cases, it is allowed to place Capoten under the tongue - this is an acute attack, a hypertensive crisis, or the risk of its development due to a sharp rise in pressure. Dissolving in saliva, captopril enters the blood faster, bringing relief within a few minutes.

special instructions

Instructions for use of Capoten contain a special instructions section, which describes the following properties of the medication:

you need to monitor your kidney function;
a characteristic nonproductive cough may be observed, which disappears after discontinuation of ACE inhibitor therapy;
with renal artery stenosis, the concentration of creatinine in the blood serum increases;
severe arterial hypotension can be observed after treatment with diuretics, while on dialysis, during major operations, or the use of anesthetics;
negatively affects the fetus during pregnancy;
a false positive reaction may occur when testing for acetone in urine;
affects the speed of psychomotor reactions and causes dizziness, so during therapy you should refrain from driving or driving dangerous machinery.

Interactions with drugs

The instructions for use of Capoten indicate drug interactions of this medication with other drugs:

when taking diuretics, strictly limiting the intake of table salt, hemodialysis, the hypotensive effect increases;
vasodilators, Nitroglycerin excessively reduce blood pressure;
not compatible with ganglion blockers, alpha-blockers;
Indomethacin, nonsteroidal anti-inflammatory drugs, acetylsalicylic acid reduce the hypotensive effect and lead to deterioration of kidney function;
only with proven hypokalemia can Capoten be combined with potassium-sparing diuretics, potassium supplements, otherwise the potassium concentration increases;
Lithium preparations increase the concentration of lithium in the blood and increase toxicity;
insulin and hypoglycemic agents may excessively reduce blood glucose levels;
Angiotensin receptor antagonists increase the incidence of side effects;
Allopurinol, Procainamide increase the risk of neutropenia;
immunosuppressants develop severe hematological disorders.

Side effects

According to the instructions, when using Capoten tablets the following may develop: side effects:

tachycardia, arrhythmia, hypotension, flushing, pallor, shock, cardiac arrest;
dry cough, shortness of breath, rhinitis, pulmonary edema;
skin itching, rashes, severity of myocardial hypertrophy;
photosensitivity, dermatitis, erythema;
insomnia, confusion, blurred vision, fainting, depression;
anemia;
nausea, vomiting, loss of taste, stomatitis;
stomach ulcer, hepatitis, pancreatitis;
myalgia, arthralgia;
chest pain;
fatigue.

Overdose

Symptoms of a drug overdose include a sharp decrease in blood pressure, shock, stupor, and bradycardia. A person's water-electrolyte balance is disturbed and renal failure occurs. For treatment, you need to rinse the stomach, administer sodium sulfate adsorbents for half an hour, instill intravenous saline or plasma replacement drugs, and perform hemodialysis. For bradycardia, atropine is administered, and sometimes an artificial pacemaker can be used. Peritoneal dialysis is not effective.