Instructions for use of Captopril: at what pressure do tablets help, their side effects, drug interactions. Interaction with alcohol

Captopril is a drug (tablet), ( pharmacological group drugs that affect the renin-angiotensin system). In the instructions for use, the following features of the drug are distinguished:

• Sold by prescription only
• IN childhood: contraindicated
• For violations of liver function: contraindicated
• In case of impaired renal function: with caution
• In old age: with caution

Package

Composition

The active ingredient is Captopril. Additional substances: lactose, anhydrous colloidal silicon dioxide, corn starch, hydrogenated castor oil.

Release form

Captopril is available in tablet form. The dosage depends on the manufacturer. Permissible dosages: 12.5, 25, 50 and 100 mg. Tablets are packed in blisters of 10 pieces. Each carton pack contains 2 blisters and instructions from the manufacturer.

pharmachologic effect

The medicine has a hypotensive effect. The active substance inhibits the angiotensin-converting enzyme, which prevents the conversion of angiotensin I to form II. It is angiotensin II that is the basic component of the renin-angiotensin system, which has a pronounced vasoconstrictor (vasoconstrictor) effect. Due to a decrease in the level of angiotensin II, a decrease in the production of aldosterone and due to the accumulation of the vasodilator substance bradykinin, a hypotensive effect is achieved.

The drug reduces the total resistance of blood vessels to blood flow, reduces the level of afterload and pressure in the pulmonary circulation. The blood pressure medication is additionally able to lower the level of aldosterone in the adrenal glands.

Pharmacodynamics and pharmacokinetics

About 75% active substance rapidly absorbed from digestive system. Eating can reduce absorption by 30-40%. The maximum level of the active substance in the blood is recorded after 30-90 minutes. The active substance binds to albumins by 25-30%.

Captopril is excreted in milk during lactation. Metabolism takes place in hepatic system. Metabolites do not have pharmacological activity. 95% of the drug is excreted through the renal system, almost half - in its original form, the rest - in the form of metabolites. With severe pathology of the kidneys, the effect of cumulation (accumulation) is observed.

Indications for use of Captopril

Captopril tablets for what? The drug is used mainly for the relief of hypertensive crisis, lowering blood pressure.

The main indications for the use of Captopril

• renal hypertension;
• essential hypertension (high blood pressure of unknown etiology);
• malignant hypertension (with resistance to other drugs).

Why Captopril Akos? Indications for use Captopril Akos

• diabetic nephropathy in patients with diabetes mellitus (type 1);
• left ventricular dysfunction in patients who have had myocardial infarction and have reached a clinically stable state.

Contraindications

Captopril pressure tablets are widely used in cardiology practice, but have certain contraindications for use:

• narrowing of the aorta;
• primary hyperaldosteronism;
• narrowing of the mitral valve;
• condition after kidney transplant;
• carrying a pregnancy;
• stenosis of the arteries of the kidneys;
• tendency to form edema;
• individual hypersensitivity;
• myocardiopathy;
• breast-feeding.

IN pediatric practice the medication can be prescribed only after reaching 14 years. Patients are advised to refrain from work that requires concentration.

Side effects

From the side nervous system the following side effects may occur:

• paresthesia;
• migraine headache;
• dizziness;
• asthenia;
• fast fatiguability.

The cardiovascular system:

• cardiopalmus;
• orthostatic hypotension.

Digestive tract:

• pancreatitis;
• cholestasis;
• stool disorders (diarrheal syndrome or constipation);
• epigastric pain;
• violation of taste perception;
• nausea;
• hepatitis;
• increased levels of bilirubin;
• increase in ALT and AST.

Hematopoietic system:

• decrease in the number of platelets;
• anemia;
• neutropenia;
• agranulocytosis (in the presence of autoimmune pathology).

Metabolism:

• acidosis;
• increase in the level of K + in the body.

Urinary system:

• disorders in the work of the kidneys;
• detection of protein in the urine.

In some cases, dry, unproductive cough. Allergic responses are possible:

• bronchospasm;
• the presence of antinuclear antibodies;
• angioedema;
• lymphadenopathy;
• serum sickness.

When registering other negative reactions, a doctor's consultation and temporary self-cancellation of the drug Captopril are required.

Instructions for use (Method and dosage)

Tablets are intended for oral administration. The medicine quickly lowers blood pressure. Only the attending physician can prescribe Captopril tablets. Instructions for use in hypertensive crises: a 25 mg tablet is placed under the tongue, which provides a faster hypotensive effect. Instructions for use Captopril Akos in renovascular form of hypertension: three times a day, 12.5 mg. The effectiveness of the drug increases when taken on an empty stomach.

How to take medication for heart failure: three times a day, 12.5-25 mg. The maximum daily dosage is 150 mg.

At what pressure should Captopril be taken? The drug belongs to the group of medicines "ambulance" and is recommended for use in emergency cases, when, during treatment according to the standard scheme, there was an increase in pressure to high numbers against the background of stress, physical activity.

Overdose

If you take the pills incorrectly, an overdose can occur, which is manifested by a pronounced decrease in blood pressure. The patient's condition may be complicated by thromboembolism, impaired cerebral blood supply, myocardial infarction.

It is recommended to give the patient a horizontal position, lift lower limbs, try to restore blood pressure by intravenous infusion of saline. Peritoneal dialysis does not give the expected effect. Against the background of hemodialysis, there is a positive trend.

Interaction

Together with the use of cytostatics and immunosuppressants, leukopenia may develop. Perhaps the development of hyperkalemia with simultaneous therapy with potassium-sparing diuretics:

• Amiloride;
• Spironolactone;
• Triamterene.

Against the background of treatment with Azathioprine, anemia may develop due to inhibition of the activity of Erythropoietin. IN medical literature cases of diagnosing leukopenia associated with additive bone marrow hematopoiesis are described. Allopurinol may increase the severity of the hematological effect. Acetylsalicylic acid can reduce the hypotensive effect of Captopril. The drug is able to increase the concentration of Digoxin. Most often, drug interactions occur in patients with severe pathology of the renal system. Captopril with Cinnarizine is not contraindicated.

Terms of sale

Storage conditions

Best before date

special instructions

What is better Captopril or Kapoten? These two drugs are absolutely identical, because active substance Captopril acts in them according to the INN. The main difference between Kapoten and Captopril is in the manufacturer.

During treatment, a false positive reaction may be recorded when determining acetone in the urine. In pediatric practice, the drug can be used in the absence of the effect of other antihypertensive drugs.

Captopril's analogs

Structural analogues of Captopril:

• Kaptopres;
• Kapoten;
• Alcadil.

captopril and alcohol

Alcohol can enhance the hypotensive effect of the drug. There is a joint negative impact on the functioning of the hepatic system.

Arterial hypertension has become a real scourge of our society. The discovery of ACE inhibitors, among which, began a new era in the treatment high blood pressure and cardiovascular pathology.

What is Captopril FPO, instructions for use, at what pressure is it most effective?

Angiotensin II is one of the hormones that act to constrict blood vessels retain sodium in the body. Its conversion from angiotensin-I occurs with the participation of an angiotensin-converting enzyme (ACE). Captopril is part of medications belonging to the group . This means that it has an inhibitory effect on the activity of ACE, which lowers the blood concentration of angiotensin-II.

As a result, the resistance of peripheral vessels decreases, the cardiac output increases and the ability to endure stress increases. Taking Captopril enhances vascular blood flow, which nourishes the kidneys and heart. Long-term use reduces hypertrophy of the vascular walls and myocardium.

According to the instructions for use, it is advisable to take Captopril FPO from high blood pressure in such cases:

• hypertonic disease;
• with impaired work of the left ventricle;
• assistance in hypertensive crisis;
• renovascular hypertension;
• parenchymal with rapid progression of glomerulonephritis;
• high blood pressure in bronchial asthma;
• nephropathy with diabetes;
• congestive form of heart failure, especially if the use of diuretics with cardiac glycosides is ineffective;
• primary hyperaldosteronism (Conn's syndrome).

At what pressure should I take it?

One of the most popular drugs used for high blood pressure. Many users would like to know about the features of taking this drug. At what pressure should Captopril FPO be taken, what does the instructions for use say about this? Captopril can be used for arterial hypertension, that is, when the pressure exceeds normal limits. It is important to limit the intake of sodium salts.

The instructions for use say that if Captopril-FPO is used at higher pressures (from 180/110 mm Hg), it must be combined with diuretics.

The dose of the drug is gradually increased to the largest allowable amount - 150 mg / day. That is, the instructions for use say that the remedy is effective for any numbers of high blood pressure, just the doses are different under different circumstances and pathologies. Efficiency increases when combined with adjuvant therapy.

Stages of hypertension

Instructions for use Captopril FPO

Captopril FPO is produced in the form of tablets of 25 and 50 milligrams. They are packaged in special cells of ten pieces. One box can contain from ten to one hundred tablets of the drug.

The instructions for use of Captopril FPO say that it is prescribed with 6.25 milligrams two or three times a day. Every two weeks, the dose can be gradually increased. It is recommended to take the remedy one hour before meals.

For the use of the drug Captopril FPO, which lowers blood pressure, the following doses are recommended for various categories of patients:

• mild degree arterial hypertension- 25 mg twice;
• severe form of hypertension - no more than 150 mg (three times);
• insufficiency of the heart chronic course- 6.25–12.5 mg three times;
• elderly people - 6.2 mg twice a day;
• patients with diabetic nephropathy from 75 to 100 mg / day. ;
• moderate kidney dysfunction - from 75 to 100 milligrams per day;
• serious kidney disorders - with a dose not exceeding 12.5 mg per day.

The instructions for the use of Captopril FPO say that after the first dose of the drug, you need to control the pressure every half hour. This is necessary in order to understand how the remedy acts on the body: when the decline begins, when it reaches its peak, when it begins to rise.

The maximum allowable dose of the drug is 150 mg per day. If you take a larger amount of the drug, then the effect will not increase, but the risk of side effects will increase. Patients with kidney failure appoint no more than one hundred milligrams a day. For elderly people, the dose of Captopril should not be raised above 6.25 mg, taken twice during the day.

Contraindications and side effects

Any remedy has contraindications and side effects. Captopril should not be used:

• during pregnancy and lactation;
• bilateral stenosis of the arteries of the kidneys (or a single kidney);
• increased residual nitrogen in the blood;
• serious pathologies of the liver;
• hypotension;
• hypersensitivity to ACE inhibitors.

The instructions for use indicate that patients taking Captopril FPO for high blood pressure who suffer from autoimmune diseases should be examined every fourteen days for the number of leukocytes in a clinical blood test. If they are halved, then the remedy is recommended to be canceled.

The person taking it medicinal substance, should at the first sign of any infection seek advice from his therapist. The instructions for use of Captopril FPO say that it is not recommended to stop taking the drug or change dosages at your own discretion. You should immediately apply for medical care if a patient taking this medicine develops diarrhea, vomiting, excessive sweating. According to the instructions for use of Captopril FPO, these symptoms dehydrate the body and lead to a decrease in pressure. In this case, taking the drug in the same dosage is dangerous.

When taking the drug, side effects may occur. Here are the main ones:

• , swelling in the legs;
• a sharp drop in blood pressure, fainting, dizziness, loss of consciousness;
• protein in the urine;
• increased creatinine and urea;
• anemia, thrombocytopenia, neuropenia;
• headache, dizziness, impaired coordination of movements;
• constant fatigue;
• reduced sensitivity of the limbs;
• decreased visual acuity;
• bronchospasm, dry cough, pulmonary edema;
• dermatitis, various rashes, pruritus;
• decreased appetite, taste sensations;
• diarrhea, abdominal pain, nausea, vomiting, hyperbilirubinemia;
• an increase in potassium and a decrease in sodium in the blood, a violation of the acid-base balance.

Captopril - medicine, which belongs to the category of angiotensin-converting enzyme (ACE) inhibitors. This drug is used to combat hypertension. He is also part of complex therapy chronic insufficiency hearts. If you need to take Captopril, the instructions for use should be studied very carefully.

The active substance of the drug is captopril. Additional ingredients that are part of the drug include lactose, corn starch, silicon dioxide, etc.

The drug is produced in the form of tablets. The dosage is different - it all depends on the manufacturer. On sale you can find tablets that contain 12.5, 25, 50, 100 mg of the active ingredient.

Pharmacological action and pharmacokinetic properties

Captopril tablets fall into the category of ACE inhibitors. Means of this group block the transformation of angiotensin I into angiotensin II. This reduces the synthesis of aldosterone. This action leads to a decrease in the total peripheral vascular resistance. This reduces blood pressure and stress on the heart.

Plasma renin activity does not affect the hypotensive effect. A decrease in pressure is observed with a normal or reduced content of the hormone. This is due to the effect on the renin-angiotensin system.

Prolonged use of the drug provokes a decrease in myocardial hypertrophy and resistive walls of arteries. In addition, the drug has the following types of effects:

• reduces the adhesion of platelets;
• stimulates coronary and renal blood flow;
• increases blood supply to the myocardium;
• reduces the level of sodium ions in people suffering from heart failure;
• reduces the degradation of bradykinin and increases the production of prostaglandin.

The decrease in pressure after the use of Captopril does not lead to the appearance of symptoms of reflex tachycardia and causes a decrease in myocardial oxygen demand. In the treatment of heart failure, the correct dosage of the drug does not affect the blood pressure.

After taking the substance, the symptoms of hypertension disappear after 1-1.5 hours. The duration of the effect depends on the dosage. It may take several weeks to reach the required parameters.

The drug is absorbed fairly quickly. Absorption is at the level of 75%. If you take Captopril with meals, this figure decreases to 35-45%. Bioavailability is 35-40%.

Approximately 25-30% of the drug binds to the protein components of blood plasma. When used orally, the maximum content of the drug in the blood is 114 ng / ml. This result is achieved after 0.5-1.5 hours.

Metabolism of the drug is carried out in the liver. Approximately 95% of the drug leaves the body through the kidneys. In its original form, 40-50% is excreted, the rest is in the form of metabolites. The half-life of the drug takes 3 hours.

In chronic kidney failure, the drug may accumulate. In this case, the half-life can be from 3.5 to 32 hours.

Indications for use

Many people are interested in what Captopril tablets are used for and what are the rules for their use. Key indications for taking this drug include the following:

Contraindications

The use of Captopril high pressure is not always acceptable. The main contraindications to the use of the drug include the following:

1. Angioedema, including hereditary form. The drug should not be used if there is a history of this disorder, which appeared after taking other ACE inhibitors.
2. Serious kidney damage. Contraindications include stenosis of the arteries of the kidneys, azotemia, the primary form of hyperaldosteronism, the condition after a kidney transplant.
3. Aortic stenosis, development mitral stenosis. Also, the tool is not allowed to be used in the presence of other obstructions to the removal of blood from the area of ​​the left ventricle.
4. Serious liver damage.
5. Arterial hypotension.
6. Pregnancy and lactation.
7. Age up to 18 years.
8. High sensitivity to Captopril and other drugs from this category.

Extremely carefully, the drug is prescribed for complex autoimmune pathologies, including systemic lupus erythematosus and scleroderma. Also, the limitations include cerebral ischemia, the presence of diabetes mellitus, and circulatory depression in the bone marrow. Caution should be observed with cardiac ischemia, in old age, with sodium restriction in the diet.

Instructions for use

The drug Captopril can only be prescribed by a doctor. The daily dosage is selected individually depending on clinical indications. Taking the medicine - 1 hour before meals.

In chronic heart failure, Captopril should be included in combination therapy. If there are no results from the use of diuretics, you should first take 6.25 mg 2-3 times a day.

Gradually (interval of 2 weeks), the volume is increased to an average maintenance rate - 25 mg 2-3 times a day. If this amount is not enough, the dosage is increased. However, this should be done with an interval of 2 weeks.

When using Captopril for the treatment of arterial hypertension, 25 mg twice a day are initially used. If the desired effect is not achieved, the dosage is gradually increased. This should be done every 2-4 weeks.

If Captopril is used, at what pressure should the dosage be changed? Support volume at moderate hypertension- 25 mg twice a day. Sometimes a large dosage is required, but it should not exceed 50 mg once with a double dose per day. In difficult cases, take 50 mg of the drug three times a day. The maximum daily volume is 150 mg.

In more complex cases, the initial dosage is 12.5-25 mg per day. If necessary, the dosage increase is carried out for a long time. However, in any case, the drug should be used at a lower dose than usual.

Important: For elderly patients, the amount of the drug is selected individually. Treatment should begin with 6.25 mg twice daily. Doctors recommend maintaining the dosage at this level.

Side effects

In some cases, the drug Captopril provokes unwanted side effects. These include the following:

Important: If adverse reactions occur, stop taking the medicine and consult a doctor. The specialist will adjust the dosage or select another remedy.

Overdose

• sudden decrease in pressure;
• shock state;
• bradycardia;
• angioedema;
• stupor;
• thromboembolism;
• kidney failure;
• change in water and electrolyte balance;
• circulatory disorders in the brain;
• myocardial infarction.

To cope with the symptoms of an overdose, you must completely eliminate the use of the drug and flush the stomach. After that, lay the patient on a flat surface and proceed with activities aimed at replenishing the volume of blood and electrolytes. For this, it is shown intravenous administration saline, plasma substitutes and other substances.

Symptomatic treatment should also be carried out, which is aimed at maintaining normal functioning. internal organs. For this purpose, adrenaline is used, which helps to increase blood pressure, an artificial pacemaker, antihistamines. If necessary, hemodialysis is possible.

Interaction with other drugs

Captopril should not be combined with medicines that increase the amount of potassium in the blood. These include potassium-sparing diuretics - Veroshpiron, Spironolactone. Also included in this category are potassium compounds such as Panangin and Asparkam, heparin, salt substitutes containing potassium.

The drug is able to enhance the effect of hypoglycemic agents - Gliclazide, Metformin, etc. Therefore, with such combinations, you need to monitor the level of glucose in the blood. Captopril also enhances the effect of analgesics and anesthetics.

Diuretics, antidepressants, vasodilators, neuroleptics lead to an increase in the hypotensive effect of Captopril. When such drugs are combined, there is a risk of a strong drop in blood pressure.

When combined with non-steroidal anti-inflammatory drugs, the effectiveness of Captopril is reduced. This should be considered when using Aspirin, Nimesulide, Ibuprofen and other similar agents.

Captopril is able to increase the level of lithium and digoxin in the blood. Therefore, the combination of the drug with lithium preparations can lead to the appearance of signs of intoxication of the body.

The combination of Captopril with Procainamide, Allopurinol and immunosuppressants increases the risk of neutropenia, which manifests itself in the form of a decrease in the volume of leukocytes in the blood. Also, this combination increases the risk of Stevens-Johnson syndrome.

Taking Captopril against the background of desensitizing therapy increases the risk of anaphylactic reactions. A similar effect is observed in combination with Estramustine and gliptins.

The use of Captopril with gold preparations provokes nausea and vomiting. Also, this combination can cause flushing of the skin of the face and a decrease in pressure.

Taking Captopril in combination with hypoglycemic drugs and insulin increases the possibility of developing hypoglycemia.

Interaction with alcohol

During the period of taking Captopril, the use of alcoholic beverages should be excluded. Alcohol leads to an increase in the activity of the drug. This combination can cause a serious drop in blood pressure.

Application in pediatrics

It is not recommended to treat children with Captopril, since the efficacy and safety of using the drug in pediatric practice have not been studied. If you can not do without the drug, the dosage is selected depending on the weight of the child. Experts recommend using 1-2 mg of the drug per 1 kg of body weight per day.

Use during pregnancy and lactation

Captopril should not be used during pregnancy and lactation. The tool can provoke serious violations in the development of the child.

special instructions

When treating with Captopril, a number of recommendations must be observed:

1. If a dose is missed, the next dose should be taken as normal. It is not necessary to increase the volume of the drug.
2. Before starting treatment, it is necessary to restore the volume of fluid and the content of electrolytes in the blood. These indicators may be disturbed due to the use of diuretics, severe diarrhea or vomiting.
3. During therapy, you need to monitor the work of the kidneys. In 20% of cases, against the background of the use of the drug, proteinuria occurs, which is accompanied by the appearance of protein impurities in the urine. This condition usually goes away on its own. If the protein content exceeds 1000 mg per day, treatment with Captopriom will have to be abandoned.
4. Within 3 months of therapy, you need to take a blood test. This must be done every 2 weeks. If the volume of leukocytes decreases to 1 g / l, the remedy must be discontinued.

Nowadays, there are many different medicines which help to cope with certain problems.

For each disease, there are more than 10 different medicines that affect the body in completely different ways and help in a given situation.

Each person is individual, and the selection of drugs should be exactly the same. Therefore, you should take any remedy only after visiting the doctor. In such cases, the dosage and the drug itself will be chosen correctly, especially when it comes to tablets that reduce or increase.

It is to such medications can be attributed. This medicine has long been used by doctors and is very often prescribed to patients who have difficulties with blood pressure. So what is Captopril from, and how should it be taken?

Captopril acts as a stabilizing and lowering blood pressure agent, which, in its mechanism, is associated with competitive.

The drug itself is an inhibitor that is prescribed to patients with severe and other diseases that occur against the background of unstable blood pressure.

This tool quickly helps to reduce the rate of change of angiotensin 1 and its transformation into the 2nd form. This drug causes a vasoconstrictor effect by stimulating aldosterone in the cortex.

The drug can be taken as a permanent remedy for patients with high blood pressure or cardiac instability. However, the appointment is prescribed only by a doctor after complete examination sick.

Continuous use of this drug does not allow bradykinin to break down, while it is created, which guarantees excellent resistance in absolutely all vessels of the body.

The drug can help reduce and also prevent an increase in heart failure and improve blood circulation, reduce platelet aggregation.

Medicine Captopril: what helps?

Captopril has proven itself well in the fight against, is widely used to reduce the load on the heart. Due to this, the agent is used in arterial hypertensive therapy, as well as in cardiac weakness and diabetic nephropathy.

Basically, the drug is prescribed to people with such symptoms and diseases:

1. a form of coronary heart disease and unstable work of the left ventricle, but only in cases where the patient has a stable dynamics of the course of the disease;
2. complex treatment for heart failure;
3. cardiomyopathy various kinds, but at the same time it is necessary to correctly and accurately select the required dosage for each person individually.

In any case, Captopril has been used by many doctors for a long time, because the drug has undergone many clinical studies and has shown excellent results in the fight against hypertension and heart failure. Thanks to this, we can safely say that the remedy is necessary for most patients with various forms hypertension.

If necessary, tablets are taken for other diseases in combination with other drugs. Such a complex is prescribed only by the attending physicians according to the individual indicators of the patient.

Contraindications

Captopril should not be taken t, it is also contraindicated in women during planning, at any gestational age and when breastfeeding.

Captopril is contraindicated in such diseases and disorders:

1. diseases and disorders of the liver;
2. renal artery stenosis;
3. the last stage of left ventricular failure;
4. rehabilitation period after liver transplantation;
5. allergy or hypersensitivity to drug components.

With the above diseases and disorders this drug strictly prohibited to anyone. Taking Captopril tablets must be fully approved by a doctor.

With the wrong method of treatment and non-compliance with the instructions, the medicine can worsen the patient's condition and lower his blood pressure. This will lead to the most complex diseases and consequences.

Instructions for use

Tablets are taken only after the appointment of a doctor and after a complete examination of the patient. It is produced in tablets - 40 pieces of 25 mg, which must be taken orally. For a better effect, a tablet is placed, which increases the absorption of useful elements and substances.

This leads to a rapid decrease in blood pressure and its normalization. In any case, when using Captopril, it is necessary to consult a doctor and only then start taking these tablets.

Captopril tablets

In order to cure a persistent increase in pressure, the drug is prescribed in the initial dose - 12.5 mg 3 times a day. If the result is poor, then the volume can be increased over time with an interval of 1-3 weeks. When the optimal effect is achieved, the dose can be reduced.

With calmly ongoing arterial hypertension, a maintenance dose of 37.5 mg per day is usually taken. The maximum intake in such cases may be 50 mg 2 times a day. At maximum dose may be 50 mg 3 times a day.

The maximum dose in 24 hours for any person can be no more than 150 mg.

It is best to take the tablet on an empty stomach. If there is a need for a rapid hypotensive effect, then it is necessary to use the medicine at a dose of 25 mg, putting the tablet under the tongue.

This will speed up the process of lowering blood pressure several times and quickly improve the patient's well-being. With heart weakness, tablets are prescribed if they do not cause positive effect. The minimum dose is 6.25 mg 2 times a day, which can be increased over time over 2 weeks.

The maintenance dose is 25 mg 2-3 times a day. The maximum dose for any patient can be 150 mg per day. For those suffering from heart failure and hypertension, the drug is prescribed individually. Most often, you need to start taking 6.25 mg per day.

It is necessary to increase the intake slowly, reaching a maximum result of 150 mg per day.

With a sufficiently high blood pressure, older people are prescribed additional drugs which are combined with Captopril.

Acceptance of such a joint course may continue long time, it all depends on the progress of the disease and the condition of the patient. This drug applies, it must be taken in extremely emergency cases.

If the patient's pressure has risen above the norm, which was determined by the doctor, then the pill can be taken earlier than it is written in the instructions, but it is not recommended to take more than the prescribed norm.

Side effects

According to the instructions, this tool has its own side effects.

First of all, it is reddening of the face and pallor, slight irritation on the hands and other areas of the skin, insomnia, hair loss, drowsiness, and vomiting.

In rare cases, a dermatological rash, impaired kidney function, discomfort in the stomach, and dry mouth may appear. In very rare cases, there is a change or loss of taste, plentiful, blurred vision.

If the medication causes severe negative reactions, you should stop taking it and contact your doctor as soon as possible.

Due to the fact that the drug can cause dizziness and, hazardous activities and work should be abandoned.

Related videos

Video review of medicines Kapoten and Captopril:

A significant date awaits us in 2015: the 40th anniversary of the first angiotensin-converting enzyme (ACE) inhibitor captopril. However, dashing trouble is the beginning. Soon after this momentous event, in the 70s of the last century, two other ACE inhibitors, enalapril and lisinopril, were created by pharmaceutical synthesis specialists, and then an account of representatives of this class of drugs that can inhibit the process of converting angiotensin I into a powerful vasoconstrictor, which is angiotensin II , moved to tens. The new ACE inhibitors, unlike the pioneer captopril, were better tolerated and had a longer duration of action. Nevertheless, this "old man" continues to be widely used in the treatment cardiovascular diseases. To realize the antihypertensive effect, captopril does not require prior biotransformation in the liver. Its action develops 15-30 minutes after oral administration, reaches its peak after 1-2 hours and lasts up to 10 hours. With the sublingual method of administration of captopril, its effect occurs faster - after 5-15 minutes. In view of the rapid development of the antihypertensive effect, the drug can be used in the relief of hypertensive crises. The pharmacokinetic characteristics of captopril do not change depending on the age of the body into which it enters, therefore, dose adjustment in elderly patients is not required. The main difference between captopril and other ACE inhibitors is the presence of a sulfhydryl group in it. It is believed that due to this circumstance, the drug can have an antioxidant effect (by binding free radicals), intensify coronary blood flow (due to the expansion of coronary vessels), prevent the development of nitrate resistance and sensitize tissues to the action of insulin.

The disadvantage of captopril is the short duration of its action, which entails an increase in the frequency of administration up to 2-3 times a day, while other ACE inhibitors are taken 1 time per day.

The antihypertensive effect of captopril is dose-dependent and can be enhanced or prolonged with joint admission drug with diuretics. An example of such a combination is the drug caposide, where hydrochlorothiazide is added to the "default" captopril. At the same time, in a number of clinical cases, the relative pharmacological "conciseness" of captopril can be considered an advantage over "long-playing" ACE inhibitors. For example, of all ACE inhibitors, only captopril can be used to relieve hypertensive crises. The exclusive "territory" of captopril (in combination with renal scintigraphy and / or radioisotope renography) is the diagnosis of renovascular hypertension. Because of its short duration of action, captopril is preferred for use in patients with hemodynamic instability (eg, acute heart attacks myocardium) than long-acting ACE inhibitors, tk. in this case, the risk of side effects is reduced. This is also true for patients suffering from chronic heart failure, at least at the initial stages of therapy. A number of sources report a lesser severity of renal dysfunction in patients with chronic heart failure while taking captopril in comparison with enalapril and lisinopril (however, before starting captopril and during the treatment process, it is necessary to carefully monitor the work of the kidneys). Completing the long list of advantages of captopril, it should be added that this drug is one of the few ACE inhibitors that can prevent the development of heart failure and increase the survival of post-infarction patients.

Pharmacology

Antihypertensive agent, ACE inhibitor. The mechanism of antihypertensive action is associated with competitive inhibition of ACE activity, which leads to a decrease in the rate of conversion of angiotensin I to angiotensin II (which has a pronounced vasoconstrictor effect and stimulates the secretion of aldosterone in the adrenal cortex). In addition, captopril appears to have an effect on the kinin-kallikrein system, preventing the breakdown of bradykinin. The hypotensive effect does not depend on the activity of plasma renin, a decrease in blood pressure is noted at normal and even reduced concentrations of the hormone, which is due to the effect on the tissue RAAS. Increases coronary and renal blood flow.

Due to the vasodilating effect, it reduces OPSS (afterload), wedge pressure in the pulmonary capillaries (preload) and resistance in the pulmonary vessels; increases cardiac output and exercise tolerance. With prolonged use, it reduces the severity of left ventricular myocardial hypertrophy, prevents the progression of heart failure and slows down the development of left ventricular dilatation. Helps reduce sodium levels in patients with chronic heart failure. Expands the arteries more than veins. Improves blood supply to ischemic myocardium. Reduces platelet aggregation.

It lowers the tone of the glomerular efferent arterioles of the kidneys, improving intraglomerular hemodynamics, and prevents the development of diabetic nephropathy.

Pharmacokinetics

After oral administration, at least 75% is rapidly absorbed from the gastrointestinal tract. Simultaneous food intake reduces absorption by 30-40%. C max in blood plasma is reached in 30-90 minutes. Protein binding, mainly to albumin, is 25-30%. It is allocated with breast milk. It is metabolized in the liver to form a disulfide dimer of captopril and captopril-cysteine ​​disulfide. Metabolites are pharmacologically inactive.

T 1/2 is less than 3 hours and increases with renal failure (3.5-32 hours). More than 95% is excreted by the kidneys, 40-50% is unchanged, the rest is in the form of metabolites.

In chronic renal failure cumulates.

Release form

10 pieces. - cellular contour packings (2) - packs of cardboard.

Dosage

When taken orally, the initial dose is 6.25-12.5 mg 2-3 times / day. With insufficient effect, the dose is gradually increased to 25-50 mg 3 times / day. For impaired renal function daily dose should be reduced.

The maximum daily dose is 150 mg.

Interaction

With simultaneous use with immunosuppressants, cytostatics, the risk of developing leukopenia increases.

With simultaneous use with potassium-sparing diuretics (including spironolactone, triamterene, amiloride), potassium preparations, salt substitutes and dietary supplements containing potassium, hyperkalemia may develop (especially in patients with impaired renal function), because. ACE inhibitors reduce the content of aldosterone, which leads to a retention of potassium in the body against the background of limiting the excretion of potassium or its additional intake into the body.

With the simultaneous use of ACE inhibitors and NSAIDs, the risk of developing impaired renal function increases; rarely observed hyperkalemia.

With simultaneous use with "loop" diuretics or thiazide diuretics, severe arterial hypotension is possible, especially after taking the first dose of the diuretic, apparently due to hypovolemia, which leads to a transient increase in the antihypertensive effect of captopril. There is a risk of developing hypokalemia. Increased risk of developing renal dysfunction.

With simultaneous use with drugs for anesthesia, severe arterial hypotension is possible.

With simultaneous use with azathioprine, anemia may develop, which is due to the inhibition of erythropoietin activity under the influence of ACE inhibitors and azathioprine. Cases of the development of leukopenia are described, which may be associated with additive inhibition of bone marrow function.

With simultaneous use with allopurinol, the risk of developing hematological disorders increases; described cases of severe hypersensitivity reactions, including Stevens-Johnson syndrome.

With the simultaneous use of aluminum hydroxide, magnesium hydroxide, magnesium carbonate, the bioavailability of captopril decreases.

Acetylsalicylic acid in high doses may reduce the antihypertensive effect of captopril. It has not been conclusively established whether acetylsalicylic acid reduces the therapeutic efficacy of ACE inhibitors in patients with coronary artery disease and heart failure. The nature of this interaction depends on the course of the disease. Acetylsalicylic acid, by inhibiting COX and prostaglandin synthesis, can cause vasoconstriction, which leads to a decrease in cardiac output and worsening of the condition of patients with heart failure receiving ACE inhibitors.

There are reports of an increase in the concentration of digoxin in the blood plasma with the simultaneous use of captopril with digoxin. The risk of drug interactions is increased in patients with impaired renal function.

With simultaneous use with indomethacin, ibuprofen, the antihypertensive effect of captopril decreases, apparently due to inhibition of prostaglandin synthesis under the influence of NSAIDs (which are believed to play a role in the development of the hypotensive effect of ACE inhibitors).

With simultaneous use with insulins, hypoglycemic agents, sulfonylurea derivatives, hypoglycemia may develop due to an increase in glucose tolerance.

With the simultaneous use of ACE inhibitors and interleukin-3, there is a risk of arterial hypotension.

With simultaneous use with interferon alfa-2a or interferon beta, cases of severe granulocytopenia have been described.

When switching from taking clonidine to captopril, the antihypertensive effect of the latter develops gradually. In the event of a sudden withdrawal of clonidine in patients receiving captopril, a sharp increase in blood pressure is possible.

With the simultaneous use of lithium carbonate, the concentration of lithium in the blood serum increases, accompanied by symptoms of intoxication.

With simultaneous use with minoxidil, sodium nitroprusside, the antihypertensive effect is enhanced.

With simultaneous use with orlistat, a decrease in the effectiveness of captopril is possible, which can lead to an increase in blood pressure, hypertensive crisis described a case of cerebral hemorrhage.

With the simultaneous use of ACE inhibitors with pergolide, an increase in the antihypertensive effect is possible.

With simultaneous use with probenecid, the renal clearance of captopril decreases.

With simultaneous use with procainamide, an increased risk of developing leukopenia is possible.

With simultaneous use with trimethoprim, there is a risk of developing hyperkalemia, especially in patients with impaired renal function.

With simultaneous use with chlorpromazine, there is a risk of developing orthostatic hypotension.

With simultaneous use with cyclosporine, there are reports of the development of acute renal failure, oliguria.

It is believed that it is possible to reduce the effectiveness of antihypertensive agents when used simultaneously with erythropoietins.

Side effects

From the side of the central nervous system and peripheral nervous system: dizziness, headache, fatigue, asthenia, paresthesia.

From the side of cardio-vascular system: orthostatic hypotension; rarely - tachycardia.

From the digestive system: nausea, decreased appetite, impaired taste sensations; rarely - abdominal pain, diarrhea or constipation, increased activity of hepatic transaminases, hyperbilirubinemia; signs of hepatocellular damage (hepatitis); in some cases - cholestasis; in isolated cases - pancreatitis.

From the hemopoietic system: rarely - neutropenia, anemia, thrombocytopenia; very rarely in patients with autoimmune diseases - agranulocytosis.

From the side of metabolism: hyperkalemia, acidosis.

From the urinary system: proteinuria, impaired renal function (increased concentration of urea and creatinine in the blood).

From the side respiratory system: dry cough.

Allergic reactions: skin rash; rarely - angioedema, bronchospasm, serum sickness, lymphadenopathy; in some cases - the appearance of anti-nuclear antibodies in the blood.

Indications

Arterial hypertension (including renovascular), chronic heart failure (as part of combination therapy), left ventricular dysfunction after myocardial infarction in patients who are in a clinically stable state. diabetic nephropathy with type 1 diabetes mellitus (with albuminuria more than 30 mg / day).

Contraindications

Pregnancy, lactation, age up to 18 years, hypersensitivity to captopril and other ACE inhibitors.

Application features

Use during pregnancy and lactation

It should be borne in mind that the use of captopril in the II and III trimesters of pregnancy can cause developmental disorders and fetal death. If pregnancy is established, captopril should be discontinued immediately.

Captopril is excreted in breast milk. If necessary, use during lactation should decide on the termination of breastfeeding.

Application for violations of liver function

Application for violations of kidney function

Caution should be used in the condition after kidney transplantation, renal failure.

In case of impaired renal function, the daily dose should be reduced.

The concomitant use of potassium-sparing diuretics and potassium preparations should be avoided in patients with renal insufficiency.

Use in children

special instructions

Caution should be used when indicating a history of angioedema during therapy with ACE inhibitors, hereditary or idiopathic angioedema, with aortic stenosis, cerebro- and cardiovascular diseases (including cerebrovascular insufficiency, coronary artery disease, coronary insufficiency), heavy autoimmune diseases connective tissue(including SLE, scleroderma), with oppression of bone marrow hematopoiesis, with diabetes mellitus, hyperkalemia, bilateral stenosis of the renal arteries, stenosis of the artery of a single kidney, condition after kidney transplantation, renal and / or liver failure, against the background of a diet with sodium restriction , conditions accompanied by a decrease in BCC (including with diarrhea, vomiting), in elderly patients.

In patients with chronic heart failure, captopril is used under close medical supervision.

arising during surgical intervention arterial hypotension against the background of taking captopril, they are eliminated by replenishing the volume of fluid.

The simultaneous use of potassium-sparing diuretics and potassium preparations should be avoided, especially in patients with renal insufficiency and diabetes mellitus.

When taking captopril, a false positive reaction can be observed in the analysis of urine for acetone.

The use of captopril in children is possible only if other drugs are ineffective.

Influence on the ability to drive vehicles and control mechanisms

Caution required when driving vehicles or other work that requires heightened attention, because dizziness is possible, especially after the initial dose of captopril.