Indications
¨ Hypertension : Mild to moderate hypertension as an adjunct to thiazide
therapy in patients who have not responded effectively to thiazide
treatment alone.
¨ Severe hypertension : Where standard therapy has failed.
Cardopril is effective alone or in combination with other
antihypertensive agents especially thiazide type of diuretics. The blood
pressure lowering effect of Cardopril and thiazides are approximately
additive.
¨ Congestive heart failure : It is also used as an adjunct to the treatment of
severe congestive heart failure.
Dosage and Administration
¨ Hypertension : Treatment with Cardopril should be at the lowest
effective dose, which should be titrated according to the need of the
patient.
Mild to moderate hypertension- In mild to moderate hypertension
Cardopril therapy should be used as an adjunct to thiazide therapy.
Starting dose is 12.5 mg twice daily. The usual maintenance dose is 25
mg twice daily.
Severe hypertension- Starting dose is 12.5 mg twice daily and can be
increased incrementally to a maximum of 50 mg thrice daily.
¨ Heart failure : In congestive heart failure an initial dose of 6.25 mg to
12.5 mg is given under close medical supervision.
Contraindication
A history of previous hypersensitivity to Captopril.
Precautions
Captopril should be used with great caution in patients with impaired
renal function particularly if reno-vascular disease is present or suspected
and in patient with collagen vascular disorders such as systemic lupus
erythematosus or scleroderma. Captopril should not be used during
pregnancy.
Drug Interactions
¨ Diuretics : Diuretics potentiate the antihypertensive effect of
Captopril. Potassium sparing diuretics (Triamterene, Amiloride and
Spironolactone) or potassium supplements may cause significant
increase in serum potassium.
¨ Vasodilators : Captopril has been reported to act synergistically with
peripheral vasodilators such as Minoxidil.
¨ Non-steroidal anti-inflammatory agents : Concomitant therapy with
Indomethacin and possibly other anti-inflammatory drugs may reduce
the antihypertensive effect of Captopril.
¨ Others : Caution should be exercised in prescribing Captopril for
patients receiving concomitant therapy with immuno-suppressant,
procainamide, allopurinol and other drugs known to cause
neutropenia especially in patients with impaired renal function.
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