Capothiazide

Capothiazide is a combination drug from the ACE inhibitor category.

Indications Capothiazide

It is used for therapy of various forms of hypertension (this includes diseases that are resistant to other antihypertensive drugs).

Release form

The medicine is released in tablets, in the amount of 10 pieces, packed in blister plates. Inside the box there are 2 such plates.

Pharmacodynamics

A complex antihypertensive drug containing the component captopril. The active element is an ACE inhibitor, inhibits the formation of angiotensin 2, and also prevents its vasoconstrictor effect and stimulation in relation to the adrenal secretion of aldosterone. In addition, it reduces the overall resistance of peripheral vessels and blood pressure indicators, weakens the post- and preload relative to the myocardium, and at the same time lowers the pressure inside the pulmonary circulation and the right atrium.

Hydrochlorothiazide has a moderate diuretic effect, increasing the volume of chlorine, sodium ions, water and potassium excreted from the body. At the same time, it reduces the sodium ion index inside the vascular membranes, weakening their sensitivity to the vasoconstrictor effect and thereby potentiating the hypotensive effect of captopril.

Pharmacokinetics

Captopril taken orally is absorbed at a high rate. It reaches peak blood levels after 60 minutes. Minimum absorption values are about 70%. Eating food reduces absorption in the gastrointestinal tract by approximately 30-40%. Protein synthesis in blood plasma is 25-30%. The plasma half-life of the drug is less than 3 hours.

Over 95% of the administered dose of the drug is excreted in the urine. If the patient has renal dysfunction, the drug may accumulate inside the body.

The hypotensive effect develops after 0.5-1 hour and persists for the next 4-8 hours.

Hydrochlorothiazide taken orally is absorbed approximately 60-80%. It takes 1.5-3 hours for the Cmax indicator to develop. The substance accumulates inside erythrocytes, where its values are 3-9 times higher than the plasma level. Protein synthesis occurring inside the plasma is 40-70%; the metabolism of the substance is extremely weak.

Excretion of the component from plasma occurs in 2 stages: the initial stage of the half-life is 2 hours, and the final stage (10-12 hours after consumption) is approximately 10 hours.

In people with healthy kidney function, excretion occurs almost entirely through the kidneys. About 50-75% of the consumed dose of the drug is excreted unchanged in the urine.

Dosing and administration

The drug should be taken orally, 60 minutes before meals. Portion sizes are selected individually for each patient, taking into account the severity of the pathology. The initial dosage is 0.5 tablets (equivalent to 25 mg), which should be taken once a day.

If the hypotensive effect is insufficient, the daily dose may be increased to 50 mg (1 tablet) once a day in one dose. The duration of the treatment course is also selected for each patient individually.

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Use Capothiazide during pregnancy

It is prohibited to prescribe the medication to lactating or pregnant women.

Contraindications

Main contraindications:

• the presence of strong sensitivity to medicinal elements;
• the presence of a tendency to develop Quincke's edema when using ACE inhibitors in the past;
• collagenoses;
• significant renal dysfunction (CC values are less than 30 ml/minute), and in addition to this, acute inflammation inside the kidneys;
• arterial stenosis inside the kidneys (unilateral (if the patient has only 1 kidney) or bilateral), as well as conditions in people who have recently had a kidney transplant;
• hypercalcemia;
• mitral or aortic stenosis;
• problems with liver function;
• Conn's syndrome;
• hypokalemia or -natremia, especially when combined with hypovolemia;
• gout.

Side effects Capothiazide

Correctly selected dosages of the drug do not lead to the appearance of negative symptoms. But in case of using high doses or in people with intolerance to the drug, the following side effects may be observed:

• problems with the functioning of the cardiovascular system: decreased blood pressure (sometimes orthostatic collapse), palpitations. There are reports of myocardial infarction, arrhythmia, angina attacks, as well as disorders of cerebral blood flow processes of an ischemic nature;
• respiratory dysfunction: development of bronchitis. Rarely, bronchial spasms, runny nose, sinusitis or laryngitis appear;
• renal dysfunction: proteinuria occasionally appears. There are also reports of acute renal failure;
• lesions affecting metabolic processes (electrolytes and other elements): hyponatremia or -magnesemia, and in addition hyperuricemia, -calcemia, -cholesterolemia or -glycemia;
• manifestations in the gastrointestinal tract or liver: discomfort in the epigastric zone, nausea and dyspeptic symptoms. Rarely, diarrhea, dry mouth, vomiting, taste disorders, loss of appetite or constipation appear. Also occasionally observed are hepatitis, intestinal obstruction, cholestatic jaundice or pancreatitis, and in addition, an increase in the activity of liver transaminases;
• problems with the central nervous system: headaches and drowsiness. Occasionally, sleep disorders, depression, dizziness, seizures, visual disturbances and tinnitus may occur;
• disorders of the hematopoietic system: thrombocytopenia or leukopenia, as well as eosinophilia or anemia, occasionally develop. Agranulocytosis or pancytopenia may appear sporadically;
• immunotoxic or allergic lesions: rash on the epidermis, urticaria, erythema multiforme, itching, Quincke's edema, exfoliative dermatitis and TEN. Eosinophilia, arthralgia or myalgia may also develop, and the temperature may increase. There is evidence of photosensitivity or drug-induced lupus;
• other manifestations: onycholysis or hair loss.

Overdose

Intoxication can lead to a potentiation of the negative manifestations described above.

Symptomatic measures are taken to eliminate the disorders.

Interactions with other drugs

The combined use of the drug with vasodilators, tranquilizers, nitrates, sleeping pills, tricyclics and alcoholic beverages leads to potentiation of its hypotensive activity.

Antihypertensive and other additionally prescribed diuretics potentiate the antihypertensive effect of Capotiazide.

NSAIDs lead to a weakening of the antihypertensive effect of the drug.

Combination with potassium drugs, heparin or potassium-sparing diuretics may cause hyperkalemia.

Use with lithium drugs may increase plasma lithium levels, increasing the likelihood of its toxic and adverse effects.

The combination of the drug with GCS, cytostatics, immunosuppressants or allopurinol increases the likelihood of developing a suppressive effect on hematopoietic processes.

The medication can reduce the effectiveness of hypoglycemic drugs taken orally.

The severity and duration of the effects of muscle relaxants may be increased when used in combination with Capothiazide.

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Storage conditions

Capotiazid should be stored in a dark and dry place, out of reach of children. Temperature indicators are within the range of 15-25°C.

Shelf life

Capothiazide can be used within 24 months from the date of manufacture of the drug.

Application for children

There is no information on the use of Capotiazide in pediatrics.

Analogues

The analogs of the drug are Captopril, Renipril GT, Enzix and Enzix Duo, as well as Normopres, Prestarium with Perindide, Prilamide, Co-diroton, Noliprel and Lisinoton N with Co-Perineva.

Reviews

Kapotiziad works effectively at elevated blood pressure values, helping to reduce these indicators quite quickly - this is exactly what patients who have used this drug write about it in their reviews.