Medical expert of the article
New publications
Preparations
Captopres
Last reviewed: 04.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Captopril is a combination antihypertensive drug.
Indications Captopresa
It is used for various types of hypertension of an arterial nature.
Release form
The medicinal substance is released in tablet form (inside a blister pack - 10 pieces). In a box - 1 or 2 similar packages.
Pharmacodynamics
The medicine contains 2 active ingredients – hydrochlorothiazide with captopril. It has powerful diuretic and antihypertensive properties. Its medicinal activity and principle of action are based on the properties of the constituent components.
The substance captopril is included in the category of ACE inhibitors. The component helps to reduce blood pressure values, reduces systemic resistance exerted by peripheral vessels and preload relative to the myocardium, and at the same time increases the minute cardiac output and resistance to physical exertion. It acts by slowing down the activity of the ACE element, as a result of which the process of transformation of angiotensin-1 into angiotensin-2 is suppressed, which has a strong vasoconstrictor effect.
Hydrochlorothiazide is a thiazide diuretic. It potentiates the excretion of potassium, sodium and chloride ions, as well as fluid. It enhances the hypotensive activity of captopril.
Pharmacokinetics
After oral administration, the active ingredients of the drug are well absorbed in the gastrointestinal tract. Plasma Cmax values of captopril are recorded after 1 hour from the moment of oral administration, and hydrochlorothiazide - after 1-2.5 hours. Approximately 30% of captopril undergoes intraplasmic protein synthesis.
Excretion of active substances occurs mostly with urine (unchanged elements and metabolic products). The half-life of captopril is 45-120 minutes, and that of hydrochlorothiazide is 5.5-15 hours.
Hydrochlorothiazide is able to cross the hematoplacental barrier and can be excreted in breast milk.
Dosing and administration
The medicine is taken orally, swallowing the tablets whole (no need to crush or chew them). The medicine should be washed down with plain water. If necessary, it is allowed to divide the tablet in half. The use of the medicine is not tied to food intake. The duration of the therapeutic cycle is selected by the attending physician, personally for each patient.
Adults with healthy renal function should initially take 25 mg of the drug 2 times a day. Later, if necessary, the dose is increased to 50 mg of the substance 2 times a day.
The maximum daily dose allowed is 0.1 g of captopril and 50 mg of hydrochlorothiazide.
People with kidney disorders and CC values within 30-80 ml/minute should first take the medication in a dose of 25 mg once a day. It is recommended to take the medicine in the morning.
During therapy, it is necessary to monitor plasma urea and potassium levels with creatinine, as well as peripheral blood function.
[ 1 ]
Use Captopresa during pregnancy
Captopril should not be administered to breastfeeding or pregnant women.
Contraindications
It is not prescribed for people with severe personal intolerance to the components of the medication, drugs from the ACE inhibitor category, and also sulfamide derivatives.
It should not be used in individuals with severe renal dysfunction (creatinine clearance below 30 ml/min or plasma creatinine level above 1.8 mg/0.1 l), stenosis in the renal artery (or both kidneys), and in patients who have undergone a kidney transplant.
It is contraindicated for use in people with obstructive disorders, when there is a violation of blood outflow from the left ventricular region (also aortic stenosis), and in addition with Conn's syndrome, decreased plasma sodium and potassium values, and along with gout, as well as hypovolemia or hypercalcemia.
Also, Captopril is not used for liver pathologies that have a severe form of expression.
The drug is used with caution in individuals with immune disorders, CC values within 30-60 ml/minute and increased levels of protein in the urine (over 1 g per day), as well as in those who use procainamide.
Also, the drug should be prescribed with caution to people with heart failure, disorders affecting renal function, increased intrarenal blood pressure, elderly people and diabetics. In case of using the drug in these groups of patients, it is necessary to constantly monitor blood pressure values, blood electrolyte levels and renal function.
People using diuretics should stop taking them at least 3 days before starting to take Captopril.
Caution is required when administering the drug to persons who drive a car or operate machinery that may be life-threatening.
Side effects Captopresa
The administration of the drug may cause some side effects:
- liver and gastrointestinal tract damage: vomiting, bowel disorder, loss of appetite, epigastric pain, nausea, dry mouth and stomatitis. In addition, jaundice, peptic ulcer, hyperbilirubinemia and hepatitis;
- disorders of hematopoiesis and cardiovascular system function: angina pectoris, Raynaud's disease, decreased blood pressure, tachycardia, paleness of the epidermis or hyperemia, thrombocytopenia, neutro- or pancytopenia, and in addition cardiogenic shock, aplastic or hemolytic anemia and agranulocytosis;
- disorders of the PNS and CNS function: headaches, confusion, circadian rhythm disorder, dizziness, tinnitus, emotional instability, stroke, paresthesia and dysfunction of taste and visual receptors;
- problems with the respiratory system: bronchial spasms, cough, respiratory distress and runny nose of allergic origin;
- urinary disorders: polyuria or nephrotic syndrome, severe renal failure and oliguria;
- signs of allergy: urticaria, erythema, Quincke's edema, rashes, photosensitivity, itching and Stevens-Johnson syndrome;
- changes in test results: an increase in the values of urea nitrogen with bilirubin, and also creatinine with calcium in the blood plasma, a decrease in blood glucose and sodium levels, a decrease in hematocrit with platelets, and also leukocytes with hemoglobin, as well as the development of proteinuria;
- other: pain in the chest area, as well as in the joints or muscles, muscle spasms, increased temperature, alopecia, gynecomastia or impotence.
Overdose
The use of too large doses of Captopril leads to tachycardia, nausea, headaches, bowel disorders, neutropenia, vomiting and anorexia, as well as a decrease in blood pressure. Subsequent increase in dosage causes the appearance of signs of hydrochlorothiazide intoxication - an imbalance of EBV and a state of coma (as a result of the effect of the drug on the central nervous system).
To eliminate the disorders, it is necessary to first perform gastric lavage, after which the patient should be given enterosorbents. Symptomatic measures are carried out if necessary.
In severe hydrochlorothiazide intoxication, the patient should be hospitalized to undergo hemodialysis and procedures required to restore and maintain EBV indices and cardiovascular function. In addition, procedures to support the respiratory system, kidneys, and central nervous system may be necessary.
Interactions with other drugs
Combination with MAOIs, vasodilators, diazoxide, ganglionic blockers, diuretics and adrenergic blockers causes an increase in the antihypertensive activity of the drug.
Potassium-sparing diuretics and potassium-containing drugs, when used in combination with Captopril, increase plasma potassium levels and increase the likelihood of hyperkalemia.
A decrease in the effectiveness of the drug is observed when combined with methenamine or NSAIDs.
Combining the substance with lithium agents leads to an increase in the plasma values of the latter.
Concomitant use with barbiturates, ethanol and narcotic medications increases the likelihood of orthostatic collapse.
Combination with GCS, amphotericin B, and also with adrenocorticotropic hormone may lead to the development of electrolyte metabolism disorders.
Captopril is able to potentiate plasma calcium levels.
The drug potentiates the toxic activity of SG when used in combination with them.
Use together with the drug may require correction of the dose of hypoglycemic agents, anti-gout drugs, sulfinpyrazone, probenecid, as well as orally taken anticoagulants.
Colestipol with cholestyramine reduces the absorption of hydrochlorothiazide.
It is also necessary to stop using the medication at least 7 days before a planned operation.
[ 2 ]
Shelf life
Captopril can be used within a 3-year period from the date of manufacture of the therapeutic substance.
Application for children
Not used in pediatrics (children under 18 years of age).
Analogues
The following drugs are considered analogs of the drug: Kapozid, Liprazid, Ramipril and Normopres with Enalozid, and in addition to this, Noliprel, Accuzid, Hartil-N, Enzix with Co-Diroton, Berlipril plus with Enzix duo and Ramizes com.
Attention!
To simplify the perception of information, this instruction for use of the drug "Captopres" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.