Adult Dosing
Hypertension
- Start 12.5-25 mg PO bid-tid
- May increased at q1-2 wks to 150 mg PO tid
- Max: 450 mg/day
- Note: Initiate therapy with 6.25-1.25 mg PO bid-tid in patients receiving diuretics
CHF
- Start 25 mg PO tid (6.25-12.5 mg tid if on diuretics)
- May increase up to 50 mg PO tid
- Usual range: 25-50 mg PO tid
- Max: 450 mg/day
Diabetic nephropathy
Left ventricular dysfunction, post MI
- 6.25-mg test dose on day 3 post MI, followed by 12.5 mg PO tid
- May be further increased up to 50 mg PO tid
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established. There is limited reported use in literature, dosage is recommended on weight basis
Renal Dose Adjustment (Based on CrCl)
- 10-50 mL/min: Decrease dose 25%
- <10 mL/min: Decrease dose 50%
- Hemodialysis: No supplement
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustment not defined
- Angioedema involving the extremities, face, lips, mucous membranes, tongue, glottis or larynx has been reported in patients treated with ACE inhibitors. If airway obstruction occurs, institute emergency therapy with epinephrine. Use with extreme caution in patients with hereditary angioedema
- Significant hypotension may occur after first dose, especially in patients with severe salt or volume depletion or those with CHF. Start therapy under close nedical supervision in these patient groups
- Assess heart failure patients for evidence of worsening failure (evaluation of peripheral edema, shortness of breath). Increase in weight (eg, 2 pounds in 1 day or 5 pounds in 1 wk), worsening edema, shortness of breath are signs of worsening of heart failure
- Rarely, ACE inhibitors can cause cholestatic jaundice progressing to fulminant hepatic necrosis and (sometimes) death. Discontiune therapy if marked elevations of hepatic enzymes occur
- Neutropenia and agranulocytosis may occur after captopril administration. Risk increases with renal function impairment, CHF
- ACE inhibitors can cause fetal morbidity/mortality if administered to pregnant women. When pregnancy is detected, dicontinue therapy as soon as possible
- Monitor BUN/Cr at baseline, then periodically, or more frequently if CHF, renal artery stenosis
- Monitor electrolytes and BP periodically
- Monitor WBC with differential count at baseline if renal impairment, then q2wk x 3mo, then periodically
Cautions: Use cautiously in
- Renal impairment
- Renal artery stenosis
- CAD
- Aortic stenosis
- Cerebrovascular disease
- Collagen vascular disease
- Hypotension
- Hyponatremia
- Volume depletion
- Severe CHF
- Hypertrophic cardiomyopathy
- Dialysis w/ high-flux membranes
- LDL apheresis w/ dextran
- Antigen desensitization tx
- Elderly patients
- Black patients
Pregnancy Category:C (D in second and third trimesters)
Breastfeeding: Excreted in breast milk in low amounts, it would not be expected to cause any adverse events in breastfed infants. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACTlast accessed 12 May 2010)
US Trade Name(s)
US Availability
captopril (generic)
- TABS: 12.5, 25, 50, 100 mg
Capoten
- TABS: 12.5, 25, 50, 100 mg
Canadian Trade Name(s)
- Apo-Capto-Tab
- Nu-Capro-Tab
- Capoten
Canadian Availability
captopril (generic)
- TABS: 12.5, 25, 50, 100 mg
Apo-Capto-Tab, Nu-Capro-Tab
- TABS: 6.25, 12.5, 25, 50, 100 mg
Capoten
UK Trade Name(s)
UK Availability
Capoten
Australian Trade Name(s)
Australian Availability
captopril (generic)
Acenorm, Captohexal
Capoten
- TABS: 12.5, 25, 50 mg
- SOLN: 5 mg/mL (95 mL)
Pricing data from www.DrugStore.com in U.S.A.
- Captopril 50 MG TABS [Bottle] (WEST-WARD)
100 mg = $16.99
200 mg = $22.97 - Captopril 100 MG TABS [Bottle] (WEST-WARD)
90 mg = $19.99
180 mg = $29.97 - Captopril 12.5 MG TABS [Bottle] (WEST-WARD)
100 mg = $12.99
200 mg = $18.98 - Captopril 25 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
90 mg = $13.99
180 mg = $26.99
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
