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Pronunciation

KAP-toe-pril

Classifications

Therapeutic Classification: antihypertensives

Pharmacologic Classification: ace inhibitors

Indications

REMS


Action

  • Angiotensin-converting enzyme (ACE) inhibitors block the conversion of angiotensin I to the vasoconstrictor angiotensin II. ACE inhibitors also prevent the degradation of bradykinin and other vasodilatory prostaglandins. ACE inhibitors also plasma renin levels and aldosterone levels. Net result is systemic vasodilation.
Therapeutic effects:
  • Lowering of BP in patients with hypertension.
  • Improved survival and reduced symptoms in patients with HF.
  • Improved survival and reduced development of overt HF after MI.
  • Decreased progression of diabetic nephropathy with decreased need for transplantation or dialysis.

Pharmacokinetics

Absorption: 60–75% absorbed following oral administration ( by food).

Distribution: Well distributed to tissues.

Metabolism/Excretion: 50% metabolized by the liver to inactive compounds; 50% excreted unchanged in urine.

Half-Life: Infants with HF: 3.3 hr (range 1.2–12.4 hr); Children: 1.5 hr (range 0.98–2.3 hr); Adults: 1.9 hr ( to 20–40 hr in renal impairment); Adults with HF: 2.1 hr.

Time/Action Profile

(effect on BP—single dose)
ROUTEONSETPEAKDURATION
PO15–60 min60–90 min6–12 hr



Full effects may not be noted for several wk.



Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

Interactions

Drug-drug:

Drug-Natural Products:

Route/Dosage

Hypertension

Heart Failure

Left Ventricular Dysfunction Post–Myocardial Infarction

Diabetic Nephropathy

Renal Impairment

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Capoten