Captopril indications and usage: Difference between revisions
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====Hypertension==== | ====Hypertension==== | ||
Captopril tablets, USP are indicated for the treatment of hypertension. | Captopril tablets, USP are indicated for the treatment of [[hypertension]]. | ||
In using captopril, consideration should be given to the risk of neutropenia/agranulocytosis. | In using captopril, consideration should be given to the risk of [[neutropenia]]/[[agranulocytosis]]. | ||
Captopril may be used as initial therapy for patients with normal renal function, in whom the risk is relatively low. In patients with impaired renal function, particularly those with collagen vascular disease, captopril should be reserved for hypertensives who have either developed unacceptable side effects on other drugs, or have failed to respond satisfactorily to drug combinations. | Captopril may be used as initial therapy for patients with normal renal function, in whom the risk is relatively low. In patients with impaired renal function, particularly those with [[collagen vascular disease]], captopril should be reserved for hypertensives who have either developed unacceptable side effects on other drugs, or have failed to respond satisfactorily to drug combinations. | ||
Captopril is effective alone and in combination with other antihypertensive agents, especially thiazide-type diuretics. The blood pressure lowering effects of captopril and thiazides are approximately additive. | Captopril is effective alone and in combination with other antihypertensive agents, especially thiazide-type [[diuretics]]. The blood pressure lowering effects of captopril and [[thiazides]] are approximately additive. | ||
====Heart Failure==== | ====Heart Failure==== | ||
Captopril tablets, USP are indicated in the treatment of congestive heart failure usually in combination with diuretics and digitalis. The beneficial effect of captopril in heart failure does not require the presence of digitalis, however, most controlled clinical trial experience with captopril has been in patients receiving digitalis, as well as diuretic treatment. | Captopril tablets, USP are indicated in the treatment of [[congestive heart failure]] usually in combination with diuretics and [[digitalis]]. The beneficial effect of captopril in heart failure does not require the presence of digitalis, however, most controlled clinical trial experience with captopril has been in patients receiving digitalis, as well as diuretic treatment. | ||
====Left Ventricular Dysfunction After Myocardial Infarction==== | ====Left Ventricular Dysfunction After Myocardial Infarction==== | ||
Captopril tablets, USP are indicated to improve survival following myocardial infarction in clinically stable patients with left ventricular dysfunction manifested as an ejection fraction ≤40% and to reduce the incidence of overt heart failure and subsequent hospitalizations for congestive heart failure in these patients. | Captopril tablets, USP are indicated to improve survival following [[myocardial infarction]] in clinically stable patients with [[left ventricular dysfunction]] manifested as an [[ejection fraction]] ≤40% and to reduce the incidence of overt heart failure and subsequent hospitalizations for congestive heart failure in these patients. | ||
====Diabetic Nephropathy==== | ====Diabetic Nephropathy==== | ||
Captopril tablets, USP are indicated for the treatment of diabetic nephropathy (proteinuria >500 mg/day) in patients with type I insulin-dependent diabetes mellitus and retinopathy. Captopril decreases the rate of progression of renal insufficiency and development of serious adverse clinical outcomes (death or need for renal transplantation or dialysis). | Captopril tablets, USP are indicated for the treatment of [[diabetic nephropathy]] ([[proteinuria]] >500 mg/day) in patients with [[type I insulin-dependent diabetes mellitus]] and [[retinopathy]]. Captopril decreases the rate of progression of [[renal insufficiency]] and development of serious adverse clinical outcomes (death or need for renal transplantation or dialysis). | ||
In considering use of captopril, it should be noted that in controlled trials ACE inhibitors have an effect on blood pressure that is less in black patients than in non-blacks. In addition, ACE inhibitors (for which adequate data are available) cause a higher rate of angioedema in black than in non-black patients.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = CAPTOPRIL (CAPTOPRIL ) TABLET CAPTOPRIL TABLET [APOTEX CORP.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=2c0f1ee3-b2b7-a1bc-059a-d65bea6cd0ef | publisher = | date = | accessdate =}}</ref> | In considering use of captopril, it should be noted that in controlled trials [[ACE inhibitors]] have an effect on blood pressure that is less in black patients than in non-blacks. In addition, ACE inhibitors (for which adequate data are available) cause a higher rate of [[angioedema]] in black than in non-black patients.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = CAPTOPRIL (CAPTOPRIL ) TABLET CAPTOPRIL TABLET [APOTEX CORP.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=2c0f1ee3-b2b7-a1bc-059a-d65bea6cd0ef | publisher = | date = | accessdate =}}</ref> | ||
==References== | ==References== | ||
Revision as of 16:29, 12 February 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2]
INDICATIONS AND USAGE
Hypertension
Captopril tablets, USP are indicated for the treatment of hypertension.
In using captopril, consideration should be given to the risk of neutropenia/agranulocytosis.
Captopril may be used as initial therapy for patients with normal renal function, in whom the risk is relatively low. In patients with impaired renal function, particularly those with collagen vascular disease, captopril should be reserved for hypertensives who have either developed unacceptable side effects on other drugs, or have failed to respond satisfactorily to drug combinations.
Captopril is effective alone and in combination with other antihypertensive agents, especially thiazide-type diuretics. The blood pressure lowering effects of captopril and thiazides are approximately additive.
Heart Failure
Captopril tablets, USP are indicated in the treatment of congestive heart failure usually in combination with diuretics and digitalis. The beneficial effect of captopril in heart failure does not require the presence of digitalis, however, most controlled clinical trial experience with captopril has been in patients receiving digitalis, as well as diuretic treatment.
Left Ventricular Dysfunction After Myocardial Infarction
Captopril tablets, USP are indicated to improve survival following myocardial infarction in clinically stable patients with left ventricular dysfunction manifested as an ejection fraction ≤40% and to reduce the incidence of overt heart failure and subsequent hospitalizations for congestive heart failure in these patients.
Diabetic Nephropathy
Captopril tablets, USP are indicated for the treatment of diabetic nephropathy (proteinuria >500 mg/day) in patients with type I insulin-dependent diabetes mellitus and retinopathy. Captopril decreases the rate of progression of renal insufficiency and development of serious adverse clinical outcomes (death or need for renal transplantation or dialysis).
In considering use of captopril, it should be noted that in controlled trials ACE inhibitors have an effect on blood pressure that is less in black patients than in non-blacks. In addition, ACE inhibitors (for which adequate data are available) cause a higher rate of angioedema in black than in non-black patients.[1]
References
Adapted from the FDA Package Insert.