Captopril (Capoten)
ACE Inhibitor | Antihypertensive
Captopril is an angiotensin-converting enzyme (ACE) inhibitor widely used in the treatment of hypertension, heart failure, and in some cases, for the prevention of kidney problems in diabetic patients.
- Rapid Onset of Action: Captopril has a quick onset of action compared to other ACE inhibitors, making it suitable for situations where an immediate effect is desirable, such as hypertensive crises. However, this also means monitoring for immediate adverse reactions is important.
- Dosing Schedule: Unlike many other ACE inhibitors that are taken once daily, captopril may need to be administered two to three times daily due to its shorter half-life. This can affect patient adherence, so patient education on the importance of following the prescribed schedule is crucial.
- First-Dose Hypotension: Patients may experience significant hypotension after the first dose, particularly if they are taking diuretics or are volume-depleted. It's important to advise patients about potential symptoms and to manage their diuretic use carefully when starting captopril.
- Monitoring Renal Function: Captopril can affect renal function, which is usually transient and reversible upon discontinuation of the drug. Regular monitoring of kidney function is necessary, especially in patients with pre-existing renal impairment or those taking concomitant nephrotoxic drugs.
- Dry Cough: A common side effect of all ACE inhibitors, including captopril, is a persistent dry cough, which can lead to discontinuation of the drug. Patients should be informed about this potential side effect.
- Hyperkalemia: As with other ACE inhibitors, captopril can increase serum potassium levels, which can be dangerous. Monitoring potassium levels and advising patients to avoid potassium-rich diets or supplements is important.
- Angioedema: Although rare, angioedema is a serious and potentially life-threatening reaction associated with ACE inhibitors. Patients should be informed about the signs of angioedema (e.g., swelling of the face, lips, tongue, or throat, difficulty swallowing or breathing) and instructed to seek immediate medical attention if they experience these symptoms.
- Pregnancy: Captopril is contraindicated in pregnancy due to the risk of congenital malformations and neonatal renal impairment. Women of childbearing age should be advised to use effective contraception and notify their healthcare provider if they plan to become or do become pregnant.
- Taste Disturbances: Some patients may experience taste disturbances (dysgeusia), usually a metallic or salty taste, which can affect adherence. This is generally reversible upon discontinuation of the medication.
- Interaction with Food: Absorption of captopril can be reduced by food intake, so it is typically advised to take it one hour before meals for optimal absorption.
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