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Captopril

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Captopril, Capoten

  • See Also
  1. ACE Inhibitor
  • Indications
  1. See ACE Inhibitor
  • Mechanism
  1. See ACE Inhibitor
  2. Captopril is a sulfhydryl-containing analog of Proline
  3. Angiotensin-converting enzyme (ACE) inhibitor
  4. Possible antineoplastic activity
    1. May decrease tumor Angiogenesis by inhibiting endothelial cell matrix metalloproteinases (MMPs) and endothelial cell migration
  • Dosing
  • Adults
  1. Hypertension
    1. Start 25 mg orally twice to three times daily
    2. Target 25 to 150 mg orally twice to three times daily
    3. Maximum 450 mg/day
  2. Congestive Heart Failure (CHF)
    1. Start 6.25 - 12.5 mg orally three times daily
    2. Target 50 to 100 mg orally three times daily
    3. Maximum 450 mg/day
  3. Diabetic Nephropathy
    1. Take 25 mg orally three times daily
  4. Hypertensive Urgency (not FDA approved)
    1. Take 12.5 to 25 mg orally every 30 to 60 minutes as needed up to 2 doses
  • Dosing
  • Children (not FDA approved)
  1. Newborns
    1. Give 0.1 to 0.4 mg/kg/day orally divided every 6 to 8 hours
  2. Infants
    1. Start 0.15 to 0.3 mg/kg/dose and titrate
    2. Maximum 6 mg/kg/day divided two to four times daily
  3. Children
    1. Start 0.3 to 0.5 mg/kg/dose and titrate
    2. Maximum 6 mg/kg/day up to 450 mg/day divided two to four times daily
  • Supplied
  1. Available as scored generic tablets: 12.5, 25, 50 and 100 mg
  2. To make Captopril solution (1 mg/ml)
    1. Disolve tablet in flavored syrup (e.g. 25 mg tablet in 25 ml syrup)
    2. Stable at room Temperature for up to 7 days
  • Metabolism
  1. Primarily renal excretion
  • Adverse Effects
  1. See ACE Inhibitor
  • Safety
  1. See ACE Inhibitor
  2. Pregnancy Category X
  3. Captopril is among only two ACE Inhibitors labeled by AAP as compatible with Breast Feeding
    1. However, Captopril is excreted in Breast Milk and may be associated with newborn adverse effects
  • Resources
  1. Captopril (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=607687f4-63cf-411c-a20b-21d238a6b7a7
  • References
  1. (2016) Presc Lett, Resource #321151, ACE Inhibitor Antihypertensive Dose Comparison
  2. (2020) Med Lett Drugs Ther 62(1598): 73-80
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 68-9
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia