Mild-to-moderate hypertension: Used as an add-on to thiazide therapy in patients who do not achieve adequate control with thiazide alone.

Severe hypertension: Recommended when conventional treatment has not been effective.

Congestive heart failure: Captopril is indicated for managing congestive heart failure and is generally used alongside diuretics and, when suitable, digitalis.

Captopril is a sulfhydryl-containing derivative of proline with antihypertensive properties. It works by competitively inhibiting angiotensin-converting enzyme (ACE), which reduces angiotensin II levels, increases plasma renin activity, and lowers aldosterone secretion. Around 60–75% of an oral dose is quickly absorbed from the gastrointestinal tract in both healthy individuals and patients with hypertension. More than 95% of the dose is eliminated via the kidneys, either unchanged (45–50%) or as metabolites.

Mild-to-moderate hypertension: The starting dose is 12.5 mg twice daily. The usual maintenance dose is 25 mg twice daily, which may be gradually increased at intervals of 2–4 weeks until an adequate response is achieved, up to a maximum of 50 mg twice daily.

Severe hypertension: In severe cases, the initial dose is 12.5 mg twice daily. The dose may be increased stepwise up to a maximum of 50 mg three times daily.

Heart failure: An initial dose of 6.25 mg or 12.5 mg may help reduce temporary hypotension. The typical maintenance dose is 25 mg three times daily, with a usual maximum of 150 mg per day.

Captopril should be taken 1 hour before meals to ensure optimal absorption.

Use in Child: Safety and effectiveness in pediatric patients have not been established.

Aliskiren should not be used together with Captopril in patients with diabetes. Renal function should be monitored regularly.

History of hypersensitivity to captopril. It is contraindicated during pregnancy and should not be used in women of childbearing potential unless effective contraception is ensured.

Neutropenia, anemia, proteinuria, hypotension, tachycardia, and rashes (usually pruritic) may occur. Gastric irritation and abdominal pain may also occur.

There are no available data in pregnant women to determine the drug-associated risk. Due to the potential for serious adverse reactions, a decision should be made whether to discontinue nursing or to discontinue the drug.

Evaluation of the patient should include assessment of renal function before captopril therapy and at appropriate intervals thereafter. Patients with renal impairment should not normally be treated with captopril. Captopril should not be used in patients with aortic stenosis or outflow tract obstruction.

Correction of hypotension would be of primary concern.

Angiotensin-converting enzyme (ACE) inhibitor

Store below 30°C, away from light and moisture. Keep out of reach of children.