Back to Angiotensin-converting enzyme (ACE) inhibitors

Name: Captopril

Pregnancy Category C

Drug classes

Antihypertensive
Angiotensin-converting enzyme (ACE) inhibitor

Mechanism of action

Blocks ACE from converting angiotensin I to angiotensin II, a powerful vasoconstrictor, leading to decreased blood pressure, decreased aldosterone secretion, a small increase in serum otassium levels, and sodium and fluid loss; increased prostaglandin synthesis also may be involved in the antihypertensive action.

Indications

Treatment of hypertension alone or in combination with thiazide-type diuretics
Treatment of CHF in patients who do not respond adquately to conventional therapy; used with diuretics anddigitalis

Unlabeled uses: management of hypertensive crises; treatment of rheumatoid arthritis; diabetic nephropathy, diagnosis of anatomic renal artery stenosis, hypertension related to scleroderma renal crisis; diagnosis of primary aldosteronism, idiopathic edema; Bartter's syndrome; Raynaud's syndrome; hypertension of Takayasu's disease

Contraindications/cautions

Allergy to captopril; impaired renal function; CHF; salt/volume depletion, lactation.

Adverse effects

CV: Tachycardia, angina pectoris, myocardial infarction, Raynaud's syndrome, CHF, hypotension in salt/volume depleted patients
GI: Gastric irritation, aphthous ulcers, peptic ulcers, dysgeusia, cholestatic jaundice, hepatocellular injury, anorexia, constipation
Hematologic: Neutropenia, agranulocytosis, thrombocytopenia, hemolytic anemia, fatal pancytopenia
GU: Proteinuria, renal insufficiency, renal failure, polyuria, oliguria, urinary frequency
Dermatologic: Rash, pruritus, pemphigoid-like reaction, scalded mouth sensation, exfoliative dermatitis, photosensitivity, alopecia
Other: Cough, malaise, dry mouth, lymphadenopathy

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