APOLEX
CAPTOPRIL · by MEDICEENA
Composition
Tab 12.5 mg/25 mg/50 mg: Captopril 12.5 mg/25 mg/50 mg.
Indications & Dosage
Hypertension: Adult: Initially 12.5-25 mg twice daily, then increased if necessary up to 150 mg daily in 2 divided doses, increased at intervals of at least 2 weeks,once-daily dosing may be appropriate if other concomitant antihypertensive drugs are taken. Elderly: Initially 6.25 mg twice daily, then increased ifnecessary up to 150 mg daily in 2 divided doses, increased at intervals of at least 2 weeks, once-daily dosing may be appropriate if other concomitant antihypertensive drugs are taken. Essential hypertension if used in volume depletion, cardiac decompensation, or renovascular hypertension: Adult: Initially 6.25-12.5 mg for 1 dose (under close medical supervision), then 6.25-12.5 mg twice daily; increased if necessary up to 100 mg daily in 1-2 divided doses, increased at intervals of at least 2 weeks, once-daily dosing may be appropriate if other concomitant antihypertensive drugs are taken. Heart failure: Adult: initially 6.25-12.5 mg 2-3 times a day, then increased if tolerated to up to 150 mg daily in divided doses, dose to be increased gradually at intervals of at least 2 weeks. Short-term treatment within 24 hours of onset of myocardial infarction in clinically stable patients: Adult: initially 6.25 mg, then increased to 12.5 mg after 2 hours, followed by 25 mg after 12 hours; increased if tolerated to 50 mg twice daily for 4 weeks. Prophylaxis of symptomatic heart failure after myocardial infarction in clinically stable patients with asymptomatic left ventricular dysfunction (starting 3-16 days after infarction): Adult: initially 6.25 mg daily, then increased to 12.5 mg 3 times a day for 2 days, then increased if tolerated to 25 mg 3 times a day, then increased if tolerated to 75-150 mg daily in 2-3 divided doses, doses exceeding 75 mg per day to be increased gradually. Diabetic nephropathy in type 1 diabetes mellitus: ADULT: 75-100 mg daily in divided doses.
Contraindications
Aortic stenosis, renal impairment, see literature.
Precautions
Patients on concomitant diuretics, first dose hypotension (especially in patients taking high doses of diuretics, on a low-sodium diet, on dialysis, dehydrated, or with heart failure), peripheral vascular disease or Generalized atherosclerosis (risk of clinically silent renovascular disease), primary aldosteronism, the risk of agranulocytosis is possibly increased in collagen vascular disease (blood counts recommended), history of idiopathic or hereditaryangioedema, hypertrophiccardiomyopathy, severe or symptomatic aortic stenosis, renal impairment, collagen vascular disease, immunosuppressant therapy, or leucopenia drugs monitor white cell count and urinary protein, anaesthesia, in congestive cardiac failure, initiate therapy under close supervision, continue diuretics and, if appropriate, digitalis concurrently.
Interactions
K+ sparing diuretics or K+ supplements, NSAID, vasodilators, clonidine, allopurinol, procainamide, probenecid, immune-suppressants
Side Effects
Pruritus, abdominal pain, altered liver function tests, angioedema, arthralgia, blood disorders, bronchospasm, cholestatic jaundice, constipation, diarrhoea, dizziness, dyspepsia, eosinophilia, fatigue, fulminant hepatic necrosis, haemolytic anaemia, headache hepatic failure, hepatitis, hyperkalaemia, hypoglycaemia, leukocytosis, leucopenia, malaise, myalgia, nausea, neutropenia, pancreatitis, paraesthesia, photosensitivity, positive antinuclear antibody, profound hypotension, renal impairment, rhinitis, serositis, sinusitis, thrombocytopenia, urticaria, vasculitis, vomiting