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| {{DrugProjectFormSinglePage
| | #redirect [[Captopril]] |
| |genericName=generic name
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| |drugClass=Angiontensin converting enzyme inhibitor
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| |indication=[[hypertension]], [[heart failure]], left ventricular dysfunction after [[myocardial infarction]], [[diabetic nephropathy]]
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| |hasBlackBoxWarning=Yes
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| |adverseReactions=[[hypotension]], [[rash]], [[hyperkalemia]] (11% ), disorder of taste, [[cough]] (0.5% to 2%)
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| |blackBoxWarningTitle=Fetal Toxicity
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| |blackBoxWarningBody=*When pregnancy is detected, discontinue captopril as soon as possible.
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| *Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus. See
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| |fdaLIADAdult======Hypertension=====
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| Captopril tablets, USP are indicated for the treatment of [[hypertension]].
| | [[Category: Cardiovascular Drugs]] |
| | | [[Category: Drug]] |
| In using captopril, consideration should be given to the risk of [[neutropenia]]/[[agranulocytosis]].
| | [[Category:ACE inhibitors]] |
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| Captopril may be used as initial therapy for patients with normal renal function, in whom the risk is relatively low. In patients with [[impaired renal function]], particularly those with [[collagen vascular disease]], captopril should be reserved for [[hypertensive]]s who have either developed unacceptable side effects on other drugs, or have failed to respond satisfactorily to drug combinations.
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| Captopril is effective alone and in combination with other antihypertensive agents, especially [[thiazide]]-type [[diuretics]]. The [[blood pressure]] lowering effects of captopril and [[thiazides]] are approximately additive.
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| ======Heart Failure======
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| * Dosing Information
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| :* (Dosage) | |
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| Captopril tablets, USP are indicated in the treatment of [[congestive heart failure]] usually in combination with [[diuretics]] and [[digitalis]]. The beneficial effect of captopril in [[heart failure]] does not require the presence of [[digitalis]], however, most controlled clinical trial experience with captopril has been in patients receiving [[digitalis]], as well as [[diuretic]] treatment.
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| ======Left Ventricular Dysfunction After Myocardial Infarction======
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| * Dosing Information
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| :* (Dosage)
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| Captopril tablets, USP are indicated to improve survival following [[myocardial infarction]] in clinically stable patients with [[left ventricular dysfunction]] manifested as an [[ejection fraction]] ≤40% and to reduce the incidence of overt [[heart failure]] and subsequent hospitalizations for [[congestive heart failure]] in these patients.
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| ======Diabetic Nephropathy======
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| * Dosing Information
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| :* (Dosage) | |
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| Captopril tablets, USP are indicated for the treatment of [[diabetic nephropathy]] ([[proteinuria]] >500 mg/day) in patients with [[type I insulin-dependent diabetes mellitus]] and [[retinopathy]]. Captopril decreases the rate of progression of [[renal insufficiency]] and development of serious adverse clinical outcomes (death or need for renal transplantation or dialysis).
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| In considering use of captopril, it should be noted that in controlled trials [[ACE inhibitors]] have an effect on blood pressure that is less in black patients than in non-blacks. In addition, ACE inhibitors (for which adequate data are available) cause a higher rate of [[angioedema]] in black than in non-black patients.
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| |offLabelAdultGuideSupport======Condition 1=====
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| * Developed by: (Organisation)
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| * Class of Recommendation: (Class) (Link)
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| * Strength of Evidence: (Category A/B/C) (Link)
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| * Dosing Information/Recommendation
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| :* (Dosage)
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| =====Condition 2=====
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| * Developed by: (Organisation)
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| * Class of Recommendation: (Class) (Link)
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| * Strength of Evidence: (Category A/B/C) (Link)
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| * Dosing Information/Recommendation
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| :* (Dosage)
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| |offLabelAdultNoGuideSupport======Condition 1=====
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| * Dosing Information
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| :* (Dosage)
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| =====Condition 2=====
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| * Dosing Information
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| :* (Dosage)
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| =====Condition 3=====
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| * Dosing Information
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| :* (Dosage)
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| |offLabelPedGuideSupport======Condition 1=====
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| * Developed by: (Organisation)
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| * Class of Recommendation: (Class) (Link)
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| * Strength of Evidence: (Category A/B/C) (Link)
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| * Dosing Information/Recommendation
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| :* (Dosage)
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| =====Condition 2=====
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| * Developed by: (Organisation)
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| * Class of Recommendation: (Class) (Link)
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| * Strength of Evidence: (Category A/B/C) (Link)
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| * Dosing Information/Recommendation
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| :* (Dosage)
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| |offLabelPedNoGuideSupport======Condition 1=====
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| * Dosing Information
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| :* (Dosage)
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| =====Condition 2=====
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| * Dosing Information
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| :* (Dosage) | |
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| =====Condition 3=====
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| * Dosing Information
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| :* (Dosage)
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| |contraindications=* [[Hypersensitivity]] to this product or any other [[angiotensin-converting enzyme inhibitor]]
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| *History of [[angioedema]] during therapy with any other [[ACE inhibitor]])
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| |warnings======Fetal Toxicity=====
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| ======{{pcat}} D======
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| Use of drugs that act on the [[renin-angiotensin system]] during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting [[oligohydramnios]] can be associated with fetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include [[skull hypoplasia]], [[anuria]], [[hypotension]], [[renal failure]], and death. When pregnancy is detected, discontinue captopril as soon as possible. These adverse outcomes are usually associated with use of these drugs in the second and third trimester of pregnancy. Most epidemiologic studies examining fetal abnormalities after exposure to [[antihypertensive]] use in the first trimester have not distinguished drugs affecting the [[renin-angiotensin system]] from other [[antihypertensive]] agents. Appropriate management of [[maternal hypertension]] during pregnancy is important to optimize outcomes for both mothers and fetus.
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| In the unusual case that there is no appropriate alternative to therapy with drugs affecting the [[renin-angiotensin system]] for a particular patient, apprise the mother of the potential risk to the fetus. Perform serial [[ultrasound]] examinations to assess the intra-amniotic environment. If [[oligohydramnios]] is observed, discontinue, captopril unless it is considered lifesaving for the mother. Fetal testing may be appropriate, based on the week of pregnancy. Patients and physicians should be aware, however, that [[oligohydramnios]] may not appear until after the fetus has sustained irreversible injury. Closely observe infants with histories of in utero exposure to captopril for [[hypotension]], [[oliguria]], and [[hyperkalemia]].
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| When captopril was given to rabbits at doses about 0.8 to 70 times (on a mg/kg basis) the maximum recommended human dose, low incidences of [[craniofacial malformations]] were seen. No teratogenic effects of captopril were seen in studies of pregnant rats and hamsters. On a mg/kg basis, the doses used were up to 150 times (in hamsters) and 625 times (in rats) the maximum recommended human dose.
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| (Description)
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| |clinicalTrials=======Central Nervous System======
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| : (list/description of adverse reactions)
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| ======Cardiovascular======
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| : (list/description of adverse reactions)
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| ======Respiratory======
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| : (list/description of adverse reactions)
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| ======Gastrointestinal======
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| : (list/description of adverse reactions)
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| ======Hypersensitive Reactions======
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| : (list/description of adverse reactions)
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| ======Miscellaneous======
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| : (list/description of adverse reactions)
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| =====Condition 2=====
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| ======Central Nervous System======
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| : (list/description of adverse reactions)
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| ======Cardiovascular======
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| : (list/description of adverse reactions)
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| ======Respiratory======
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| : (list/description of adverse reactions)
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| ======Gastrointestinal======
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| : (list/description of adverse reactions)
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| ======Hypersensitive Reactions======
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| : (list/description of adverse reactions)
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| ======Miscellaneous======
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| : (list/description of adverse reactions)
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| |postmarketing=(Description)
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| |drugInteractions=* Drug 1
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| * Drug 2
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| * Drug 3
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| * Drug 4
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| * Drug 5
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| =====Drug 1=====
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| (Description)
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| =====Drug 2=====
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| (Description)
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| =====Drug 3=====
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| (Description)
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| =====Drug 4=====
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| (Description)
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| =====Drug 5=====
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| (Description)
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| |useInPregnancyFDA=(Description)
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| |useInPregnancyAUS=(Description)
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| |useInLaborDelivery=(Description)
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| |useInNursing=(Description)
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| |useInPed=(Description)
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| |useInGeri=(Description)
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| |useInGender=(Description)
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| |useInRace=(Description)
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| |useInRenalImpair=(Description)
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| |useInHepaticImpair=(Description)
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| |useInReproPotential=(Description)
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| |useInImmunocomp=(Description)
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| |administration=(Oral/Intravenous/etc)
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| |monitoring======Condition 1=====
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| (Description regarding monitoring, from ''Warnings'' section)
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| =====Condition 2=====
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| (Description regarding monitoring, from ''Warnings'' section)
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| =====Condition 3=====
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| (Description regarding monitoring, from ''Warnings'' section)
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| |IVCompat====Solution===
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| ====Compatible====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Not Tested====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Variable====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Incompatible====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ===Y-Site===
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| ====Compatible====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Not Tested====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Variable====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Incompatible====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ===Admixture===
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| ====Compatible====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Not Tested====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Variable====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Incompatible====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ===Syringe===
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| ====Compatible====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Not Tested====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Variable====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Incompatible====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ===TPN/TNA===
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| ====Compatible====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Not Tested====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Variable====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| ====Incompatible====
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| * Solution 1
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| * Solution 2
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| * Solution 3
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| |overdose====Acute Overdose===
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| ====Signs and Symptoms====
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| (Description)
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| ====Management====
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| (Description)
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| ===Chronic Overdose===
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| ====Signs and Symptoms====
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| (Description)
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| ====Management====
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| (Description)
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| |drugBox={{Drugbox2
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| | verifiedrevid =
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| | IUPAC_name =
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| | image =
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| | drug_name =
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| <!--Clinical data-->
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| | tradename =
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| | MedlinePlus =
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| | licence_US =
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| | pregnancy_AU =
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| | pregnancy_US =
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| | legal_status =
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| | routes_of_administration =
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| <!--Pharmacokinetic data-->
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| | bioavailability =
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| | metabolism =
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| | elimination_half-life =
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| | excretion =
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| <!--Identifiers-->
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| | CAS_number_Ref =
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| | CAS_number =
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| | ATC_prefix =
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| | ATC_suffix =
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| | PubChem =
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| | IUPHAR_ligand =
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| | DrugBank_Ref =
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| | DrugBank =
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| | ChemSpiderID_Ref =
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| | ChemSpiderID =
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| | UNII_Ref =
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| | UNII =
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| | KEGG_Ref =
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| | KEGG =
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| | ChEBI_Ref =
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| | ChEBI =
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| | ChEMBL_Ref =
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| | ChEMBL =
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| | |
| <!--Chemical data-->
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| | C= | H= | N= | O=
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| | molecular_weight =
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| | smiles =
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| | InChI =
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| | InChIKey =
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| | StdInChI_Ref =
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| | StdInChI =
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| | StdInChIKey_Ref =
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| | StdInChIKey =
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| | melting_point =
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| }}
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| |mechAction=(Description)
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| |structure=(Description with picture)
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| |PD=(Description)
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| |PK=(Description)
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| |nonClinToxic=(Description)
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| |clinicalStudies======Condition 1=====
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| (Description)
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| =====Condition 2=====
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| (Description)
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| =====Condition 3=====
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| (Description)
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| |howSupplied=(Description)
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| |fdaPatientInfo=(Patient Counseling Information)
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| |nlmPatientInfo=(Link to patient information page)
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| |lookAlike=* (Paired Confused Name 1a) — (Paired Confused Name 1b)
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| * (Paired Confused Name 2a) — (Paired Confused Name 2b)
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| * (Paired Confused Name 3a) — (Paired Confused Name 3b)
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| |drugShortage=Drug Shortage
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| }}
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