Captopril belongs to the group of medications known as ACE inhibitors. It is used to treat high blood pressure, congestive heart failure, and diabetic nephropathy (kidney problems caused by diabetes). Captopril is also used to improve survival after a heart attack. It works by relaxing blood vessels and making the heart pump more efficiently.
Captopril may be used in addition to other blood pressure medications, such as a diuretic (water pill) like hydrochlorothiazide, when one medication has not been found to satisfactorily control blood pressure or congestive heart failure.
Each white, biconvex tablet, inscribed “P” and scored on opposite sides, contains 12.5 mg of captopril. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, lactose, microcrystalline cellulose, palmitic acid, and talc.
Each white, square, biconvex tablet, inscribed “CAPTOPRIL 25” on one side and double-scored on the other side, contains 25 mg of captopril. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, lactose, microcrystalline cellulose, palmitic acid, and talc.
Each white, oval, biconvex tablet, inscribed “CAPTOPRIL 50” and “P” logo scored “P” logo on the other side, contains 50 mg of captopril. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, lactose, microcrystalline cellulose, palmitic acid, and talc.
Each white, oval, biconvex tablet, inscribed “CAPTOPRIL 100” and “P” logo scored “P” logo on the other side, contains 100 mg of captopril. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, lactose, microcrystalline cellulose, palmitic acid, and talc.
The usual starting dose of captopril depends on the condition for which you are taking this medication.
For treating high blood pressure, the usual starting dose is 25 mg taken by mouth 2 or 3 times a day. After 1 or 2 weeks, your doctor may increase your dose, depending on side effects and how well the medication is working for you. The dose of captopril to control blood pressure does not usually go above 50 mg 3 times daily. The maximum dose of captopril is 450 mg daily given in 3 equally divided doses.
For treating heart failure, the usual starting dose is 25 mg taken by mouth 2 or 3 times a day. After 1 or 2 weeks, your doctor may increase your dose, depending on side effects and how well the medication is working for you. The dose of captopril to treat heart failure does not usually go above 50 mg to 100 mg given 3 times daily. The maximum dose of captopril is 450 mg daily given in 3 divided doses.
After a heart attack, the usual starting dose is 12.5 mg taken by mouth, 3 times a day. This dose will be increased gradually, to the recommended daily dose of 50 mg taken 3 times a day.
When treating kidney disease caused by diabetes, the recommended dose is 25 mg taken by mouth, 3 times daily. If this dose does not adequately lower blood pressure, other medications will be used in addition to captopril. Captopril should be taken 1 hour before meals.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.
Do not take this medication if you:
Although most of these side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Signs of too much potassium in the body:
Stop taking the medication and seek immediate medical attention if any of the following occur:
Angioedema: Angioedema (a serious allergic reaction that causes the area around the throat and tongue to swell) may occur with the use of ACE inhibitors, including captopril. This occurs for about 1 in 1,000 people. If you experience swelling of the face, tongue, or throat, stop taking captopril at once and seek immediate medical attention. People who have had angioedema caused by other substances may be at increased risk of angioedema while taking an ACE inhibitor.
Cough: People taking captopril may develop a dry, persistent cough that usually disappears only after stopping or lowering the captopril dose. Be sure to tell your doctor of any cough that does not seem to be related to a usual cause.
Fluid and electrolyte levels: Increases in blood levels of potassium occur for a small percentage of people who take captopril. This rarely causes problems, but your doctor should monitor your potassium levels. People with kidney disease or diabetes are at a higher risk of having increased blood potassium while taking captopril.
Infection: Captopril can reduce the number of cells that fight infection in the body (white blood cells). Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.
Report any signs of infection, such as sore throat or fever, to your doctor.
Kidney function: Changes in kidney function have been seen in certain people taking this medication. The use of diuretics (water pills) or aliskiren may further increase the risk of kidney problems for those already at risk for this problem. If you have kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Let your doctor know if you notice any decrease in urine output or increased swelling of the lower limbs, which suggests an accumulation of fluid due to decreased urination.
Liver function: Changes in liver function have occurred in people with or without preexisting liver problems during treatment with this medication. In most cases, the changes were reversed when the medication was stopped. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Low blood pressure: Occasionally, blood pressure drops too low after taking captopril. This usually happens after the first or second dose or when the dose is increased. It is more likely to occur for those who take aliskiren or water pills, have a salt-restricted diet, are on dialysis, are suffering from diarrhea or vomiting, or have been sweating excessively and not drinking enough liquids. Get up slowly when rising from a sitting or lying down position. If low blood pressure causes you to faint or feel lightheaded, contact your doctor.
Excessive sweating and lack of fluid intake may lead to an excessive fall in blood pressure because of reduced fluid in your blood vessels. Vomiting or diarrhea may also lead to a fall in blood pressure. Consult your doctor if you feel your blood pressure is too low.
Surgery: If you are scheduled to have any type of surgery, inform all the doctors involved in your care that you are taking captopril.
Pregnancy: ACE inhibitors such as captopril may cause severe harm or death to the developing baby if taken by the mother during pregnancy. This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: Small amounts (1%) of captopril are passed from the mother to the infant in breast milk. The effect of this amount on the breast-fed child has not been determined. Talk to your doctor about whether you should breast-feed while taking this medication.
Children: The safety and effectiveness of using this medication have not been established for children.
There may be an interaction between captopril and any of the following:
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