Kaptopril Krka (Captopril)

Captopril belongs to the ACE inhibitor class and acts on the renin‑angiotensin‑aldosterone system to control cardiovascular conditions.

• Hypertension: reduces systolic and diastolic pressure, decreasing risk of stroke and heart attack.
• Heart failure: improves cardiac output and symptoms by lowering afterload.
• Post‑myocardial infarction: limits ventricular remodeling and reduces mortality.
• Diabetic nephropathy: slows progression of renal impairment by lowering intraglomerular pressure.

• Captopril inhibits angiotensin‑converting enzyme (ACE), preventing the conversion of angiotensin I to the potent vasoconstrictor angiotensin II. This results in vasodilation, reduced aldosterone secretion, decreased sodium and water retention, and ultimately lower systemic blood pressure.

Captopril may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Cough: dry, persistent throat irritation.
• Dizziness or light‑headedness, especially after standing.
• Headache.
• Fatigue or weakness.
• Taste disturbances, often metallic.
• Mild hypotension.

Serious or Rare Side Effects

• Angioedema: swelling of face, lips, tongue, or airway.
• Neutropenia or leukopenia.
• Severe skin reactions such as Stevens‑Johnson syndrome.
• Hepatic injury with elevated enzymes.
• Acute renal failure, particularly in volume‑depleted patients.
• Anaphylactic reactions.

Before initiating therapy, clinicians should evaluate patient‑specific risk factors and monitor for adverse events.

• Monitor blood pressure: adjust dose if hypotension occurs.
• Assess renal function: dose may need adjustment in impairment.
• Avoid use in pregnancy: category D, risk to fetus.
• Use cautiously with potassium‑sparing diuretics or supplements to prevent hyperkalaemia.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Captopril can interact with several medicines, altering efficacy or safety.

Major Interactions (Avoid)

• Aliskiren in diabetic patients: increased risk of renal dysfunction.
• Lithium: may raise lithium levels, causing toxicity.
• Potassium supplements or other ACE inhibitors/ARBs: risk of severe hyperkalaemia.

Moderate Interactions (Monitor Closely)

• NSAIDs: may blunt antihypertensive effect and affect renal function.
• Loop or thiazide diuretics: can enhance hypotensive response.
• Beta‑blockers: additive blood‑pressure lowering effect, requiring careful titration.