Noyada (Captopril)

Captopril is an ACE inhibitor that reduces activity of the renin‑angiotensin system, used in several cardiovascular and renal conditions.

• Hypertension: lowers systemic blood pressure and reduces cardiovascular risk.
• Heart failure: improves cardiac output and decreases symptoms of fluid overload.
• Diabetic nephropathy: slows progression of kidney damage by lowering intraglomerular pressure.

• Captopril inhibits the angiotensin‑converting enzyme (ACE), preventing the conversion of angiotensin I to the potent vasoconstrictor angiotensin II. This results in vasodilation, reduced aldosterone secretion, and decreased sodium and water retention, collectively lowering arterial pressure and easing cardiac workload.

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

Common Side Effects

• Cough: persistent dry cough in some patients.
• Taste disturbances: metallic or salty taste.
• Dizziness or light‑headedness, especially after the first dose.
• Fatigue or mild weakness.
• Hypotension: noticeable drop in blood pressure.
• Skin rash or itching.

Serious or Rare Side Effects

• Angioedema: swelling of face, lips, tongue, or throat that can compromise breathing.
• Severe hyperkalemia: elevated potassium levels leading to cardiac arrhythmias.
• Acute renal impairment: sudden decline in kidney function.
• Neutropenia or agranulocytosis: marked reduction in white blood cells.
• Hepatotoxicity: rare liver injury with jaundice.
• Lupus‑like syndrome: systemic symptoms resembling lupus.

Before initiating therapy with Captopril, several safety considerations should be observed.

• Blood pressure monitoring: check baseline and periodic readings to avoid excessive hypotension.
• Renal function assessment: evaluate serum creatinine and eGFR, especially in patients with pre‑existing kidney disease.
• Electrolyte surveillance: monitor potassium levels to detect hyperkalaemia.
• Pregnancy avoidance: contraindicated in pregnancy due to risk of fetal toxicity.
• Cardiac status review: use cautiously in patients with aortic stenosis or recent myocardial infarction.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

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

Major Interactions (Avoid)

• Aliskiren: combined use may cause severe hypotension and renal dysfunction.
• Potassium‑sparing diuretics (e.g., spironolactone): increase risk of dangerous hyperkalaemia.
• Lithium: may raise lithium concentrations, leading to toxicity.
• Dual ACE inhibitor/ARB therapy: heightens risk of renal impairment and hyperkalaemia.
• NSAIDs (high‑dose): can blunt antihypertensive effect and worsen renal function.

Moderate Interactions (Monitor Closely)

• Thiazide diuretics: additive blood‑pressure lowering effect; monitor for hypotension.
• Other antihypertensives: may require dose adjustments.
• Trimethoprim‑sulfamethoxazole: can increase serum potassium.
• Cyclosporine: may raise Captopril levels and affect renal function.
• Diuretics causing volume depletion: monitor renal parameters and electrolytes.