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Captopril and Hydrochlorothiazide (Captopril / Hydrochlorothiazide) - Summary

 
 



USE IN PREGNANCY

When used in pregnancy during the second and third trimesters, ACE Inhibitors can cause injury and even death to the developing fetus. When pregnancy is detected, Captopril and Hydrochlorothiazide should be discontinued as soon as possible. See WARNINGS: Captopril: Fetal/Neonatal Morbidity and Mortality.

 

SUMMARY

CAPTOPRIL and HYDROCHLOROTHIAZIDE
TABLETS, USP
25 mg/15 mg, 25 mg/25 mg, 50 mg/15 mg,
and 50 mg/25 mg

Captopril and hydrochlorothiazide are two oral antihypertensive agents. Captopril, the first of a new class of antihypertensive agents, is a specific competitive inhibitor of angiotensin I-converting enzyme (ACE), the enzyme responsible for the conversion of angiotensin I to angiotensin II. Hydrochlorothiazide is a benzothiadiazide (thiazide) diuretic-antihypertensive. Captopril is a white to off-white crystalline powder that may have a slight sulfurous odor; it is soluble in water (approx. 160 mg/mL), methanol, and ethanol and sparingly soluble in chloroform and ethyl acetate. Hydrochlorothiazide is a white crystalline powder slightly soluble in water but freely soluble in sodium hydroxide solution.

Captopril and Hydrochlorothiazide tablets are indicated for the treatment of hypertension. The blood pressure lowering effects of captopril and thiazides are approximately additive.

This fixed combination drug may be used as initial therapy or substituted for previously titrated doses of the individual components.

When captopril and hydrochlorothiazide are given together it may not be necessary to administer captopril in divided doses to attain blood pressure control at trough (before the next dose). Also, with such a combination, a daily dose of 15 mg of hydrochlorothiazide may be adequate.

Treatment may, therefore, be initiated with Captopril and Hydrochlorothiazide tablets 25 mg/15 mg once daily. Subsequent titration should be with additional doses of the components (captopril, hydrochlorothiazide) as single agents or as Captopril and Hydrochlorothiazide tablets 50 mg/15 mg, 25 mg/25 mg, or 50 mg/25 mg (see DOSAGE AND ADMINISTRATION).

In using Captopril and Hydrochlorothiazide tablets, consideration should be given to the risk of neutropenia/agranulocytosis (see WARNINGS).

Captopril and Hydrochlorothiazide tablets may be used 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 and Hydrochlorothiazide tablets should be reserved for hypertensives who have either developed unacceptable side effects on other drugs, or have failed to respond satisfactorily to other drug combinations.

ACE inhibitors (for which adequate data are available) cause a higher rate of angioedema in black than in non-black patients (see WARNINGS: Angioedema).


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NEWS HIGHLIGHTS

Media Articles Related to Captopril and Hydrochlorothiazide (Captopril / Hydrochlorothiazide)

Research suggests team-based care is most effective way to control hypertension
Source: Hypertension News From Medical News Today [2014.10.24]
Patients diagnosed with high blood pressure are given better control of their condition from a physician-pharmacist collaborative intervention than physician management alone, according to new...

Exalenz Bioscience launches pivotal study of world's first breath-based test to diagnose clinically significant portal hypertension
Source: Clinical Trials / Drug Trials News From Medical News Today [2014.10.23]
Exalenz Bioscience, a leader in developing and marketing non-invasive medical devices for diagnosing and monitoring a range of gastrointestinal and liver diseases, announced the start of a pivotal...

Binge drinking in young men linked with increased risk of hypertension
Source: Alcohol / Addiction / Illegal Drugs News From Medical News Today [2014.10.21]
Binge drinking in early adulthood is associated with an increased likelihood of high blood pressure in males, while low to moderate alcohol use in early adulthood is associated with a decreased...

Uncontrolled hypertension highest among patients with moderate-to-severe psoriasis
Source: Hypertension News From Medical News Today [2014.10.20]
Patients with moderate and severe psoriasis have the greatest likelihood of uncontrolled hypertension compared to patients without psoriasis.

UF researchers use plants to study new ways of delivering drugs for pulmonary hypertension
Source: Endocrinology News From Medical News Today [2014.10.17]
UF researchers are using the leaves of plants to study new ways to deliver drugs that treat pulmonary hypertension, a disease with few treatment options, according to a study published online in...

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Published Studies Related to Captopril and Hydrochlorothiazide (Captopril / Hydrochlorothiazide)

[Impact of patient compliance on the outcomes in hypertensive patients receiving hydrochlorothiazide based combination therapy with spironolactone or captopril.] [2008.12]
OBJECTIVE: To explore the impact of patient compliance on the long-term outcomes in hypertensive patients receiving hydrochlorothiazide (HCTZ) based combination therapy with spironolactone or captopril... CONCLUSIONS: This study indicates that patient compliance could affect the long-term outcome and antihypertensive efficacy in hypertensive patients receiving HCTZ based combination therapy with spironolactone or captopril.

Polymorphisms of ACE2 gene are associated with essential hypertension and antihypertensive effects of Captopril in women. [2007.08]
ACE2 appears to counterbalance the vasopressor effect of angiotensin I converting enzyme (ACE) in the reninangiotensin system...

Polymorphisms of ACE2 Gene are Associated With Essential Hypertension and Antihypertensive Effects of Captopril in Women. [2007.05.02]
ACE2 appears to counterbalance the vasopressor effect of angiotensin I converting enzyme (ACE) in the renin-angiotensin system... The adjusted diastolic blood pressure response to Captopril was 3.3 mm Hg lower in ACE2 T allele carriers than in CC genotype carriers (P=0.019) in women.

Simultaneous determination of captopril and hydrochlorothiazide in human plasma by reverse-phase HPLC from linear gradient elution. [2006.05.03]
A simple, rapid and sensitive high-performance liquid chromatographic method for the simultaneous determination of captopril and hydrochlorothiazide in human plasma samples was developed. Captopril was derivatized with 2,4'-dibromoacetophenone (pBPB) to form a captopril-pBPB adduct... The method was suitably validated and successfully applied to the determination of captopril and hydrochlorothiazide in human plasma samples.

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Clinical Trials Related to Captopril and Hydrochlorothiazide (Captopril / Hydrochlorothiazide)

Assessment of the Effect of Captopril Versus Combination of Captopril and Pentoxifylline on Reducing Proteinuria in Type 2 Diabetic Nephropathy [Completed]

Clonidine Versus Captopril for Treatment of Postpartum Very High Blood Pressure [Recruiting]
The postpartum period represents a stage of the pregnancy-puerperal still rarely addressed scientifically. There are no reports in the literature and concrete enough to elucidate important issues, especially in the field of hypertension and pregnancy.

Searches based on current evidence concentrate their focus on the diagnosis of hypertensive disorders and treatment of these diseases maternofetais repercussions. However, the prognosis in the short and long term, as the BP outcome in mothers with severe preeclampsia, the most effective treatment for the control of hypertensive crisis and metabolic and cardiovascular events after two years of termination of pregnancy require further clarification.

The main idea for developing this research came from the clinical experience with the use of captopril in Obstetric ICU IMIP. This drug has long been used in postpartum women with severe preeclampsia or chronic hypertension exacerbated by pregnancy for control of hypertensive crisis and keeping pressure levels. Following the technical standards of the institution and during his administration, there were reports of side effects such as dry cough and nausea, beyond the threshold dose of 150mg daily captopril was easily achieved hindering control the use of hypotensive.

Alternative therapy, clonidine began to be used in mothers with some restriction on the use of ACE inhibitors and its hypotensive effect for peak pressure was satisfactory. What is not known yet is how long clonidine reduces high blood pressure and how long to leave stabilized compared to the use of captopril.

There are no reports in the literature databases, no randomized clinical trials that prove the effectiveness of clonidine for the treatment of hypotensive pressure peaks in this particular group of patients, even in comparison with other classes of antihypertensive drugs, especially captopril, to this purpose.

The investigators' primary assumption is that clonidine has better effectiveness in decreasing the frequency of pressure peaks when compared with captopril.

Rapid Versus Prolonged Inpatient Up-Titration of Captopril [Recruiting]

Diagnosis of Primary Aldosteronism: Comparison of Post Captopril Active Renin Concentration and Plasma Renin Activity [Recruiting]
Background: The most common pharmacologic test for diagnosis of primary aldosteronism (PA) is administration of captopril to examine whether abnormal aldosterone to plasma rennin activity (PRA)(ARR) persists, although active rennin concentration (ARC) in contrast to PRA may offers advantages with regard to processing and standardization.

Objective: To assess whether post captopril ARC offer any additional advantage in screening primary aldosteronism (PA) than PRA and establish thresholds for the diagnosis using ARC.

Spironolactone Combined With Captopril and Carvedilol for the Treatment of Pulmonary Arterial Hypertension [Completed]
The purpose of this study is to determine whether a larger dose of the aldosterone antagonist spironolactone combined with an ACE inhibitor (captopril) and a beta-blocker (carvedilol) is effective in reverse pulmonary artery remodeling in patients with pulmonary arterial hypertension (PAH)secondary to congenital heart disease

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Page last updated: 2014-10-24

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