CAPTOPRIL and HYDROCHLOROTHIAZIDE
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).
Media Articles Related to Captopril and Hydrochlorothiazide (Captopril / Hydrochlorothiazide)
EHRs Take Center Stage in Battle to Control Hypertension
Source: MedPageToday.com - medical news plus CME for physicians [2015.03.27]
(MedPage Today) -- "Home-grown" electronic health record largely credited for better BP control.
Hypertension Becoming More Deadly?
Source: MedPage Today Cardiovascular [2015.03.26]
(MedPage Today) -- Cited more often as a factor on death certificates.
Vitamin D 'ineffective as treatment for hypertension'
Source: Cardiovascular / Cardiology News From Medical News Today [2015.03.19]
Researchers report that vitamin D supplementation does not work as an antihypertensive agent and cannot be recommended to control high blood pressure.
ACC: Folate Supplements Cut Strokes in Hypertension
Source: MedPage Today Neurology [2015.03.19]
(MedPage Today) -- Hypertensive patients with low blood folate levels gain big benefit.
Expanding blood pressure screenings beyond primary care can improve hypertension detection
Source: Hypertension News From Medical News Today [2015.03.16]
Expanding blood pressure screenings to non-primary care settings can help identify more patients with high blood pressure, commonly called hypertension, and could contribute to better hypertension...
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.
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
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.
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
Captopril in Treating Patients Undergoing Bone Marrow or Stem Cell Transplantation [Active, not recruiting]
RATIONALE: Captopril may protect the lungs from the side effects of bone marrow or stem cell
PURPOSE: Randomized phase III trial to determine the effectiveness of captopril to lessen the
side effects in patients who are undergoing bone marrow or stem cell transplantation
following chemotherapy and radiation therapy.
In Vivo Angiostatin Generation Using Tissue Plasminogen Activator and Captopril in Treating Patients With Progressive Metastatic Cancer [Active, not recruiting]
RATIONALE: Tissue plasminogen activator and captopril may help the body generate angiostatin.
Angiostatin may stop the growth of cancer by stopping blood flow to the tumor.
PURPOSE: This phase I/II trial is studying the side effects and best dose of tissue
plasminogen activator and captopril and to see how well they work in treating patients with
progressive metastatic cancer.