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.
Captopril and hydrochlorothiazide tablets, USP for oral
administration combines two antihypertensive agents: captopril and
hydrochlorothiazide. Catopril, 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)
Captopril, USP 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, USP 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, consideration should be given to
the risk of neutropenia/agranulocytosis (see WARNINGS).
Captopril and Hydrochlorothiazide 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 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: Captopril: Head and Neck Angioedema and
Media Articles Related to Captopril and Hydrochlorothiazide (Captopril / Hydrochlorothiazide)
Hypertension Affects VTE Too
Source: theheart.org | Medscape Cardiology Headlines [2015.11.19]
Dr Goldhaber discusses some changes we may see in the incidence of MI, stroke, DVT, and PE if the medical community were to accept and adopt the new blood pressure targets studied in SPRINT.
theheart.org on Medscape
Hypertension Management After SPRINT: Fast Forward or Pause?
Source: theheart.org | Medscape Cardiology Headlines [2015.11.18]
Dr Clyde Yancy leads a panel discussion on the practice implications of the SPRINT findings suggesting a more stringent blood pressure target with Drs Bittner, Curtis, and O'Gara.
theheart.org on Medscape
Emricasan Shows Benefit in Portal Hypertension (CME/CE)
Source: MedPage Today Gastroenterology [2015.11.18]
(MedPage Today) -- Post-hoc analysis suggests severe disease should be the target
International Conference on Hypertension & Treatment, August 04-06, 2016, Toronto
Source: Conferences News From Medical News Today [2015.11.13]
OMICS International announces the International Conference on Hypertension & Treatment to be held during August 04-06, 2016 at Toronto, Canada, focusing on "Hypertension and Treatment" with a view...
White coat and masked hypertension associated with higher rates of heart and vascular disease
Source: Hypertension News From Medical News Today [2015.11.10]
Patients whose blood pressures spikes in the doctor's office but not at home, and patients whose blood pressure spikes at home but not in the doctor's office, suffer more heart attacks, heart...
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)
Clonidine Versus Captopril for Treatment of Postpartum Very High Blood Pressure [Completed]
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.
Assessment of the Effect of Captopril Versus Combination of Captopril and Pentoxifylline on Reducing Proteinuria in Type 2 Diabetic Nephropathy [Completed]
Captopril in Treating Patients With Non-Small Cell Lung Cancer or Limited-Stage Small Cell Lung Cancer That Has Been Previously Treated With Radiation Therapy With or Without Chemotherapy [Active, not recruiting]
RATIONALE: Captopril is a drug that may be able to decrease side effects caused by radiation
therapy, and may improve the quality of life of patients with non-small cell lung cancer or
limited-stage small cell lung cancer.
PURPOSE: This randomized phase II trial is studying how well captopril works in decreasing
side effects and improving the quality of life in patients who have received radiation
therapy with or without chemotherapy for stage I, stage II, or stage IIIB non-small cell
lung cancer or limited-stage small cell lung cancer.
Rapid Versus Prolonged Inpatient Up-Titration of Captopril [Recruiting]
Page last updated: 2015-11-19