Captopril
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Trade Name
Capoten (historical brand name); generic captopril
Classification
Angiotensin-converting enzyme (ACE) inhibitor; antihypertensive
Dosage/Route
- * Dosage: Tablets: 12.5 mg, 25 mg, 50 mg, 100 mg
- * Route: Oral (PO)
Usual Dosage
- * Hypertension: Start 25 mg PO BID-TID; usual 50-100 mg/day; max 450 mg/day
- * Heart Failure: Start 6.25-12.5 mg PO TID; target 50 mg TID; max 450 mg/day
- * Post-MI: Start 6.25 mg PO single dose, then 12.5 mg TID, titrate to 50 mg TID
- * Elderly/Renal Impairment: Lower initial doses (e.g., 6.25 mg)
Mechanism of Action
Inhibits ACE, preventing conversion of angiotensin I to angiotensin II. Reduces vasoconstriction and aldosterone secretion, lowering blood pressure and cardiac workload. Increases bradykinin, aiding vasodilation
Side Effects & Adverse Effects
- * Side Effects: Dry cough, dizziness, fatigue, rash, taste alteration
- * Adverse Effects:
- – Hyperkalemia (potassium retention)
- – Angioedema (rare, severe; swelling of face/throat)
- – Hypotension (first-dose effect)
- – Renal impairment (esp. in renal artery stenosis)
- – Neutropenia (rare, early treatment)
Nursing Management (Implications & Teachings)
- * Implications:
- – Monitor BP (first-dose hypotension risk; supine/standing)
- – Check potassium, creatinine (baseline/periodically)
- – Assess for cough or swelling (angioedema—stop drug)
- – Give 1 hr before meals (food reduces absorption)
- * Teachings:
- – Take on empty stomach; same time daily
- – Rise slowly to avoid dizziness
- – Report persistent cough, swelling, or dark urine
- – Avoid potassium supplements/NSAIDs unless prescribed
Indication for This Patient
- * Hypertension (alone or with diuretics)
- * Heart failure (reduces preload/afterload)
- * Post-myocardial infarction (left ventricular dysfunction)
- * Diabetic nephropathy (renal protection)
Time
- * Timing: BID or TID (consistent schedule)
- * Onset: 15-60 min
- * Peak: 1-2 hours
- * Duration: 6-8 hours (shorter than other ACEIs)
