Capoten

Capoten is the brand name for captopril, an oral medication in the angiotensin-converting enzyme (ACE) inhibitor class. Captopril lowers blood pressure and reduces the workload on the heart by blocking the conversion of angiotensin I to angiotensin II and decreasing aldosterone secretion. This produces vasodilation and increased salt and water excretion. ACE inhibition also raises levels of bradykinin, which can contribute to cough and, less commonly, angioedema.

Indications include essential hypertension, symptomatic heart failure, and the prevention of death after myocardial infarction in patients with left ventricular dysfunction. It is also used to treat diabetic nephropathy or proteinuria in diabetic patients, due to its protective effects on the kidneys.

Pharmacokinetics and administration: captopril is rapidly absorbed after oral administration, with onset typically within 15 to 60 minutes and peak concentrations in about 1 to 2 hours. It has a relatively short half-life and is administered in two to three divided doses daily. Dosing is individualized, usually starting at a low dose and titrating based on response and tolerance.

Adverse effects and safety: common side effects include cough, dizziness, fatigue, and rash. A serious but less common risk is angioedema. Hyperkalemia and deterioration of kidney function can occur, especially in patients with renal impairment or those taking other potassium-increasing medicines. A distinctive side effect of captopril is a taste disturbance (sour or metallic) due to its sulfhydryl group. Drug interactions include NSAIDs, potassium-sparing diuretics, potassium supplements, and other antihypertensives.

Contraindications and notes: use during pregnancy is contraindicated; bilateral renal artery stenosis is a contraindication. Capoten has been largely supplanted by newer ACE inhibitors but may still be prescribed in certain clinical contexts.