Pharmacotherapeutic group: Combined preparations of ACE inhibitors. Captopril and diuretics. ATX code С09В А01.
active ingredients of captopres: captopril, hydrochlorothiazide;
1 tablet contains captopril 50 mg, hydrochlorothiazide 25 mg captopres excipients: potato starch, lactose, colloidal silicon dioxide, povidone, magnesium stearate.
- Hypersensitivity to captopril, other ACE inhibitors, hydrochlorothiazide, other drugs, sulfonamide derivatives, or other components of the drug;
- a history of angioedema during treatment with other ACE inhibitors;
- congenital (idiopathic) angioedema;
- severe renal dysfunction (plasma creatinine concentration more than 1.8 mg / 100 ml or creatinine clearance less than 30 ml / min), severe renal failure;
- bilateral stenosis of the renal arteries or stenosis of an artery of a solitary kidney with progressive azotemia;
- condition after kidney transplantation;
- aortic stenosis and other obstructive disorders that impede the release of blood from the left ventricle; hypertrophic cardiomyopathy with low cardiac output;
- severe liver dysfunction (precomatose state, hepatic coma, liver failure);
- primary hyperaldosteronism;
- hypokalemia, hyperkalemia, hyponatremia with hypovolemia, hypercalcemia, gout;
- pregnant women or women planning to become pregnant (see “Use during pregnancy or lactation”).
Method of administration and dosage:
The drug Kaptopres should be used orally 1:00 before meals, since in the presence of food in the stomach, the absorption of the drug Kaptopres decreases. The dose of the drug captopres is set by the doctor individually, depending on the clinical picture of the disease.
The initial dose of Captopres is ½ Captopres tablet (25 mg of captopril and 12.5 mg of hydrochlorothiazide) once a day. In the future, if necessary, the maintenance dose of captopres can be increased to 1 captopress tablet (50 mg captopril and 25 mg hydrochlorothiazide) once a day.
The maximum therapeutic effect of captopres occurs 6-8 weeks after the start of treatment. Dose adjustments should be made at 6-week intervals unless clinical manifestations require a rapid dosage change. In case of insufficient decrease in blood pressure, captopril and hydrochlorothiazide can be additionally included in the treatment regimen as monopreparations. Moreover, the daily dose of Captopres should not exceed 150 mg, hydrochlorothiazide – 50 mg. Patients with impaired renal function.
Since captopril and hydrochlorothiazide are excreted from the body mainly by the kidneys, the level of drugs may increase if their function is impaired. It is recommended to reduce the dose of the drug captopres: with QC from 30 to 80 ml / min, the initial dose is ½ captopres tablet (25 mg captopril and 12.5 mg hydrochlorothiazide) once a day in the morning.
The ability to influence the reaction rate when driving or operating machinery:
When using the drug, you should refrain from driving or working with other mechanisms, dizziness and drowsiness are possible, especially at the beginning of therapy.
Application during pregnancy or lactation:
The drug is contraindicated for use by pregnant women or women planning to become pregnant. If pregnancy is confirmed during treatment with the drug, its use should be immediately discontinued and replaced with another drug approved for use by pregnant women. The drug should not be used during breastfeeding.
Symptoms: a sharp decrease in blood pressure, tachycardia, headache, lack of appetite, impaired taste, allergic skin reactions, neutropenia. In severe cases, convulsions, paresis, shock, stupor, heart rhythm disturbances, bradycardia, renal failure, electrolyte imbalance are possible. If these symptoms appear, you should immediately stop taking the medication and consult a doctor.
Treatment: The patient should be given a horizontal position and the stomach should be flushed.
In case of severe symptoms of an overdose, the patient is subject to urgent hospitalization for intensive detoxification methods, including hemodialysis, and measures aimed at increasing the volume of circulating blood, normalizing the functions of the cardiovascular, respiratory and nervous systems, and restoring kidney function. It is necessary to avoid carrying out hemodialysis through high-performance membranes of polyacrylonitrite metal sulfate, (AN69), hemofiltration due to the possibility of developing anaphylactoid reactions. Peritoneal dialysis is ineffective. Symptomatic therapy aimed at normalizing blood pressure and eliminating other symptoms.
Symptoms: weakness, nausea, vomiting, thirst, diarrhea. These phenomena quickly disappear when the dose is reduced or the drug is discontinued. In some cases, when taking high doses of the drug, it was reported about the possibility of the occurrence of such symptoms: tachycardia, arterial hypotension, shock, dizziness, confusion of consciousness, disturbances of consciousness, muscle spasms, paresthesia, exhaustion, polyuria, oliguria, anuria, hypokalemia, hyponatremia, hypochloremia, alkalosis, an increase in the level of urea nitrogen in the blood (in patients with renal failure).
Severe manifestations of an overdose can be severe violations of the water-electrolyte balance and the development of a coma as a result of the direct pathological effect of hydrochlorothiazide on the central nervous system.
Store the captopres out of the reach of children in its original packaging at a temperature not exceeding 25 ° C.