What Factors Affect a Sufficient Captopril Dose?

B. Chisholm
B. Chisholm

The sufficient captopril dose depends on the indication for which it is being used and the patient's response. Most commonly it is used to treat hypertension, or high blood pressure, and heart failure, but it may also be used in the acute treatment of a hypertensive crisis or heart attack. The sufficient dosage will be determined by the prescribing doctor on a patient-by-patient basis and this should never be exceeded. Captopril is available by prescription only in most countries and may be known by different trade names in different countries, according to manufacturer.

Captopril belongs to the class of drugs called ACE-inhibitors, which also include enalapril and perindopril. They work by blocking the action of ACE, or angiotensin-converting enzyme, resulting in vasodilation, or opening up, of the blood vessels which allow a drop in blood pressure. This drop in blood pressure allows a decrease in the work load of the heart and can be beneficial in patients with heart failure.

When prescribing captopril for hypertension or chronic heart failure, the doctor will normally start with a low captopril dose and work it up slowly until a sufficient response has been obtained. It is usually taken two or three times daily and will be built up slowly over a number of weeks. The captopril dose is usually only increased every week or two if no response is seen. A lower dose may be used in patients with renal or kidney dysfunction.

Regardless of the captopril dose that is prescribed, adverse effects may occur. These can include allergic reactions, cough which may occur at any time during treatment and taste disturbances. There is a risk of postural hypotension and dizziness, especially at initiation, so the patient should not handle heavy machinery or attempt driving and should stand up carefully from a lying position. Should any adverse effects occur, medical attention should be sought.

In some cases, even at the maximum captopril dose, sufficient control over the blood pressure may not be maintained. In these cases the prescribing doctor may add a second antihypertensive, such as a diuretic. There are a number of combination products available which make administration easier in these cases.

As with any medication, captopril may be contraindicated in people with some underlying conditions and may interact with other medications, including homeopathic, over-the-counter and complementary medicines. These should be discussed with the prescribing doctor before initiating treatment. Pregnancy, desired pregnancy and lactation should also be disclosed.

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