II. Indications
- See ACE Inhibitor
III. Mechanism
- See ACE Inhibitor
- Captopril is a sulfhydryl-containing analog of Proline
- Angiotensin-converting enzyme (ACE) inhibitor
- Possible antineoplastic activity
- May decrease tumor Angiogenesis by inhibiting endothelial cell matrix metalloproteinases (MMPs) and endothelial cell migration
IV. Dosing: Adults
-
Hypertension
- Start 25 mg orally twice to three times daily
- Target 25 to 150 mg orally twice to three times daily
- Maximum 450 mg/day
-
Congestive Heart Failure (CHF)
- Start 6.25 - 12.5 mg orally three times daily
- Target 50 to 100 mg orally three times daily
- Maximum 450 mg/day
-
Diabetic Nephropathy
- Take 25 mg orally three times daily
-
Hypertensive Urgency (not FDA approved)
- Take 12.5 to 25 mg orally every 30 to 60 minutes as needed up to 2 doses
V. Dosing: Children (not FDA approved)
- Newborns
- Give 0.1 to 0.4 mg/kg/day orally divided every 6 to 8 hours
- Infants
- Start 0.15 to 0.3 mg/kg/dose and titrate
- Maximum 6 mg/kg/day divided two to four times daily
- Children
- Start 0.3 to 0.5 mg/kg/dose and titrate
- Maximum 6 mg/kg/day up to 450 mg/day divided two to four times daily
VI. Supplied
- Available as scored generic tablets: 12.5, 25, 50 and 100 mg
- To make Captopril solution (1 mg/ml)
- Disolve tablet in flavored syrup (e.g. 25 mg tablet in 25 ml syrup)
- Stable at room Temperature for up to 7 days
VII. Metabolism
- Primarily renal excretion
VIII. Adverse Effects
- See ACE Inhibitor
IX. Safety
- See ACE Inhibitor
- Pregnancy Category X
- Captopril is among only two ACE Inhibitors labeled by AAP as compatible with Breast Feeding
- However, Captopril is excreted in Breast Milk and may be associated with newborn adverse effects
X. Resources
XI. References
- (2016) Presc Lett, Resource #321151, ACE Inhibitor Antihypertensive Dose Comparison
- (2020) Med Lett Drugs Ther 62(1598): 73-80
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 68-9
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
Images: Related links to external sites (from Bing)
Related Studies
| captopril (on 11/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CAPTOPRIL 100 MG TABLET | Generic | $1.38 each |
| CAPTOPRIL 12.5 MG TABLET | Generic | $0.45 each |
| CAPTOPRIL 25 MG TABLET | Generic | $0.38 each |
| CAPTOPRIL 50 MG TABLET | Generic | $0.68 each |