Capoten
Capoten (Captopril)Pharmacological action
Competitive inhibitor the enzyme promoting transformation of angiotensin I in angiotensin II.
The preparation has antihypertensive an effect, a preload and resistance in pulmonary vessels; raises minute volume of heart and tolerance to an exercise stress.
At long application reduces expression of a hypertrophy of a myocardium of a left ventricle, prevents advance of a heart failure and slows down development of a dilatation of a left ventricle.
Indications
- An arterial hypertensia (in the form of monotherapy and in a combination with other antihypertensive preparations);
- A chronic heart failure (as a part of the combined therapy);
- An ischemic heart disease (disturbance of function of a left ventricle after the transferred myocardial infarction at patients in a stable clinical condition);
Dosage regimen
At an easy and moderate arterial hypertensia the initial dose makes on 12.5 mg 2 times/days If necessary a dose enlarge each 2-4 weeks. The average therapeutic dose makes on 50 mg 2 times/days the Maintenance dose makes on 25 mg 2 times/days
At a serious arterial hypertensia the initial dose makes on 12.5 mg 2 times/days the Dose gradually enlarge to the maximum daily dose of 150 mg (on 50 mg 3 times/sut). At Capoten application as a part of the combined antihypertensive therapy its dose should be selected individually.
If necessary it is in addition possible to prescribe other antihypertensive preparations: diuretics, beta adrenoblockers, preparations of the central action.
At a heart failure the initial dose makes on 6.25 mg 3 times/days If necessary a dose enlarge each 2 weeks. A maintenance dose - on 25 mg 2-3 times/days the Maximum daily dose - 150 mg.
At an ischemic heart disease treatment can be begun in 3 days after the transferred myocardial infarction. The initial dose makes on 6.25 mg 3 times/sut with gradual augmentation (within several weeks) to 75 mg/24h (on 25 mg 3 times/24h). If necessary a dose gradually enlarge to maximum daily - 150 mg (on 50 mg 3 times/24h). Capoten is possible to apply as a part of the combined therapy of a myocardial infarction.
At a diabetic nephropathy the daily dose makes from 75 mg to 100 mg, parted on 2-3 receptions.
To patients with disturbance of function of kidneys of easy or moderate degree Capoten prescribe in a daily dose from 75 mg to 100 mg, parted on 2-3 receptions. At serious disturbances of function of kidneys an initial dose makes 30 ml/minutes/1 no more 2 times/days At insufficient efficiency a dose gradually enlarge than 12.5 mg each 1-2 weeks before therapeutic effect, but the maximum daily dose of a preparation should be the interval between preparation receptions is lowered or enlarged.
If necessary in addition prescribe loopback diuretics.
To patients of advanced age the dose steals up individually. Treatment is recommended to be begun with the least therapeutic dose and to support at level of the least effective dose.
Side effect
From cardiovascular system: an orthostatic hypotension, a tachycardia, peripheric edemas.
From respiratory system: dry tussis, a bronchospasm, a fluid lungs.
Allergic reactions: a Quincke's disease of extremities, persons, labiums, mucosas, tongue, a pharynx or a larynx.
From vodno-electrolytic balance: a hyperpotassemia (it is most probable at renal insufficiency), a hyponatremia (is the most frequent at a saltless diet and simultaneous application of diuretics.
From hemopoiesis system: in rare instances - a neutropenia, an agranulocytosis, a thrombocytopenia and an anaemia, the positive test for antibodies to a nuclear antigen. At patients with normal function of kidneys in the absence of other complicating factors the neutropenia was observed in 0.02 % of cases.
From the alimentary system: reversible and usually independently passing disturbance of taste, dryness in a mouth, an aphthous stomatitis; seldom - abdominal pains, a diarrhoeia, a hyperplasia of gums, a hepatitis, rising of level of hepatic transaminases in a blood plasma, a hyperbilirubinemia.
Dermatological reactions: a hyperemia, vesicular or violent rashes, erythemas (including Stevens-Johnson's syndrome), a photosensitization.
From party TSNS and peripheric nervous system: a headache, giddiness, paresthesias, drowsiness, sight disturbances.
Contraindications
- The expressed disturbances of function of kidneys;
- The expressed disturbances of function of a liver;
- A hyperpotassemia;
- A bilateral stenosis of renal arteries or a stenosis of an artery of a unique kidney with a progressing azotemia;
- A condition after kidney transplantation;
- A stenosis of a mouth of an aorta and the similar obstructive changes complicating outflow of blood from a left ventricle;
- Pregnancy;
- The lactemia period (thoracal feeding);
Pregnancy and lactemia
The preparation is contraindicative to application at pregnancy and in a lactemia.
Special indicatings
With care it is necessary to Capoten prescribe at collagenoses in view of augmentation of risk of occurrence of a neutropenia and an agranulocytosis.
At appointment of a preparation patients with the expressed disturbances of vodno-electrolytic balance should spend correction of this condition. During Capoten treatment is not recommended to accept potassium preparations, especially to patients with the expressed disturbances of function of kidneys.
The Quincke's disease of extremities, persons, labiums, mucosas, tongue, a pharynx, including captopril. If puffiness is limited to the person and labiums, such condition usually passes after preparation phase-out. For simplification of clinical symptoms antihistamine preparations can be used. Patients should be under observation of the doctor before disappearance of symptoms. If the edema covers tongue, a pharynx or a larynx with threat of development of obstruction of respiratory tracts.
During Capoten treatment observance of a diet with the low maintenance of sodium is shown.
Capoten can cause false positive reaction at the urine analysis on acetone.
Use in pediatrics
Safety and efficiency of application of a preparation at children are not studied.
Overdosage
Symptoms: the expressed depression of a BP.
Treatment: introduction of plasma substituting preparations and a hemodialysis are effective.
Conditions and periods of storage
The preparation should be stored in a dry place inaccessible to children at a room temperature. A period of validity - 5 years.
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