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captopril & hydrochlorothiazide (Capozide) Side Effects & Dosage

What is captopril and hydrochlorothiazide, and what is it used for?

Capozide is a combination of captopril (Capoten) and hydrochlorothiazide (HCTZ), an angiotensin converting enzyme (ACE) inhibitor and a diuretic (water pill), respectively, and is used in the treatment of high blood pressure. ACE is an enzyme in the body that causes the formation of angiotensin II. Angiotensin II causes the arteries in the body to narrow, thereby elevating blood pressure. ACE inhibitors, such as captopril, lower blood pressure by preventing the formation of angiotensin II thereby relaxing the arteries. HCTZ is a diuretic (water pill) used for treating high blood pressure (hypertension) and accumulation of fluid. It works by blocking salt and fluid reabsorption in the kidneys, causing increased urine output (diuresis). The mechanism of its action in lowering high blood pressure is not well understood. The combination of captopril and HCTZ reduces blood pressure better than either drug alone. Captopril increases potassium levels while HCTZ reduces potassium levels; the combination of both drugs has less effect on potassium levels. The FDA approved captopril/HCTZ in October 1984.

What brand names are available for captopril and hydrochlorothiazide?

Capozide

Is captopril and hydrochlorothiazide available as a generic drug?

Yes

Do I need a prescription for captopril and hydrochlorothiazide?

Yes

What are the side effects of captopril and hydrochlorothiazide?

A dry, persistent cough has been reported commonly with
the use of ACE inhibitors. Coughing resolves after discontinuing the drug.

Other common side effects include:

Increased blood glucose
and potassium levels also may occur.

Serious but, fortunately, very rare side effects are liver failure angioedema (swelling of lips and throat that can obstruct breathing).

Capozide may reduce kidney function in some patients and
should not be used by patients who have bilateral renal artery stenosis
(narrowing of both arteries going to the kidneys).

Rare cases of rhabdomyolysis
(muscle breakdown), reduced number of platelets, and pancreatitis have been
reported.




QUESTION

Salt and sodium are the same.
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What is the dosage for captopril and hydrochlorothiazide?

The starting dose is 25/15 mg once daily. The dose may be
increased every 6 weeks.

Which drugs or supplements interact with captopril and hydrochlorothiazide?

Captopril may increase potassium levels (hyperkalemia)
in blood. Therefore, there is an increased risk of hyperkalemia when captopril
is given with potassium supplements or drugs that increase potassium levels
(for example, spironolactone
[Aldactone]).

There have been reports of increased lithium (Eskalith,
Lithobid) levels when lithium is used in combination with ACE inhibitors. The
reason for this interaction is not known, but the increased levels may lead to
toxicity from lithium.

There have been reports that aspirin and other
nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil,
Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc.),
indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn,
Aleve) may reduce the effects of ACE inhibitors.

Combining captopril or other
ACE inhibitors with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients
who are elderly, volume-depleted (including those on diuretic therapy), or with
poor kidney function may result in reduced kidney function, including
kidney
failure. These effects usually are reversible.

Nitritoid reactions (symptoms
include facial flushing, nausea, vomiting and hypotension or low blood pressure)
may occur when injectable gold (sodium
aurothiomalate), used in the treatment of
rheumatoid arthritis, is combined with ACE inhibitors, including captopril. 

Hydrochlorothiazide reduces the elimination of lithium (Lithobid) by the kidneys
and can lead to lithium toxicity. Nonsteroidal antiinflammatory
drugs, for example, ibuprofen, may reduce the blood pressure lowering effects of
hydrochlorothiazide. Blood sugar levels can be elevated by HCTZ, necessitating
adjustment in the doses of medications that are used for treating diabetes.
Combining HCTZ with corticosteroids may increase the risk for low levels of
blood potassium and other electrolytes. Low blood potassium can increase the
toxicity of digoxin (Lanoxin).
Cholestyramine (Questran, Questran Light) and
colestipol (Colestid) bind to hydrochlorothiazide and reduce its absorption from
the gastrointestinal tract by 43%-85%.

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Is captopril and hydrochlorothiazide safe to take if I’m pregnant or breastfeeding?

When used in the
second or third trimester of pregnancy ACE
inhibitors can cause injury and even death to the fetus. Capozide should not be
used during pregnancy.

Both captopril and HCTZ are excreted in
breast milk
and may potentially affect nursing infants.

What else should I know about captopril and hydrochlorothiazide?

What preparations of captopril and hydrochlorothiazide are available?

Tablets (captopril/HCTZ): 25/15, 25/25, 50/15, and 50/25
mg.

How should I keep captopril and hydrochlorothiazide stored?

Tablets should be stored at room temperature, 15 C – 30 C (59 F – 86 F).

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