Kapoten - instructions for use, analogs, reviews and release forms (25 mg and 50 mg tablets) of the drug to reduce high blood pressure in adults, children and in pregnancy

In this article, you can read the instructions for using the drug Kapoten. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Kapoten in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Kapoten in the presence of existing structural analogs. Use to treat hypertension and reduce high blood pressure in adults, children, as well as during pregnancy and lactation.

Kapoten - ACE inhibitor. The active substance is Captopril. Suppresses the formation of angiotensin 2 and eliminates its vasoconstrictive effect on arterial and venous vessels.

Reduces OPSS, postnagruzku, reduces blood pressure. Reduces preload, reduces pressure in the right atrium and a small circle of circulation.

Reduces the secretion of aldosterone in the adrenal glands.

Pharmacokinetics

When administered, the bioavailability of Captopril is 60-70%. Simultaneous food intake slows the absorption of the drug by 30-40%. The drug is excreted from the body mainly with urine, up to 50% unchanged.

Indications

• arterial hypertension, incl. Renovascular;
• chronic heart failure (as part of combination therapy);
• violations of left ventricular function after a myocardial infarction with a clinically stable condition;
• Diabetic nephropathy in the background of type 1 diabetes mellitus (with albuminuria> 30 mg per day).

Forms of release

Tablets 25 mg and 50 mg.

Instructions for use and dosage

The hood is prescribed inside for 1 h before meals. The dosage regimen is set individually.

With arterial hypertension, the initial dose is 12.5 mg twice a day.If necessary, increase the dose gradually (with an interval of 2-4 weeks) until the optimal effect is achieved. With mild and moderate arterial hypertension, the average therapeutic dose is 25 mg 2 times a day; the maximum dose is 50 mg twice a day. In severe arterial hypertension, the initial dose is 12.5 mg 2 times a day. The dose is gradually increased to a maximum daily dose of 150 mg (50 mg 3 times per day).

In chronic heart failure, Kapoten is prescribed in those cases when the use of diuretics does not provide an adequate effect. The initial dose is 6.25 mg 3 times a day. If necessary, increase the dose every 2 weeks. The maintenance dose is 25 mg 2-3 times a day. The maximum daily dose is 150 mg.

When violations of left ventricular function after a myocardial infarction in patients in a clinically stable state, the use of Kapoten can begin as early as 3 days after myocardial infarction. The initial dose is 6.25 mg per day, then the daily dose can be increased to 37.5-75 mg for 2-3 doses (depending on the drug tolerability) up to a maximum of 150 m per day.

With diabetic nephropathy, the daily dose is 75 mg to 100 mg divided into 2-3 doses. With insulin-dependent diabetes mellitus with microalbuminuria (albumin clearance 30-300 mg per day) the dose of the drug is 50 mg twice a day. With a total protein clearance of more than 500 mg per day, the drug is effective at a dose of 25 mg 3 times a day.

For elderly patients, the dose is selected individually. It is recommended to start treatment with the lowest therapeutic dose of 6.25 mg twice a day and, if possible, maintain it at this level.

If necessary, additionally prescribed "loop" diuretics, and not diuretics thiazide series.

Side effect

• orthostatic hypotension;
• tachycardia;
• peripheral edema;
• dry cough (usually occurring after withdrawal of the drug);
• bronchospasm;
• pulmonary edema;
• angioedema, swelling of the extremities, face, lips, mucous membranes, tongue, throat or larynx;
• headache, dizziness;
• paresthesia;
• drowsiness;
• visual impairment;
• hyperkalemia, hyponatremia;
• neutropenia, agranulocytosis, thrombocytopenia, anemia;
• a taste disorder;
• dry mouth;
• stomatitis;
• stomach ache;
• diarrhea.

Contraindications

• angioedema (hereditary or associated with the use of ACE inhibitors in the anamnesis);
• severe renal dysfunction;
• severe liver dysfunction;
• hyperkalemia;
• bilateral stenosis of the renal arteries or stenosis of the artery of a single kidney with progressive azotemia;
• condition after kidney transplantation;
• stenosis of the aortic orifice and similar obstructive changes that hinder the outflow of blood from the left ventricle;
• pregnancy;
• lactation period (breastfeeding);
• age to 18 years;
• hypersensitivity to the drug and other ACE inhibitors.

Application in pregnancy and lactation

The drug is contraindicated for use in pregnancy and lactation.

special instructions

Before the onset, and also regularly during the treatment with Kapoten, kidney function should be monitored. In patients with chronic heart failure, Kapoten should be used under close medical supervision.

Against the background of prolonged use of Kapoten, approximately 20% of patients have an increase in urea and creatinine in the blood serum by more than 20% compared to the norm or the baseline value.Less than 5% of patients, especially in severe nephropathies, require discontinuation of treatment due to increased creatinine concentrations.

In patients with arterial hypertension in the application of Kapoten, severe arterial hypotension is observed only in rare cases; the likelihood of developing this condition increases with increased loss of fluid and salts (eg, after intensive treatment with diuretics), in patients with heart failure or who are on dialysis.

The possibility of a sharp decrease in blood pressure can be minimized by first canceling (for 4-7 days) a diuretic or increasing the intake of sodium chloride (approximately one week before the start of the intake) or by prescribing Kapoten at the start of treatment in small doses (6.25-12.5 mg in day).

In the first 3 months. therapy should monitor the number of white blood cells a month, then - 1 time in 3 months. In patients with autoimmune diseases, the number of leukocytes in the first 3 months. Treatment should be monitored every 2 weeks, then every 2 months. If the number of leukocytes is less than 4000 / μl, a general blood test is performed, if less than 1000 / μl - the drug is stopped.

In some cases, against the background of the use of ACE inhibitors, incl.Kapoten, there is an increase in the concentration of potassium in the blood serum. The risk of hyperkalemia in the use of ACE inhibitors is increased in patients with renal insufficiency and diabetes mellitus, as well as taking potassium-sparing diuretics, potassium preparations or other drugs that cause an increase in the potassium concentration in the blood (for example, heparin). It should avoid the simultaneous use with Kapoten potassium-sparing diuretics and potassium preparations.

When hemodialysis in patients receiving Kapoten, the use of dialysis membranes with high permeability (for example, AN 69) should be avoided, since in such cases the risk of anaphylactoid reactions increases.

In the case of angioedema, the drug is withdrawn and carefully monitored. If the edema is localized on the face, special treatment is usually not required (to reduce the severity of symptoms can be used antihistamines); If the swelling spreads to the tongue, throat or larynx and there is a threat of development of airway obstruction, 0.5 ml of a 0.1% solution of epinephrine (epinephrine) should be injected immediately.

When taking Kapoten, a false positive reaction can be observed when analyzing urine for acetone.

Caution should be given to a patient who is on a low-salt or salt-free diet because in this case, the risk of developing arterial hypotension increases.

If a symptomatic arterial hypotension occurs after taking Kapoten, the patient should take a horizontal position with raised legs.

Use in Pediatrics

Safety and efficacy of the drug in children and adolescents under the age of 18 years have not been established.

Impact on the ability to drive vehicles and manage mechanisms

During the period of treatment it is necessary to refrain from driving motor vehicles and practicing potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions. possibly dizziness, especially after taking the initial dose.

Drug Interactions

Diuretics, vasodilators (eg, minoxidil) increase the antihypertensive effect of the drug Kapoten.

Indomethacin and other NSAIDs can reduce the antihypertensive effect of Kapotene.

Simultaneous application of Kapoten with potassium-sparing diuretics (triamterene, amiloride and spironolactone) or potassium preparations can lead to hyperkalemia.

Simultaneous use of lithium and Kapoten salts can lead to an increase in the concentration of lithium in the blood serum.

Against the background of simultaneous application of Kapoten with Allopurinol and procainamide, there may be neutropenia and / or Stevens-Johnson syndrome.

With the simultaneous administration of immunosuppressants (eg, azathioprine and cyclophosphamide) with Kapoten, the risk of hematological disorders increases.

Analogues of the drug Kapoten

Structural analogs for the active substance:

• Alkadyl;
• Angiopril-25;
• Blokordil;
• Vero-Captopril;
• Captopril;
• Captopril Sandoz;
• Captopril-AKOS;
• Captopril-Acry;
• Captopril-Ferein;
• Katopil;
• Epsetron.

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