Captopril

Mild-to-moderate hypertension : As an adjunct to thiazide therapy in patients who have not responded effectively to thiazide treatment alone. Severe hypertension : Where standard therapy has failed. Congestive heart failure : Acetor is indicated for the treatment of congestive heart failure. The drug should be used together with diuretics and where appropriate, digitalis.

Captopril is a sulfhydryl-containing analog of proline with antihypertensive activity. Captopril competitively inhibits angiotensin converting enzyme (ACE), thereby decreasing levels of angiotensin II, increasing plasma renin activity, and decreasing aldosterone secretion. Approxiately 60-75% of an oral dose of captopril is repidly absorbed from the GI tract in fasting healthy individuals or hypertensive patients. More than 95% of a dose is excreted renally, both as unchanged (45-50%) drug and as metabolites.

Mild-to-moderate hypertension : The initial dose is 12.5 mg twice daily. The usual maintenance dose is 25mg twice daily which can be increased incrementally, at two to four week intervals, until a satisfactory response is achieved, to a maximum of 50 mg twice daily. Severe hypertension : In severe hypertension the starting dose is 12.5 mg b.d. The dosage may be increased incrementally to a maximum of 50 mg t.d.s. Heart failure : A starting dose of 6.25mg or 12.5mg may minimise a transient hypotensive effect. The usual maintenance dose is 25mg three times a day. The usual maximum dose is 150 mg daily. Captopril must be taken 1 hour before meals to ensure maximum absorption. Use in Child : Safety and effectiveness in pediatric patients have not been established.