At what pressure is appointed Kapoten: instruction for use

Kapoten is an inhibitor of the angiotensin-converting enzyme (ACE).

The active substance of the tablets reduces blood pressure without causing tachycardia, and reduces the need for myocardium in oxygen (cardioprotector). The preparation quickly absorbed and reaches a maximum concentration in the blood after 1 hour, 25-30% by binding to plasma proteins, 75% is excreted by the kidneys. The half-life period is 2-3 hours.

In clinical trials, the drug showed good efficacy, it can be used in standard medical schemes for the treatment of hypertension. Kapoten has proven itself for people who are faced with the problem of high blood pressure situationally, from case to case.

Clinical and pharmacological group

ACE inhibitor.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much does a bonnet cost? The average price in pharmacies is at the level of200 rubles.

Form of issue and composition

The hood is produced in the form of white, square tablets with a characteristic odor. On each tablet, on one side, there is a cross-shaped notch that facilitates dosing.

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Tablets may contain 25 or 50 mg of active ingredient captopril + auxiliary components (cellulose, stearic acid, starch, lactose, etc.).

Tablets of 10 or 14 pieces are packaged in blisters. In the pack with the drug can contain two or four blisters with tablets.

Pharmacological effect

Kapoten is an ACE inhibitor. It suppresses the formation of angiotensin II and eliminates its vasoconstrictive effect on arterial and venous vessels. The drug reduces OPSS, postnagruzku, lowers blood pressure, as well as reduces preload, reduces pressure in the right atrium and a small circle of circulation. It reduces the production of aldosterone in the adrenal glands.

The peak of effectiveness is noted 60-90 minutes after ingestion. The degree of decrease in blood pressure is the same in the patient's standing and lying position. At reception during meal absorption of a preparation is slowed down on 30-40%. Half-life is 2-3 hours. The drug is excreted in the urine to 50% - unchanged, the rest - in the form of metabolites.

Indications for use

According to the instructions for use, tablets from the pressure of Kapoten are prescribed at the following indications:

Arterial hypertension of the renovascular type.
Chronic heart failure.
Decrease in left ventricular function after therapy of myocardial infarction.
Diabetic nephropathy.

Most often, patients are interested in what pressure is administered by Kapoten? Everything depends on the patient's condition and working pressure. Usually the drug is prescribed if the pressure rises above 160/100. The regimen of intake and dosage is selected by the doctor individually, taking into account possible risks and side effects. The fact is that when pressure jumps take medicine with caution, under the supervision of a specialist, since the likelihood of heart disorders is high.

Contraindications

Contraindications to the use of Kapoten are:

Pronounced disorders of kidney and liver function;
Condition after kidney transplantation;
Hyperkalemia;
Pregnancy and the period of breastfeeding;
Angioneurotic edema (associated with hereditary factors or with the use of ACE inhibitors in the anamnesis);
Stenosis of the artery of a single kidney with progressive azotemia or bilateral stenosis of the renal arteries;
Hypersensitivity to the drug components and other ACE inhibitors;
Stenosis of the aortic orifice and similar obstructive changes complicating the outflow of blood from the left ventricle;
Age under 18 years (safety and efficacy of the drug for this age group are not established).

The drug is administered with caution under the following conditions / diseases:

Cardiac ischemia;
Ischemia of the brain;
Primary hyperaldosteronism;
Diabetes mellitus (due to the increased risk of hyperkalemia);
Oppression of bone marrow hemopoiesis (due to the risk of agranulocytosis and neutropenia);
Conditions accompanied by a decrease in the volume of circulating blood (including vomiting, diarrhea);
Severe autoimmune diseases of connective tissue (including systemic lupus erythematosus, scleroderma).

Kapoten should be taken with caution elderly patients (dose adjustment is necessary), as well as patients on hemodialysis and observing a diet with sodium restriction.

Use in pregnancy and lactation

Kapoten during pregnancy and breastfeeding is prohibited for use, as the drug may have a negative effect on the growth and development of the fetus. In experimental animal studies, it was found that Kapoten is embryotoxic and can provoke intrauterine fetal death, miscarriage, etc. Therefore, during the entire period of pregnancy, a woman should not take it

If a woman takes Kapoten as a routine therapy, then the drug should be discontinued as soon as it becomes aware of the onset of pregnancy. If pregnancy is planned, it is recommended to switch to another antihypertensive drug before pregnancy attempts, which can be taken by pregnant women (for example, Nifedipine, etc.).

Dosage and route of administration

The instructions for use indicate: Take the inside of the hood 1 hour before meals. The dosage regimen under increased pressure is set individually.

With arterial hypertensionthe initial dose is 12.5 mg (1/2 table. 25 mg) 2 times / 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 maintenance dose is 25 mg 2 times / day; the maximum dose is 50 mg 2 times / day. With severe arterial hypertension, the initial dose is 12.5 mg (1/2 table. 25 mg) 2 times / day. The dose is gradually increased to a maximum daily dose of 150 mg (50 mg 3 times / day).
In cases of violations of left ventricular function after a previous myocardial infarctionin patients in a clinically stable state, the use of the Kapoten drug can begin as early as 3 days after myocardial infarction. The initial dose is 6.25 mg / day (1/4 tab. 25 mg), then the daily dose can be increased to 37.5-75 mg for 2-3 doses (depending on the drug's tolerance) up to a maximum of 150 mg / day.
With diabetic nephropathythe drug is prescribed in a dose of 75-100 mg, divided into 2-3 doses. In type 1 diabetes mellitus with microalbuminuria (albumin clearance 30-300 mg / day) the dose of the drug is 50 mg 2 times / day. With proteinuria more than 500 mg / day the drug is effective at a dose of 25 mg 3 times / day.
With chronic heart failurethe initial daily dose is 6.25 mg (1/4 tab. 25 mg) 3 times / day. If necessary, increase the dose gradually (at intervals of not less than 2 weeks). The maintenance dose is 25 mg 2-3 times / day. The maximum daily dose is 150 mg. If before the appointment of the drug Kapoten, therapy with diuretics was carried out, it is necessary to exclude the presence of a marked decrease in the content of electrolytes and bcc.

For elderly patients, the dose is selected individually. Treatment is recommended to begin with a dose of 6.25 mg (1/4 tab. 25 mg) 2 times / day and, if possible, maintain it at this level.

Patients with moderate renal dysfunction (CK ≥ 30 mL / min / 1.73 m2) are given a dose of 75-100 mg / day. In severe violations of kidney function (KK <30 ml / min / 1.73 m2) the initial dose is not more than 12.5 mg / day (1/2 table. 25 mg). In the future, if necessary, the dose is gradually increased (with sufficiently large intervals), but use a smaller, than usual, daily dose of the drug.

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

Side effects

According to the instructions, when using Kapoten tablets, the following side effects may develop:

Violation of the cardiovascular system (persistent lowering of blood pressure, disturbance of the heart rhythm);
Violation of the circulatory system (various changes in the percentage of blood cells, numbness of the hands);
Disturbances of the skin (increased sensitivity to light, hives, itching, various rashes);
Various allergic reactions (Quincke's edema, urticaria, bronchospasm, serum sickness);
Disturbances of the digestive system (disorders of taste perception, stomatitis, gastric irritation, increased activity of enzymes liver, abdominal pain, inflammation of the liver, congestion in the biliary tract, accompanied by jaundice);
Violation of the urinary system (increasing the content of various elements in the urine (protein, potassium ions, creatinine, urea), shifting the acid-base balance of urine to the acid side).

Overdose

Symptoms of drug overdose are a sharp decrease in pressure, shock, stupor, bradycardia. A person is disturbed by water-electrolyte balance and renal failure is observed.

For treatment, it is necessary to wash the stomach, introduce sodium sulfate adsorbents for half an hour, intravenously to drip saline or plasma-substituting drugs, to conduct hemodialysis. At a bradycardia the atropine is entered, sometimes the artificial driver of a rhythm can be applied. Peritoneal dialysis is not effective.

special instructions

Before the start of therapy, as well as regularly in the process of taking Kapoten, it is necessary to monitor the kidney function. In patients with chronic heart failure, the drug should be used under close medical supervision.

Against the backdrop of prolonged treatment, there may be an increase in creatinine and urea in the blood serum.

When developing after receiving Kapoten symptomatic arterial hypotension, the patient needs to take a horizontal position and raise his legs.

In patients with hypertension with the use of the drug, severe arterial hypotension is observed only in certain cases; The probability of this state increases with excessive loss of salts and fluid (for example, after intensive diuretic therapy), in dialysis patients or in patients with heart failure.

When conducting hemodialysis, it is recommended to avoid the use of dialysis membranes with high permeability (for example, AN69), which is associated with an increased risk of anaphylactoid reactions.

The possibility of a sharp lowering of blood pressure can be minimized if after 4-7 days, diuretics are canceled or beforehand (in 7 days) the intake of sodium chloride increases. Also this can be achieved by prescribing small doses of Kapoten (6.25-12.5 mg per day) at the beginning of treatment.

The risk of hyperkalemia in the use of Kapoten is increased in patients with renal insufficiency and diabetes, as well as in patients who take potassium preparations, potassium-sparing diuretics, or other drugs that lead to an increase in the concentration of potassium in the blood (for example, heparin). Simultaneous use of potassium and potassium-sparing diuretics with Kapoten should be avoided.

In the first 3 months of treatment, it is necessary to monitor the number of blood leukocytes on a monthly basis, in the future - once in 3 months. Patients with autoimmune diseases in the first 3 months of treatment the number of leukocytes should be monitored every 14 days, then every 2 months. When the number of leukocytes is less than 4000 / μl, a general blood test is performed, less than 1000 / mm3 - therapy should be interrupted.

With the development of angioedema, Kapoten should be abolished and thorough medical supervision should be carried out. In case of localization of the edema on the face, as a rule, special therapy is not performed (to reduce the severity of symptoms, it is possible to prescribe antihistamines). When spreading the edema to the tongue, throat or throat, there is a threat of developing airway obstruction. In this case, an immediate injection of 0.5 ml of a 0.1% solution of epinephrine (epinephrine) may be required.

Kapoten should be taken with caution to patients who observe a salt-free or low-salt diet, since in this case the risk of developing arterial hypotension increases.

During therapy, a false positive reaction may be observed when analyzing urine for acetone.

The patient receiving the Kapoten should refrain from driving and performing other potentially hazardous activities requiring increased concentration of attention and rapid psychomotor reactions (due to the likelihood of developing dizziness, especially after taking the initial dose).

Drug Interactions

The drug can change its effect on the body when interacting with different types of drugs, and also influence their effect. Therefore, when combined with other medicines, be sure to consult with a specialist about their compatibility.

Here are the most common examples of the effect change when interacting with other means:

When interacting with immunosuppressants: the probability of developing hematologic-type disorders increases.
Indomethacin and other NSAIDs: the antihypertensive effect of the drug may decrease.
When interacting with lithium salts: Kapoten can increase the concentration of lithium in the blood serum.
With potassium-sparing diuretics: the likelihood of developing hyperkalemia increases.
With procainamide and allopurinol: Stevens-Johnson syndrome and / or neutropenia may occur.
When interacting with diuretics and vasodilators: the antihypertensive effect of Kapoten is potentiated.

Reviews

We picked up some reviews of people taking the drug Kapoten from high blood pressure:

Angelica. I tried analogs, including the aforementioned blockade, but still the hood works best, at least the pressure decreases more effectively with fewer side effects.
Anna. A good preparation is Kapoten. Worked in the store, a sharp jump in pressure, well the boss was next! He took me to a pharmacy nearby, where the pressure was measured - 140/100. He himself struggles with pressure, but because of the fullness, it weighs 180 kg, and I'm skinny 56 kg. Says, where did the leaner get such a lot of pressure, he went and brought the "Kapoten" from the car. I put a quarter under the tongue, in 15-20 minutes was normal, but he immediately said, if after it gets better, and then again starts to become bad, another quarter, how he looked into the water! After that in a bag I wear on everyone always!
Julia. Kapoten helped me when the pressure went off for 180/120. After a month of treatment, the pressure came back to normal. Now I take the drug regularly, in the dosage prescribed by the doctor. But recently he began to torment dry cough and a small red rash appeared on his shoulder. The doctor said that antihypertensive drugs often provoke similar reactions, but while canceling the pill did not, said that he would pick up another remedy if these symptoms become more pronounced.
Fedor. I'm diabetic, plus pressure often increases. Doctors at the inspection found that you can drink tablets Kapoten. Corrected to me a dose in view of my features and have told or said to begin with the minimum. A month later a little increased. I feel well, only sometimes I feel dizzy and dizzy, and the drug is excellent.

Analogues

Analogues of Kapoten tablets are preparations on the active substance of captopril, they are quite numerous and often have a name similar to DV. Perhaps one of the most popular analogues of Kapoten is tablets with the same name Captopril and variations of Captopril Akos, Vero-Captopril.

Other analogues: