captopril
Captopril is an angiotensin-converting enzyme (ACE) inhibitor. It's used in adults to treat high blood pressure, heart failure, and to prevent the worsening of kidney problems in people who have diabetes. Captopril is available as a tablet that's taken by mouth two to three times per day. Your healthcare team will help determine your dose based on different factors, such as how high your blood pressure is and what other medications you're taking. Side effects include a dry cough, changes in taste, and dizziness. Brand name Capoten has been discontinued; captopril is only available as a generic medication.
What is Captopril?
What is Captopril used for?
- High blood pressure
- Heart failure (in combination with other medications)
- Improve survival after heart attack in people who have heart failure
- Prevent worsening kidney problems in people who have diabetes (diabetic nephropathy)
How Captopril works
Captopril is an angiotensin-converting enzyme (ACE) inhibitor. It relaxes your blood vessels by blocking a protein (called ACE) from making a hormone that squeezes your blood vessels.
Drug facts
Side effects of Captopril
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Skin rash (up to 7%)
- Changes in taste (up to 4%)
- Dry cough (up to 2%)
- Itching (2%)
Less Common Side Effects
- Fast heartbeat
- Chest pain
- Kidney problems
- Flushing
- Low blood pressure
Captopril serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Angioedema (severe swelling): swelling (in the face, arms or legs, lips, tongue, or throat); trouble breathing; wheezing; nausea; vomiting; severe stomach pain
- Dangerously low blood pressure: dizziness, lightheadedness, pale skin, feeling faint
- Serious kidney problems: urinating less often than usual; swelling in your feet, ankles, or hands; unexplained weight gain
- High blood potassium levels: nausea, muscle weakness, abnormal heartbeat
- Severe allergic reaction: swelling of your lips, tongue, throat, or face; trouble breathing; rash
More on Captopril side effects
The following Captopril side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
Arm, back, or jaw pain
bloody urine
chest discomfort
chest tightness or heaviness
decreased blood pressure
decreased or increased frequency or amount of urine
dilated neck veins
increased thirst
irregular breathing
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
loss of appetite
lower back or side pain
paleness or cold feeling in the fingertips and toes
sweating
swelling of the face, fingers, feet, or lower legs
tingling or pain in the fingers or toes when exposed to cold temperatures
troubled breathing
unusual tiredness or weakness
vomiting
Incidence not known
Bleeding gums
bloody, black, or tarry stools
blurred vision
chills
confusion
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
high fever
painful or difficult urination
pale skin
pinpoint red spots on the skin
sores, ulcers, or white spots on the lips or in the mouth
swollen glands
unusual bleeding or bruising
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Change in taste
feeling of warmth
itching skin
loss of taste
rash
redness of the face, neck, arms, and occasionally, upper chest
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Captopril
Pros
- A first-choice medication for lowering blood pressure for many people
- Taken by mouth
- Available as a lower-cost generic
Cons
- Taken two to three times per day
- Need to take on an empty stomach, 1 hour before meals
- Can't take during pregnancy
Pharmacist tips for Captopril
- Mark your appointments on your calendar to see your healthcare providers and get any blood work done while you're taking captopril. These blood tests help your prescriber check for side effects, like changes in your potassium levels or kidney health. Your dose might need to be adjusted based on your lab results.
- Take captopril 1 hour before food. You should take it on an empty stomach because food can lower how much of the medication gets absorbed into your body.
- ACE inhibitors like captopril are known to cause a dry cough as a side effect. This can happen at any time during treatment, and might not go away until you stop the medication. Let your prescriber know if you develop a cough that becomes too bothersome.
- It's possible to feel dizzy when you start taking captopril, and when your prescriber raises your dose. This should get better over time as you continue taking the medication and your body gets used to your new blood pressure. Stand up slowly and carefully from a sitting or lying down position to avoid falling.
- Captopril can cause a change in taste. Let your prescriber know if this happens to you and it's too bothersome. It typically goes away when the medication is stopped.
- Drink enough fluids to stay hydrated while you're taking captopril, especially on hot days or after exercising. Your blood pressure might drop too much if you don't have enough fluids in your body. This can worsen dizziness and raise your risk of falls. Ask your provider about how to safely stay hydrated if you have heart failure or kidney problems.
- Check your blood pressure on a regular basis and keep a log of your readings. Bring your log to your office visits so you can discuss with your provider about how well captopril is working for you.
- Make sure to tell your providers about all the medications you're taking or planning to take. Captopril can interact with other medications. These interactions can affect how well your medications work or raise your risk for side effects. Your providers and pharmacists can check that your medications are safe to take together.
- Avoid using nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), with captopril unless your provider says it's okay. Taking these medications with captopril can raise your risk for kidney problems.
- Make sure to eat a variety of fruits and vegetables, follow a low-salt diet, and get regular exercise while you're taking captopril. This helps lower your blood pressure.
- Stop taking captopril and tell your care team right away if you're pregnant. This medication isn't safe to take during pregnancy because it can harm your unborn baby. Your prescriber might recommend a different medication that's safer during pregnancy and lifestyle changes you can make to help lower your blood pressure.
Common questions about Captopril
No, captopril isn't a diuretic or "water pill"; it's an ACE inhibitor. Diuretics and ACE inhibitors are medications that can lower blood pressure, but they do so in different ways. Diuretics lower blood pressure by causing your body to urinate more to get rid of extra fluids. ACEI inhibitors, like captopril, do so by blocking a protein in your body, which causes your blood vessels to widen. Depending on how high your blood pressure is and what other medical conditions you have, it's possible your healthcare team might have you take both captopril and a diuretic together.
Captopril can cause a noticeable drop in blood pressure within 60 to 90 minutes after a dose. But you might need to take this medication for 1 to 2 weeks to see more consistent changes in your blood pressure. Check your blood pressure at home as instructed by your prescriber. Write down your blood pressure readings and bring them to your appointments. This can help your healthcare team understand how well captopril is working for you and whether they need to make any changes to your dose.
Captopril should be taken at least 1 hour before meals. Studies show food can lower the amount of medication that gets absorbed into your body. This means taking captopril with food might cause it to not work as well in lowering your blood pressure. However, if your prescriber specifically recommended you take captopril with food, it's important to be consistent with every dose.
Typically, you should take captopril on an empty stomach, at least 1 hour before meals. Taking captopril with any food will cause your body to absorb less medication, which means captopril won't work as well to lower your blood pressure. But taking captopril with foods high in potassium levels can raise your risk of high blood potassium levels, which is a rare but serious side effect of captopril. And taking captopril with foods that raise blood pressure can further cancel out the effects of captopril on your blood pressure. If you have questions about a particular food interaction, talk with your healthcare team.
Medications that raise your blood pressure can reduce the antihypertensive effect of captopril and cause it to not work as well in lowering blood pressure. Examples of medications that can raise your blood pressure include nonsteroidal anti-inflammatory drugs (NSAIDs) and certain antidepressants. Let your healthcare team know what other medications you're taking when you first start captopril. They might ask you to check your blood pressure more often.
Though not common, captopril and other ACE inhibitors can cause hyperkalemia (high blood potassium levels) as a side effect. Sometimes, this can be life-threatening. You're at higher risk for this side effect if you have kidney problems or diabetes, or if you take other medications that also raise potassium levels. If needed, your healthcare team might order blood tests to measure you potassium levels regularly throughout treatment. If you experience symptoms of high potassium levels, such as nausea, muscle weakness, or abnormal heartbeat, get medical help right away.
Both captopril and lisinopril (Zestril) are ACE inhibitors that can treat high blood pressure and heart failure, but they're not the same. One major difference is how often you take them. Captopril is typically taken two to three times a day, but lisinopril (Zestril) is usually taken just once daily. Another differences is who can take them. Captopril is usually prescribed for adults only, but lisinopril (Zestril) is FDA-approved for children as young as 6 years old who have high blood pressure. Talk with your healthcare team if you have more questions about captopril and lisinopril (Zestril).
No. All ACE inhibitors, including captopril, are only available by a prescription from a healthcare professional.
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Risks and warnings for Captopril
Captopril can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Not safe during pregnancy
Captopril, as well as other ACE inhibitors, can cause serious harm to unborn babies. Don't take captopril during pregnancy. Before you start captopril, discuss with your cardiology team about safer options to lower blood pressure if you're pregnant or thinking of becoming pregnant. If you become pregnant while you're taking captopril, stop the medication and let your healthcare team know right away.
Angioedema (swelling) and serious allergic reactions
- Risk factors: Black people | History of angioedema in the past
People who take ACE inhibitors like captopril can experience a rare, but serious side effect called angioedema. This involves swelling in different parts of the body, including the face, throat, tongue, and stomach. Swelling of the tongue or throat area can be potentially life-threatening since it can make it difficult to breathe. Angioedema can happen at any time during treatment. You might be more likely to experience angioedema if you're Black, an older adult, or of female sex. Get medical attention immediately if you notice any unusual swelling, stomach pain, or difficulty breathing. You'll have to stop taking captopril if this happens.
Some people who received ACE inhibitors, like captopril, have experienced serious allergic reactions. They developed certain symptoms, such as trouble breathing, tightness in the throat, nausea, confusion, and anxiety. Get medical help right away if you experience these symptoms.
Risk of infection (lower white blood cell count)
- Risk factors: Kidney problems | Certain autoimmune conditions Though rare, some people develop lower white blood cell (WBC) count after starting captopril. The risk is higher for people with kidney problems and certain autoimmune conditions, such as lupus. Typically, the drop in WBC count is noted within 3 months of starting captopril. Having lower WBC count puts you at risk for serious infections. If you have kidney problems, your healthcare team might perform blood draws regularly to check your WBC count. If your levels are too low, you'll need to pause captopril. Usually, WBC levels return to the normal ranges within 2 weeks of stopping captopril. Let your healthcare team know if you have symptoms of an infection, such as fever, chills, cough, or tiredness.
Low blood pressure
- Risk factors: Not enough fluid or salt in your body | Taking higher doses of diuretic medications | Taking other medications that can lower blood pressure | Receiving dialysis | Heart failure
Though rare, taking captopril can sometimes cause your blood pressure to drop too low. This can make you feel dizzy, tired, or lightheaded. This side effect is more common when you first start captopril or when your cardiologist raises your dose. Make sure to stay well-hydrated during treatment. Sit or lie down slowly while holding onto something if you feel dizzy, lightheaded, faint, or tired. And get medical help right away if you accidentally fall and hit your head.
Worsening kidney problems
- Risk factors: Severe heart failure | Kidney problems or renal artery stenosis | Not enough fluid in your body | Taking other medications that can cause kidney damage
Captopril is usually good for the kidneys. But in some cases, it can make kidney problems worse. The risk is higher for people who have certain types of kidney problems, such as renal artery stenosis or kidney damage from severe heart failure. Your cardiology team might order lab tests every so often to make sure your kidneys are healthy and working properly. Tell your care team if you're urinating less often than usual, as this could be a sign that your kidneys aren't working as well.
High potassium levels
- Risk factors: Diabetes | Kidney problems | Taking other medications that also raise potassium levels
Captopril can raise the amount of potassium in your body, which can sometimes be dangerous. Your risk of having high potassium levels is greater if you have diabetes or kidney problems or if you're taking other medications that also raise potassium levels. For this reason, make sure your cardiology team knows your full medical history and what medications you're taking before you start treatment. Get medical help right away if you have symptoms of high potassium levels, such as nausea, muscle weakness, or abnormal heartbeat.
Risk of liver problems
In some rare cases, people who took ACE inhibitors like captopril developed serious liver problems. Your healthcare team might order blood tests to check your liver health from time to time. Let your care team know right away if you notice symptoms of liver problems, such as tiredness, stomach pain, or yellowing of your skin.
More on Captopril warnings
Captopril dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 12.5mg | 60 tablets | $29.16 | $0.49 |
| 25mg | 60 tablets | $19.37 | $0.32 |
| 50mg | 180 tablets | $53.52 | $0.30 |
| 100mg | 60 tablets | $27.49 | $0.46 |
Typical dosage for Captopril
Take captopril on an empty stomach (at least 1 hour before meals).
- High blood pressure: The typical starting dose is 25 mg by mouth two or three times per day. If needed, your prescriber might raise the dose to 50 mg two or three times per day after a couple of weeks. The typical maintenance dose ranges from 25 mg to 150 mg by mouth two to three times per day, depending on what other blood pressure medications you're taking.
- Heart failure: The typical starting dose ranges from 6.25 mg to 25 mg by mouth three times per day. The typical maintenance dose ranges from 50 mg to 100 mg three times per day.
- Improve survival after heart attack: Your prescriber might ask you to start captopril as early as 3 days after a heart attack. The typical starting dose is 6.25 mg by mouth once as a single dose, then 12.5 mg by mouth three times per day. Your prescriber will slowly raise your dose over the next couple of weeks. The typical maintenance dose is 50 mg three times per day.
- Kidney problems related to diabetes: The typical dose is 25 mg by mouth 3 times per day.
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Interactions between Captopril and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Aliskiren
- Sacubitril
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Allopurinol
- Alteplase, Recombinant
- Amiloride
- Azathioprine
- Azilsartan
- Azilsartan Medoxomil
- Candesartan Cilexetil
- Canrenoate
- Digoxin
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Eplerenone
- Eprosartan
- Everolimus
- Interferon Alfa-2a
- Irbesartan
- Lithium
- Losartan
- Mercaptopurine
- Morphine
- Morphine Sulfate Liposome
- Nilotinib
- Olmesartan Medoxomil
- Oxypurinol
- Pixantrone
- Potassium
- Sirolimus
- Spironolactone
- Telmisartan
- Triamterene
- Trimethoprim
- Valsartan
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aspirin
- Azosemide
- Bromfenac
- Bufexamac
- Bumetanide
- Bupivacaine
- Bupivacaine Liposome
- Capsaicin
- Celecoxib
- Chlorpromazine
- Choline Salicylate
- Clonixin
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Dipyrone
- Droxicam
- Ethacrynic Acid
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Furosemide
- Gold Sodium Thiomalate
- Ibuprofen
- Icatibant
- Indomethacin
- Ketoprofen
- Ketorolac
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Morniflumate
- Nabumetone
- Naproxen
- Nepafenac
- Nesiritide
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenylbutazone
- Piketoprofen
- Piretanide
- Piroxicam
- Proglumetacin
- Propionic Acid
- Propyphenazone
- Proquazone
- Rofecoxib
- Salicylic Acid
- Salsalate
- Sodium Salicylate
- Sulindac
- Tenoxicam
- Tiaprofenic Acid
- Tolfenamic Acid
- Tolmetin
- Torsemide
- Valdecoxib
How much does Captopril cost?
$19.37
Captopril contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Captopril will not be safe for you to take.
- Angioedema with other ACE inhibitors in the past
- Taking aliskiren (Tekturna) at the same time (people with diabetes)
- Taking captopril within 36 hours of Entresto (sacubitril/valsartan)
What are alternatives to Captopril?
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