ACE inhibitors.

Generic

Tablets.

Tablets, captopril 12.5mg , 25 mg , 50 mg . Available from APS, Berk (KaplonR ), Cox, Generics UK, Genus, Goldshield (Ecopace R ), Hillcross, Kent, Lagap, Norton (Tensopril R ), Regent, Sovereign, Sterwin, Tillomed.

Mild to moderate essential hypertension alone, or with thiazide therapy for severe hypertension resistant to other treatment.

Hypertension, initially 12.5 mg twice daily if used alone. Usual maintenance dose, 25mg twice maintenance dose, 25mg twice daily; maximum dose, 50mg twice daily (or three times daily in severe hypertension).

Hypersensitivity to ACE inhibitors. Pregnancy and lactation. Aortic stenosis or outflow obstruction.

ACE inhibitors should be used with caution in patients using diuretics. ACE inhibitors can cause very rapid fall of blood pressure in volume depleted patients - all diuretics should be discontinued if possible, or the dose reduced significantly 2- 3 days before the initiation of an ACE inhibitor. Diuretic therapy may be resumed after a few weeks if necessary. If diuretic therepy cannot be stopped, medical supervison is recommended for at least two hours after administration of first dose of ACE inhibitor or until blood pressure has stabilised. First doses of ACE inhibitors may cause hypotension especially in patients taking diuretics, patients on a low sodium diet, on dialysis, dehydrated or with heart failure. They should also be used with caution in peripheral vascular disease or generalised atherosclerosis owing to the risk of clinically silent renovascular disease. Renal function should be monitored before and during treatment, and the dose reduced in renal impairment. The risk of agranulocytosis is possibly increased in collagen vascular disease (blood counts recommended).

Diuretics, indometacin (indomethacin), peripheral vasodilators (eg, minoxidil), clonidine, allopurinol, procainamide, immunosuppressants, probenicid, lithium, potassium salts.

impairment. Angioedema (onset may be delayed). Neutropenia, anaemia, thrombocytopenia. Tachycardia, rashes (usually pruritic), pruritus, flushing, vesicular or bullous rash, photosensitivity, taste impairment, weight loss, stomatitis, elevation of liver enzymes. Rarely, hepatocellular injury, cholestatic jaundice. Gastric irritation, abdominal pain, pancreatitis. Also, paraesthesias of the hands, serum sickness, cough, bronchospasm, lymphadenopathy.

(POM)