Angiten – Captopril

Description:
Angiten® is an antihypertensive drug, a highly specific competitive inhibitor of Angiotensin Converting Enzyme (ACE). It is extensively used in the management of hypertension and congestive cardiac failure. Angiten inhibits ACE and thus inhibits formation of Angiotensin-II which is a potent vasoconstrictor and thus reduces blood pressure through reducing total peripheral resistance.

Composition:
Each Angiten® tablet contains Captopril USP 25 mg.

Indication:
Angiten® is indicated in the management of -
Hypertension : Angiten® is indicated alone or in combination with thiazide diuretics in the management of hypertension.
Heart Failure : Angiten® can be used in heart failure in patients who have not responded adequately to or cannot be controlled by conventional diuretics or digitalis therapy.
Left Ventricular Dysfunction (LVD) after Ml : To improve survival following Ml (Myocardial infarction) in clinically stable patients with LVD and to reduce the incidence of overt heart failure and subsequent hospitalization in CHF, Angiten® can be used.
Diabetic Nephropathy : Angiten® is used for Diabetic Nephropathy (Proteinuria) with type-1 Insulin Dependent Diabetic Mellitus (IDDM) & Retinopathy.

Dosage & Administration:
Administer one hour before meal, if possible discontinue previous antihypertensive drug regimen one week before starting Captopril.

Hypertension : 

In the treatment of hypertension, an initial dose is 12.5 mg twice daily by mouth, increased gradually at intervals of 2 to 4 weeks according to the response. The usual maintenance dose is 25 to 50 mg twice daily and should not normally exceed 50 mg three times daily. Even in more severe hypertension, addition of a second agent or substitution of an alternative drug, being preferred. (An initial dose of 6.25 mg twice daily is recommended if Captopril is given in addition to a diuretic, to elderly patients or to those with renal impairment.)

Heart Failure : 

An initial dose of 6.25 to 12.5 mg of Captopril is given under close medical supervision. The usual maintenance dose is 25 mg two or three times daily and doses should not normally exceed 50 mg three times daily.

LVD After Ml : 

The target maintenance dose is 50 mg thrice daily after a single starting dose of 6.25 mg and initially 12.5 mg thrice daily, then increase to 25 mg thrice daily during the next several days. Other post myocardial infarction therapies (eg. Thrombolytic agent, Aspirin, b-blocker) may be used concurrently.

Diabetic Nephropathy : Use 25 mg thrice daily of Captopril.

Precaution
Captopril should be used with great caution in patients with impaired renal function and patient with collagen vascular disorder, such as : systemic erythematous or scleroderma. Captopril is not recommended for children.

Side effect
The commonest adverse effects are skin rashes, persistent dry cough, loss of taste, sore mouth, angioedema, hypotension, abdominal pain, proteinurea, agranulocytosis, neutropenia and hyperkalaemia.

Contraindication
Captopril is contraindicated in patients who are hypersensitive to ACE inhibitors, in pregnancy and nursing mother and in patient with critical renovascular disease.

Drug interaction
Diuretics : Diuretics potentiate the antihypertensive effect of Captopril. Potassium sparing diuretics (Triamterene, Amiloride and Spironolactone) or Potassuim supplements may cause significant increase in serum Potassium.
Nonsteroidal anti-inflammatory agents : Concomitant therapy with Indomethacin and possibly other anti-inflammatory drugs may reduce the antihypertensive effect of Captopril.

How supplied
Angiten® Tablet : Box contains 10 x 10's tablets in blister strip. preferred.

Manufacturer’s Source: IBN SINA