What is the dosage for captopril?

  • The recommended dose of captopril for treating hypertension in adults is 25-150 mg two or three times daily.
  • The maximum dose is 450 mg daily. The dose for treating heart failure is 6.25 to 12.5 mg every 8 hours.
  • The target dose is 50 mg every 8 hours and the maximum dose is 450 mg daily.
  • The dose for diabetic nephropathy is 25 mg every 8 hours.
  • It should be taken on an empty stomach one hour before or two hours after meals since absorption of captopril is reduced when it is taken with food.

Which drugs or supplements interact with captopril?

: The use of ACE inhibitors with potassium supplements, salt substitutes or diuretics, for example, spironolactone (Aldactone), that increase potassium in the blood may lead to excessive potassium levels (hyperkalemia). Potassium levels should be monitored whenever ACE inhibitors are used in combination with these drugs.

There have been reports of increased lithium (Eskalith, Lithobid) levels when lithium is used in combination with ACE inhibitors. The reason for this interaction is not known, but the increased levels may lead to toxicity from lithium.

There have been reports that aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen (Advil, Children’s Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc.), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effects of ACE inhibitors.

Combining captopril or other ACE inhibitors with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who are elderly, volume-depleted (including those on diuretic therapy), or with poor kidney function may result in reduced kidney function, including kidney failure. These effects are usually reversible.

Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and low blood pressure) may occur when injectable gold (sodium aurothiomalate), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors, including captopril.