Captopril and Hydrochlorothiazide

Captopril and hydrochlorothiazide is a prescription medication used to treat high blood pressure. It is a single product containing 2 medications: captopril and hydrochlorothiazide. Captopril belongs to a group of drugs called angiotensin-converting enzyme (ACE) inhibitors. Captopril works by blocking the ACE enzyme, which helps blood vessels to relax and lowers blood pressure. Hydrochlorothiazide belongs to a group of drugs called thiazide diuretics, which work by stopping reabsorption of salt into your body. This prevents fluid from building up in the body.

This medication comes in tablet form and is typically given once daily with or without food.

Common side effects of captopril and hydrochlorothiazide include rash, loss of taste, and headache.

Captopril and hydrochlorothiazide may also cause dizziness. Do not drive or operate heavy machinery until you know how captopril and hydrochlorothiazide affects you.

Captopril and hydrochlorothiazide is a prescription medication used to treat high blood pressure.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. 

Captopril and Hydrochlorothiazide may be found in some form under the following brand names:

• Capozide

Serious side effects have been reported with captopril and hydrochlorothiazide. See the "Captopril and hydrochlorothiazide Precautions" section. 

Common side effects of captopril and hydrochlorothiazide include the following:

• skin reactions such as rash, itching, and sensitivity to the sun
• loss of taste
• low blood pressure (especially upon standing)
• fast heart beat
• chest pain
• a noticeably rapid, strong, or irregular heartbeat (palpitation)
• cough
• dizziness
• feeling like your surroundings are spinning or moving (vertigo)
• an eating disorder associated with low body weight (anorexia)
• nausea or vomiting
• cramping
• diarrhea or constipation
• headache

This is not a complete list of captopril and hydrochlorothiazide side effects. Ask your doctor or pharmacist for more information. 

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. 

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• certain medicines that lower blood pressure such as diuretics like furosemide (Lasix), hydrochlorothiazide (Microzide, HCTZ), spironolactone (Aldactone), and triamterene (trade name Dyrenium), or vasodilators like doxazosin (Cardura), prazosin (Minipress), terazosin (Hytrin), clonidine (Catapres), hydralazine (Bidil, Hydra­Zide), and minoxidil
• potassium products including potassium chloride (K-Dur, Klor-Con, Micro-K), potassium citrate (Urocit-K, Polycitra-K), potassium gluconate, potassium phosphate (Neutra-Phos-K, K-Phos)
• salt substitutes that contain potassium
• anticoagulant (blood thinner) medications such as warfarin (Coumadin, Jantoven), heparin, enoxaparin (Lovenox), fondaparinux (Arixtra), rivaroxaban (Xarelto), and apixaban (Eliquis)
• gout medications such as allopurinol (Aloprim, Lopurin, Zyloprim), febuxostat (Uloric), probenecid (Benemid), and sulfinpyrazone (Anturane)
• a group of pain medicines called narcotics such as oxycodone (Roxicodone, Oxycontin, Oxecta)
• barbiturates such as amobarbital (Amytal), butalbital (Fioricet, Fiorinal), phenobarbital (Luminal) and others
• substances that raise blood pressure (pressor amines) such as norepinephrine (Levophed)
• medicines that relax skeletal muscles such as cyclobenzaprine (Flexeril) and carisoprodol (Soma)
• cholestyramine (Questran) and colestipol (Colestid)
• nonsteroidal anti-inflammatory medications such as ibuprofen (Motrin, Nuprin) or naproxen (Aleve) and salicylates
• amphotericin B
• corticosteroids such as prednisone, hydrocortisone (Cortef), and dexamethasone (Decadron, Dexone, Hexadrol)
• lithium (Eskalith, Lithobid)
• calcium salts
• digoxin (Digox, Lanoxin) and digitoxin (Crystodigin)
• diazoxide (Proglycem, Hyperstat)
• monoamine oxidase inhibitors such as tranylcypromine (Parnate), phenelzine (Nardil), selegiline (Eldepryl, Zelapar), isocarboxazid (Marplan), and rasagiline (Azilect)
• methenamine (Hiprex)

Do not drink alcohol while taking this medication.

This is not a complete list of captopril and hydrochlorothiazide drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with captopril and hydrochlorothiazide or its ingredients including the following:

• protein in your urine (proteinuria)
• lowered white blood cell count (neutropenia/agranulocytosis) increasing the risk of infections
• low red blood cell count (anemia)
• low amount of platelets in the blood which causes bleeding into the tissues, bruising, and slow blood clotting after injury (thrombocytopenia)
• deficiency of all three cellular components of the blood (red cells, white cells, and platelets) called pancytopenia
• angioedema (a severe allergic reaction). Tell your healthcare provider right away if you have signs or symptoms of angioedema, which include the following:
  • swelling of face, eyes, lips, tongue, larynx and extremities
  • difficulty in swallowing or breathing
  • hoarseness (having difficulty making sounds when trying to speak)
• liver, pancreas, and kidney damage
• inflammation of a saliva gland (sialadenitis)
• allergic reactions. Tell your healthcare provider right away if you have some or all of the following symptoms:
  • swelling of the face, limbs, lips, tongue, throat
  • difficulty breathing
  • stomach (abdominal) pain (intestinal angioedema) with or without nausea or vomiting
• excessive low blood pressure
• harm to an unborn baby (fetal toxicity). Do not take captopril and hydrochlorothiazide if you are pregnant or will become pregnant.
• an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue (systemic lupus erythematosus)
• imbalances in the levels of salts and fluids in your body (electrolyte and fluid imbalance). Tell your healthcare provider right away if you have some or all of the following symptoms:
  • dry mouth
  • thirst
  • weakness
  • drowsiness
  • restlessness
  • muscle pains or cramps
  • low blood pressure
  • low output of urine
  • fast heart rate
  • nausea
  • vomiting

Captopril and hydrochlorothiazide can cause dizziness. Do not drive or operate heavy machinery until you know how captopril and hydrochlorothiazide affects you.

Do not take captopril and hydrochlorothiazide if you:

• are allergic to captopril and hydrochlorothiazide or to any of its ingredients, other sulfonamide-derived drugs, or other ACE inhibitors
• kidneys are unable to produce urine (anuric)
• history of a type of swelling that affects deeper layers in your skin, often around your eyes and lips (angioedema) with other ACE inhibitors

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of captopril and hydrochlorothiazide, salt substitutes containing potassium should be avoided. 

Before taking captopril and hydrochlorothiazide, tell your doctor about all of your medical conditions. Especially tell your doctor if:

• you are allergic to captopril and hydrochlorothiazide or to any of its ingredients, other sulfonamide-derived drugs, or other ACE inhibitors
• your kidneys are unable to produce urine (anuric)
• you have a history of a type of swelling that affects deeper layers in your skin, often around your eyes and lips (angioedema) with other ACE inhibitors
• you have diabetes
• you are about to have major surgery
• you are breastfeeding or plan to breastfeed
• you are pregnant or plan to become pregnant

Tell you doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. 

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Captopril and hydrochlorothiazide falls into category C in the first trimester and category D in the second and third trimester. When pregnancy is detected, discontinue captopril and hydrochlorothiazide as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the unborn baby.

Tell your doctor is you are breastfeeding or plan to breastfeed. 

Captopril and hydrochlorothiazide has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from captopril and hydrochlorothiazide, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered. 

• Take captopril and hydrochlorothiazide exactly as prescribed. 
• Captopril and hydrochlorothiazide comes in a tablet form and is usually taken by mouth once daily with or without food. 

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• your blood pressure
• previous medications used and the doses tried
• how you respond to this medication
• your other medical conditions

The recommended starting dose of captopril and hydrochlorothiazide to treat high blood pressure is one 25 mg/15 mg tablet by mouth once daily. May increase to maximum daily dose of captopril 150 mg and hydrochlorothiazide 50 mg which can be given in one single dose or divided doses. 

If you take too much captopril and hydrochlorothiazide, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away. 

• Store at controlled room temperature, 68° to 77°F (20° to 25°C).
• Dispense in a tight, light-resisitant container using a child-resistant closure.
• Protect from moisture.
• Keep this and all medications out of the reach of children. 

USE IN PREGNANCY

When used in pregnancy during the second and third trimesters, ACE inhibitors can cause injury and even death to the developing fetus. When pregnancy is detected, captopril and hydrochlorothiazide should be discontinued as soon as possible.