What is the dosage for captopril and hydrochlorothiazide?
The starting dose is 25/15 mg once daily. The dose may be
increased every 6 weeks.
Which drugs or supplements interact with captopril and hydrochlorothiazide?
Captopril may increase potassium levels (hyperkalemia)
in blood. Therefore, there is an increased risk of hyperkalemia when captopril
is given with potassium supplements or drugs that increase potassium levels
(for example, spironolactone
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 anti-inflammatory 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
failure. These effects usually are reversible.
Nitritoid reactions (symptoms
include facial flushing, nausea, vomiting and hypotension or low blood pressure)
may occur when injectable gold (sodium
aurothiomalate), used in the treatment of
rheumatoid arthritis, is combined with ACE inhibitors, including captopril.
Hydrochlorothiazide reduces the elimination of lithium (Lithobid) by the kidneys
and can lead to lithium toxicity. Nonsteroidal antiinflammatory
drugs, for example, ibuprofen, may reduce the blood pressure lowering effects of
hydrochlorothiazide. Blood sugar levels can be elevated by HCTZ, necessitating
adjustment in the doses of medications that are used for treating diabetes.
Combining HCTZ with corticosteroids may increase the risk for low levels of
blood potassium and other electrolytes. Low blood potassium can increase the
toxicity of digoxin (Lanoxin).
Cholestyramine (Questran, Questran Light) and
colestipol (Colestid) bind to hydrochlorothiazide and reduce its absorption from
the gastrointestinal tract by 43%-85%.