Caposide is a combination drug with hypotensive and diuretic effects.
Release form and composition
Caposid dosage form - oval biconvex tablets with a sulfide-like odor (14 each in a blister pack, 2 packs in a carton box).
Active ingredients (in 1 tablet):
- Captopril - 50 mg;
- Hydrochlorothiazide - 25 mg.
Auxiliary components: stearic acid, pregelatinized corn starch, magnesium stearate, microcrystalline cellulose, lactose.
Indications for use
Capozid is used for hypertension.
- Cardiogenic shock;
- Chronic heart failure;
- Mitral stenosis;
- Aortic stenosis;
- Hypertrophic obstructive cardiomyopathy;
- Angioedema in the history of, resulting from the use of an ACE inhibitor;
- Primary hyperaldosteronism;
- Severe renal dysfunction (anuria, serum creatinine more than 1.8 mg / dl or QA less than 30 ml / min);
- Condition after kidney transplantation;
- Bilateral renal artery stenosis or single kidney artery stenosis;
- Severe abnormal liver function (precomatose state or hepatic coma);
- Lactation period;
- Age up to 18 years;
- Hypersensitivity to caposide;
- Hypersensitivity to sulfonamide derivatives or thiazide diuretics (since there is a possibility of the development of cross-allergic reactions).
In the following cases, the drug must be used with extreme caution and under constant medical supervision:
- Mild renal dysfunction (if serum creatinine is less than 1.8 mg / dL or CC is 30-60 ml / min);
- Proteinuria (more than 1 g per day);
- Medication is not corrective hypokalemia;
- Collagenoses and other autoimmune diseases, including systemic lupus erythematosus, scleroderma, and periarteritis nodosa;
- The elderly are over 65;
- The simultaneous use of drugs lithium, glucocorticosteroids, immunosuppressants, cytotoxic drugs, allopurinol and procainamide.
Dosing and Administration
Caposide should be taken orally 1 time per day, 1 tablet 1 hour before meals.
- Cardiovascular system: flushing of the skin of the face, tachycardia, headache, feeling of heartbeat, dizziness, swelling of the legs, feeling of heat, severe arterial hypotension (including orthostatic) with symptoms of weakness and dizziness; rarely - fainting; with a prolonged or sharply pronounced decrease in blood pressure - Raynaud's syndrome, stroke, myocardial infarction, transient cerebrovascular accident;
- Water and electrolyte metabolism: thirst and dry mouth; in rare cases, decreased tear production;
- Respiratory system: dry cough and bronchospasm; rarely - rhinitis, sinusitis, laryngitis, respiratory failure;
- Digestive System: constipation or diarrhea, nausea, vomiting, abdominal pain, epigastric discomfort, loss of appetite, hepatitis, hemorrhagic pancreatitis, acute cholecystitis (cholelithiasis), hyperbilirubinemia, elevated liver transaminases, cholestatic jaundice; with prolonged use - taste disorders, gingival hyperplasia;
- Hematopoietic system: decrease in hematocrit, leukopenia, thrombocytopenia, anemia (including hemolytic and aplastic forms), an increase in the titer of antinuclear antibodies, eosinophilia, neutropenia (up to the development of agranulocytosis and pancytopenia, especially with the simultaneous use of immunosuppressants, procainamide or allopurin) and
- Central and peripheral nervous system: fatigue and headache; rarely, sleep disturbances, drowsiness, depression, weakness, dizziness, ataxia, tinnitus, convulsions, visual disturbances, paresthesias, depression, tremors;
- Urinary system: oliguria, polyuria, glycosuria, proteinuria, pollakiuria; in rare cases (especially in patients with renal insufficiency) - hyponatremia, an increase in the serum concentration of urea, creatinine and potassium ions (the risk of hyperkalemia is also high in diabetic patients); with prolonged use - impaired renal function and nephritis;
- Metabolism: hyperglycemia, hyperlipidemia, hypermagnemia, hyperuricemia (up to exacerbation of gout);
- Dermatological reactions: exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome, skin rash (exanthema), toxic epidermal necrolysis. These changes can be accompanied by pain in the joints and muscles, temperature rise, the development of vasculitis. In some cases, alopecia, photosensitivity, onycholysis, psoriasis-like skin changes are observed;
- Allergic reactions: angioedema of the extremities, face, lips, larynx, mucous membranes, pharynx and / or tongue; rarely - urticaria;
- Other: the progression of myopia, impotence.
If you take too high a dose of caposide, it may be possible to increase the severity of side effects. In this case, symptomatic therapy is indicated.
Before using Capozid, it is necessary to examine the functional state of the kidneys and correct the water-salt balance (to do this, reduce the dose or even completely cancel previously prescribed diuretics).
At the beginning of taking Caposid, an excessive decrease in blood pressure (blood pressure) is possible, especially in patients with severe hypertension (including kidney origin), cardiac and renal failure.
The entire period of taking Caposid requires regular monitoring of liver transaminase activity, as well as plasma and calcium concentrations in plasma (especially in the elderly and patients who take glucocorticosteroids, cardiac glycosides or laxative drugs), uric acid, glucose, creatinine, urea, lipids ( triglycerides and cholesterol).
Especially careful monitoring of laboratory parameters and blood pressure is necessary for older people (over 65), patients with renal insufficiency, impaired water and electrolyte balance, arterial hypertension characterized by severe course (including renal genesis), decompensated chronic heart failure, and also to patients taking immunosuppressants, lithium salts, allopurinol or procainamide.
In case of swollen lymph nodes, fever, signs of pharyngitis and / or laryngitis, a peripheral blood picture should be analyzed immediately.
The risk of anaphylactic reactions is increased when caposide is used during hemodialysis sessions using high-permeability dialysis membranes (for example, polyacrylonitrile-methylsulfonate).
During the period of taking the drug, care should be taken when engaging in potentially hazardous activities, including when driving a car.
With the simultaneous use of caposide with procainamide and drugs that block tubular secretion, the risk of an immunosuppressive effect increases.
Caposid enhances the effects of ethanol and non-depolarizing muscle relaxants of a competitive type of action, increases the neurotoxicity of salicylates, increases the content of digoxin in the plasma by 15-20%, increases the bioavailability of propranolol.
The drug reduces the excretion of quinidine, reduces the effect of anti-gouty and oral hypoglycemic agents, norepinephrine and epinephrine. Strengthens the side effects of cardiac glycosides, especially when used in combination with drugs that increase the excretion of magnesium and potassium ions and / or inhibit calcium ions (for example, diuretics, laxatives, adrenal hormones, salicylates, carbenoxolone, amphotericin B and penicillin G).
Hydrochlorothiazide may enhance the action of anesthetic initiators and anesthetics used in surgery (for example, gallamine triethoidide and tubocurarine chloride).
Cimetidine slows down the metabolism of captopril in the liver, thereby increasing its plasma concentration.
The absorption of hydrochlorothiazide and the antihypertensive effect of caposide can be reduced by nonsteroidal anti-inflammatory drugs (including indomethacin and COX inhibitors) and table salt. Tricyclic antidepressants, ethanol, hypnotics, MAO inhibitors, ganglioblokatory, beta-blockers, thiazide diuretics, verapamil, nitrates and other antihypertensive drugs can enhance the severity of its hypotensive effect.
Hydrochlorothiazide absorption may be delayed or reduced by colestipol and colestiramine.
Methenamine enhances the alkaline reaction of urine, which may decrease the effect of hydrochlorothiazide.
The diuretic effect of Caposid is enhanced by agents that bind intensively to proteins.
With simultaneous use with lithium preparations it is possible to slow the elimination of lithium ions and, as a consequence, to increase the damaging effect on the central nervous system and heart.
Hydrochlorothiazide significantly weakens the effect of oral anticoagulants, sulfinpyrazone and probenecid, therefore, it may be necessary to adjust their doses.
The hyperuricemic, hyperglycemic and antihypertensive effect of hydrochlorothiazide increases diazoxide. If you need to use this combination, you need to control the concentration of uric acid and glucose in the blood.
With the simultaneous use of methyldopa increases the risk of hemolysis of red blood cells.
When combined with potassium-sparing diuretics (triamterene, amiloride and spironolactone), potassium salts and heparin, hyperkalemia may develop.
Terms and conditions of storage
Keep out of reach of children, in a dry place at temperatures up to 25 ºС.
Shelf life - 3 years.