Captopril
Pronounced
"KAP-toe-pril"
Drug Interactions
See also Precautions section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: aliskiren, certain drugs that weaken the immune system/increase the risk of infection (such as everolimus, sirolimus), lithium, drugs that may increase the level of potassium in the blood (such as ARBs including losartan/valsartan, birth control pills containing drospirenone), sacubitril.
Some products have ingredients that could raise your blood pressure or worsen your heart failure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).
A very serious reaction may occur if you are getting injections for bee/wasp sting allergy (desensitization) and are also taking captopril. Make sure all your doctors know which medicines you are using.
This medication may interfere with certain lab tests (such as acetone urine test), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.
Negative Interactions
2- Potential Negative Interaction
Captopril
Potassium
An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels. This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements, potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others), or large amounts of high-potassium foods at the same time as ACE inhibitors could cause life-threatening problems. Therefore, individuals should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.
PotassiumCaptopril- Good CB, McDermott L, McCloskey B. Diet and serum potassium in patients on ACE inhibitors. JAMA 1995;274:538.
- Rush JE, Merrill DD. The Safety and tolerability of lisinopril in clinical trials. J Cardiovasc Pharmacol 1987;9(Suppl 3):S99-107.
- Sifton DW, ed. Physicians' Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1965-8.
- Burnakis TG, Mioduch HJ. Combined therapy with captopril and potassium supplementation. A potential for hyperkalemia. Arch Intern Med 1984;144:2371-2.
- Burnakis TG. Captopril and increased serum potassium levels. JAMA 1984;252:1682-3 [letter].
- Ray K, Dorman S, Watson R. Severe hyperkalemia due to the concomitant use of salt substitutes and ACE inhibitors in hypertension: a potentially life threatening interaction. J Hum Hypertens 1999;13:717-20.
- Stoltz ML. Severe hyperkalemia during very-low-calorie diets and angiotensin converting enzyme use. JAMA 1990;264:2737-8 [letter].
- Potential Negative Interaction
Captopril
Salt Substitutes
An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels. This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements, potassium-containing salt substitutes (No Salt, Morton Salt Substitute, and others), or large amounts of high-potassium foods (such as bananas and other fruit) at the same time as taking ACE inhibitors could cause life-threatening problems. Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.
Salt SubstitutesCaptopril- Good CB, McDermott L, McCloskey B. Diet and serum potassium in patients on ACE inhibitors. JAMA 1995;274:538.
- Rush JE, Merrill DD. The Safety and tolerability of lisinopril in clinical trials. J Cardiovasc Pharmacol 1987;9(Suppl 3):S99-107.
- Sifton DW, ed. Physicians' Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1965-8.
- Burnakis TG, Mioduch HJ. Combined therapy with captopril and potassium supplementation. A potential for hyperkalemia. Arch Intern Med 1984;144:2371-2.
- Burnakis TG. Captopril and increased serum potassium levels. JAMA 1984;252:1682-3 [letter].
- Ray K, Dorman S, Watson R. Severe hyperkalemia due to the concomitant use of salt substitutes and ACE inhibitors in hypertension: a potentially life threatening interaction. J Hum Hypertens 1999;13:717-20.
- Stoltz ML. Severe hyperkalemia during very-low-calorie diets and angiotensin converting enzyme use. JAMA 1990;264:2737-8 [letter].
Supportive Interactions
1- Replenish Depleted Nutrients
Captopril
Zinc
Preliminary research has found significant loss of zinc in urine triggered by taking captopril. In this trial, depletion of zinc reduced red blood cell levels of zinc. Although details remain unclear, it now appears that chronic use of captopril may lead to a zinc deficiency.
It makes sense for people taking captopril long term to consider taking a zinc supplement or a multimineral tablet containing zinc as a precaution. (Such multiminerals usually contain no more than 99 mg of potassium, probably not enough to trigger the above-mentioned interaction.) Supplements containing zinc should also contain copper, to protect against a zinc-induced copper deficiency.
ZincCaptopril- Golik A, Modai D, Averbukh Z, et al. Zinc metabolism in patients treated with captopril versus enalapril. Metabolism 1990;39:665-7.
- Golik A, Zaidenstein R, Dishi V, et al. Effects of captopril and enalapril on zinc metabolism in hypertensive patients. J Am Coll Nutr 1998;17:75-8.
Explanation Required
1- Needs Explanation
Captopril
Iron
Iron may interfere with captopril absorption. They should not be taken within two hours of each other.
In a double-blind study of patients who had developed a cough attributed to an ACE inhibitor, supplementation with iron (in the form of 256 mg of ferrous sulfate per day) for four weeks reduced the severity of the cough by a statistically significant 45%, compared with a nonsignificant 8% improvement in the placebo group.
IronCaptopril- Wolters Kluwer. Facts & Comparisons; accesssed 6/18/2009.
- Lee SC, Park SW, Kim DK, et al. Iron supplementation inhibits cough associated with ACE inhibitors. Hypertension 2001;38:166-70.
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