Side Effects of captopril: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Major Research Findings

Captopril is a commonly used angiotensin-converting enzyme (ACE) inhibitor for treating hypertension, heart failure, and other cardiovascular diseases. However, studies have shown that captopril can cause various side effects. , 3 , 12 , 4 , 14 , 2 , 1 For example, found that captopril can cause cough, taste disturbances, rash, and neutropenia. 22 suggested that captopril might worsen cardiac hypertrophy, while 17 indicated that captopril can affect the kidneys. 10 investigated a new drug delivery system to enhance the effectiveness of captopril in the kidneys. 11 explored the possibility of captopril as a treatment for SARS-CoV-2 infection (COVID-19), but it also raised concerns about its potential to increase the risk of infection by promoting the expression of the viral receptor. 18 discovered that polymorphisms in the ACE2 gene could influence the risk of hypertension in women and the effectiveness of captopril in lowering blood pressure. This suggests that individual responses to captopril might vary.

5 investigated the use of mucosal administration of captopril as an alternative for patients who struggle with oral medication. However, the long-term safety of this approach requires further study.

Reasons for Side Effects

The side effects of captopril are generally attributed to its ACE inhibitory action. ACE is an enzyme that converts angiotensin I to angiotensin II, which plays a role in vasoconstriction and can contribute to hypertension. Captopril inhibits ACE, reducing the production of angiotensin II and lowering blood pressure. However, ACE also acts as a bradykinin-degrading enzyme, and the inhibition of ACE by captopril can lead to the accumulation of bradykinin, causing airway hypersensitivity and resulting in side effects like cough. 1

Common Side Effects

Cough

Approximately 10% of patients taking captopril experience cough or other respiratory symptoms. 1 Cough is the most common side effect associated with captopril. This side effect is thought to be linked to the accumulation of bradykinin, which can cause airway hypersensitivity due to ACE inhibition by captopril. 1 The cough often appears a few weeks to months after starting captopril, and in serious cases, it can lead to shortness of breath.

Taste Disturbances

Around 10% of patients taking captopril experience taste disturbances. This is likely due to captopril stimulating taste buds on the tongue. 2 Taste disturbances frequently appear immediately after starting captopril and can manifest as difficulty tasting food or a metallic taste.

Rash

Approximately 5% of patients taking captopril experience a rash. This is thought to be triggered by an allergic reaction to captopril. 2 A rash can appear a few weeks to months after starting captopril, and in severe cases, it can progress to hives or anaphylactic shock.

Neutropenia

About 1% of patients taking captopril experience neutropenia. This is thought to be caused by captopril suppressing bone marrow. 2 Neutropenia can occur a few weeks to months after starting captopril, and if it becomes severe, it can increase susceptibility to infections.

Kidney Damage

Captopril can have an impact on the kidneys. 17 Kidney damage can appear a few weeks to months after starting captopril and, in severe cases, can lead to kidney failure.

Cardiac Hypertrophy

Captopril may worsen cardiac hypertrophy. 22 This is believed to be due to captopril's ability to weaken the heart's contractile force.

Hypotension

Captopril can cause hypotension. 19 This can occur because captopril has a strong blood pressure-lowering effect. Hypotension can cause dizziness, lightheadedness, and fainting.

Others

Captopril can cause various other side effects besides the ones mentioned above. 15 If you suspect a side effect, consult your doctor.

Countermeasures for Side Effects

Cough

If you experience cough due to captopril, consult your doctor. If the cough is mild, it may improve by reducing the dosage. If the cough doesn't improve, you may need to switch to a different medication.

Taste Disturbances

Taste disturbances caused by captopril usually improve with continued use of the medication. If you experience significant taste disturbances, consult your doctor.

Rash

If you are concerned about a rash due to captopril, consult your doctor. If the rash is mild, it may improve with continued use of the medication. If the rash doesn't improve, you may need to switch to a different medication.

Neutropenia

If you suspect neutropenia due to captopril, consult your doctor. Neutropenia can increase susceptibility to infections, so it is important to take precautions.

Kidney Damage

If you suspect kidney damage due to captopril, consult your doctor. Kidney damage can lead to kidney failure in severe cases, so it is crucial to seek medical attention.

Cardiac Hypertrophy

Captopril may worsen cardiac hypertrophy. 22 If you are concerned about cardiac hypertrophy, consult your doctor.

Hypotension

Captopril can cause hypotension. 19 If you are concerned about hypotension, consult your doctor. Hypotension can cause dizziness, lightheadedness, and fainting.

Comparison Across Studies

Commonalities Across Studies

Many studies have reported that captopril can cause side effects such as cough, taste disturbances, and rash. , 3 , 12 , 4 , 14 , 2 , 1 Furthermore, studies have indicated that captopril could affect the kidneys. 17

Differences Across Studies

The frequency and severity of captopril's side effects vary across studies. Studies also suggest that the side effects of captopril may differ among individuals. 18

Considerations for Real-Life Application

While captopril is an effective drug for treating hypertension and other cardiovascular diseases, it can cause various side effects. It is important to consult your doctor about potential side effects before taking captopril and to follow their instructions carefully. If you experience any unusual symptoms while taking captopril, consult your doctor immediately.

Limitations of Current Research

Research on the side effects of captopril is still insufficient. In particular, the long-term side effects of captopril are not yet fully understood, and further research is needed.

Future Research Directions

Further research is necessary to explore methods for reducing the side effects of captopril and develop alternative treatments. Since the side effects of captopril can vary among individuals, developing personalized treatment approaches is also crucial.

Conclusion

Captopril is an effective drug for treating hypertension and other cardiovascular diseases, but it can cause various side effects. It is important to consult your doctor about potential side effects before taking captopril and to follow their instructions carefully. If you experience any unusual symptoms while taking captopril, consult your doctor immediately.

Literature analysis of 26 papers
Positive Content
23
Neutral Content
1
Negative Content
2
Article Type
3
1
1
2
26
1.

Angiotensin-converting enzyme inhibitor induced cough compared with placebo, and other antihypertensives: A systematic review, and network meta-analysis.

Author: HuYiyun, LiangLing, LiuShuang, KungJanice Y, BanhHoan Linh

Cardiac mortality and morbidity prevention
Dry cough

Angiotensin converting enzyme inhibitors (ACEIs) are known to cause dry cough. This systematic review and network meta-analysis ranked the risk of cough induced by different ACEIs and compared them to placebo, ARB, or CCB. Moexipril had the highest risk of cough (80.4%), while spirapril had the lowest (12.3%). ACEIs should be avoided in patients at risk of cough, and an ARB or CCB is a possible alternative.

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

2.

Ethanolic Extract of <i>Salvia hispanica</i> L. Regulates Blood Pressure by Modulating the Expression of Genes Involved in BP-Regulatory Pathways.

Author: Arredondo-MendozaGerardo I, Jiménez-SalasZacarías, GarzaFrancisco Javier Guzmán-de la, Solís-PérezElizabeth, López-Cabanillas-LomelíManuel, González-MartínezBlanca Edelia, Campos-GóngoraEduardo

HT regulation

This study investigated the effects of an ethanolic extract of <i>Salvia hispanica</i> L. seeds (EESH) on hypertension (HT) in rats. EESH exhibited ACE-inhibitory activity and regulated the expression of genes involved in pathways that control blood pressure, suggesting its potential as a natural antihypertensive agent.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Side effects of angiotensin converting enzyme inhibitor (captopril) in newborns and young infants.

Author: GantenbeinMonika Herbst, BauersfeldUrs, BaenzigerOskar, FreyBernhard, NeuhausThomas, SennhauserFelix, BernetVera

Reversible side effects
Low blood pressure
Oxygen saturation deficit
Renal impairment

A study of 43 infants with congenital heart disease found that while captopril was effective in treating heart failure, renal side effects were more common in smaller infants.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Dietary sodium restriction specifically potentiates left ventricular ACE inhibition by zofenopril, and is associated with attenuated hypertrophic response in rats with myocardial infarction.

Author: WestendorpBart, SchoemakerRegien G, BuikemaHendrik, de ZeeuwDick, van VeldhuisenDirk J, van GilstWiek H

Blood pressure control
Heart failure inhibition
Kidney protection
Sodium restriction

This study investigated the potential benefits of dietary sodium restriction in patients with heart failure following a myocardial infarction.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Mucosal delivery systems of antihypertensive drugs: A practical approach in general practice.

Author: BialyLukasz P, WojcikCezary, Mlynarczuk-BialyIzabela

Mucosal antihypertensive delivery

This study explores the possibility of mucosal delivery of antihypertensive drugs as an alternative to oral medication in patients unable to receive oral medication. The authors describe the use of mucosal delivery systems for various antihypertensive drugs including Captopril, Nitrendipine, Metoprolol tartrate, Propranolol and Furosemide, and provide a case report of successful prolonged-term use of these drugs delivered via the mucosal route in a patient with severe hypertension. While the treatment was effective and without side effects, the long-term safety and efficacy of such therapy needs further confirmation through randomized clinical trials.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

Doxorubicin-induced behavioral disturbances in rats: protective effect of melatonin and captopril.

Author: AziriovaS, Repova BednarovaK, KrajcirovicovaK, HrenakJ, RajkovicovaR, ArendasovaK, KamodyovaN, CelecP, ZoradS, AdamcovaM, PaulisL, SimkoF

Behavioral disturbances

This study investigated whether doxorubicin administration could induce behavioral disturbances in rats and whether captopril or melatonin could modify these potential alterations.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Antihypertensive nano-ceuticales based on chitosan biopolymer: Physico-chemical evaluation and release kinetics.

Author: NiazTaskeen, ShabbirSaima, ManzoorShahid, RehmanAsma, RahmanAbdur, NasirHabib, ImranMuhammad

Improved drug solubility
Sustained drug release

This study fabricated antihypertensive nano-ceuticals in hydrophilic carriers of natural origin to improve drugs' solubility, protection, and sustained release.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Synthesis, synchrotron X-ray diffraction, and kinetic studies on the formation of a novel thiolatocobalamin of captopril: evidence for cis-trans isomerization in the beta-axial ligand.

Author: MukherjeeRiya, McCaddonAndrew, SmithClyde A, BraschNicola E

Enhanced captopril absorption
Reduced side effects
Unknown

Captopril-cobalamin, a derivative of vitamin B(12) with captopril bound at the beta-axial site, enhances absorption and cellular uptake of captopril, potentially reducing side effects associated with high doses.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

l-Serine-modified polyamidoamine dendrimer as a highly potent renal targeting drug carrier.

Author: MatsuuraSatoru, KatsumiHidemasa, SuzukiHiroe, HiraiNatsuko, HayashiHidetaka, KoshinoKazuhiro, HiguchiTakahiro, YagiYusuke, KimuraHiroyuki, SakaneToshiyasu, YamamotoAkira

Kidney targeting

This study synthesized l-serine (Ser)-modified polyamidoamine dendrimer (PAMAM) as a renal targeting drug carrier to improve drug delivery to the kidneys. Ser-PAMAM accumulated significantly in the kidneys compared to unmodified PAMAM, demonstrating its potential for treating kidney diseases. The study suggests that Ser-PAMAM is a promising renal targeting drug carrier for delivering drugs to the kidneys.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

FDA-approved thiol-reacting drugs that potentially bind into the SARS-CoV-2 main protease, essential for viral replication.

Author: Lobo-GaloNaún, Terrazas-LópezManuel, Martínez-MartínezAlejandro, Díaz-SánchezÁngel Gabriel

Potential antiviral drug
Susceptibility to infection

This study investigated the potential of two drugs, disulfiram and captopril, to inhibit a key enzyme in the SARS-CoV-2 virus. The study found that disulfiram, a drug used to treat alcoholism, may be a potential antiviral drug. However, captopril was found to increase the risk of infection and is not recommended as a treatment for COVID-19.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Imidapril in heart failure.

Author: DolezalTomas

Acute MI treatment
Diabetic nephropathy treatment
Heart failure treatment
Hypertension treatment

Imidapril is a long-acting ACE inhibitor used to treat hypertension, chronic heart failure, acute MI, and diabetic nephropathy. It improves exercise time, physical working capacity, and left ventricular ejection fraction while reducing blood pressure. Imidapril is well tolerated and has a lower incidence of cough compared to other ACE inhibitors.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Prevalence and profile of adverse drug reactions in high-risk pregnancy: a cohort study.

Author: da SilvaKathlen Dayanne Lopes, FernandesFlávia Evelyn Medeiros, de Lima PessoaThiago, LimaSara Iasmin Vieira Cunha, OliveiraAntônio Gouveia, MartinsRand Randall

Adverse drug reactions

This study aimed to determine the risk of an adverse drug reaction in hospitalized high-risk pregnant women. It was found that the risk of an adverse drug reaction was high in this population, and factors associated with their occurrence were identified.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

15.

[A comparison of the effect of oral captopril and nicardipine in hypertensive crisis].

Author: AddadFaouzi, FerjaniHayet, ChaabaniAbdelghani, JellitiMounir, GamraHabib, MakniHatem, KhaldounBen Hamda, DridiZohra, Ben FarhatMohamed

Reduced BP
Therapeutic success

Oral captopril and nicardipine are both effective and safe in the treatment of hypertensive crisis. Both drugs effectively reduced blood pressure within 15 minutes of administration, with similar results at 2 hours. Captopril was associated with a significant decrease in heart rate after 30 minutes, an effect that persisted for 4 hours.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : French

17.

A murine ex vivo 3D kidney proximal tubule model predicts clinical drug-induced nephrotoxicity.

Author: DiekjürgenDorina, GraingerDavid W

Nephrotoxicity prediction
Nephrotoxicity

A new 3D proximal tubule model provides ex vivo data that accurately predict clinical nephrotoxicity, offering a more reliable tool for drug safety assessment during development compared to traditional 2D cell assays.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Polymorphisms of ACE2 gene are associated with essential hypertension and antihypertensive effects of Captopril in women.

Author: FanX, WangY, SunK, ZhangW, YangX, WangS, ZhenY, WangJ, LiW, HanY, LiuT, WangX, ChenJ, WuH, HuiR,

Hypertension treatment
Reduced antihypertensive response

This study found that the ACE2 T allele was associated with a higher risk of hypertension in women, particularly when combined with the ACE DD genotype. The T allele also showed a reduced antihypertensive response to ACE inhibitors in women.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Nifedipine, Captopril or Sublingual Nitroglycerin, Which can Reduce Blood Pressure the Most?

Author: MalekiAli, SadeghiMasumeh, ZamanMahyar, TarrahiMohammad Javad, NabatchiBehjat

Blood pressure reduction

This study compared the effectiveness of nifedipine, captopril, and sublingual nitroglycerin in lowering blood pressure in patients with hypertension. Nifedipine, captopril, and nitroglycerin are all medications used to treat high blood pressure.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

20.

[The effects of captopril and metoprolol on blood pressure and side effects in patients with mild to moderate hypertension].

Author: KornerupH J, KorsagerS

Blood pressure regulation
Few side effects
Wellbeing
Side effects

Captopril + a diuretic is as effective as metoprolol + a diuretic in treating mild to moderate hypertension. In a randomized study of 76 patients, satisfactory blood pressure regulation and wellbeing were achieved in 29 patients in the captopril group and 23 patients in the metoprolol group. Side effects were similar between the two groups, with 14 side effects in 8 patients in the captopril group and 23 side effects in 15 patients in the metoprolol group.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Danish

22.

Combined effects of low-dose spironolactone and captopril therapy in a rat model of genetic hypertrophic cardiomyopathy.

Author: de ResendeMicheline Monteiro, KriegelAlison Jessica, GreeneAndrew Seth

Heart failure treatment
Hypertension management
Hypertrophic cardiomyopathy prevention

Low-dose spironolactone, combined with captopril, was more effective in preventing the progression of heart hypertrophy and ventricular dysfunction in a congenic rat model of hypertrophic cardiomyopathy than captopril alone.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

23.

Side effects of the therapy with peginterferon and ribavirin in chronic hepatitis C: a small audit.

Author: NogueiraJosé Barreto Cruz, SenaLaís Cristina Santana, QuintansJullyana de Souza Siqueira, AlmeidaJackson Roberto Guedes da Silva, FrançaAlex Vianey Callado, JúniorLucindo José Quintans

Adverse reactions
Potential medication interactions

Treatment of chronic hepatitis C with peginterferon and ribavirin can cause various side effects, including fatigue, fever, weight loss, irritability, and body pain. These side effects can interfere with the patient's quality of life or treatment compliance.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

Successful treatment of suicide attempt by megadose of propafenone and captopril.

Author: AvciAhmet, YilmazAhmet, CelikMustafa, DemirKenan, KelesFikret

Captopril intoxication treatment
Propafenone intoxication treatment
Cardiac side effects

This case report describes the successful treatment of a young woman who ingested a very high dose of propafenone, a heart rhythm medication, and captopril, a blood pressure medication. The patient experienced severe heart rhythm abnormalities but recovered after receiving supportive care and a permanent pacemaker. This case highlights the rare but potentially serious consequences of high-dose propafenone and captopril ingestion.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

25.

A novel S-nitrosocaptopril monohydrate for pulmonary arterial hypertension: H<sub>2</sub>O and -SNO intermolecular stabilization chemistry.

Author: ZhouYuyang, LinMin, WangJie, ChenFan, LiFeiyang, ChenWenge, HanLongyu, WangChiahung, ChenJianming, ShaoJing-Wei, JiaLee

Treats hypertension
Treats pulmonary hypertension

S-nitrosocaptopril (CapNO) is a drug that combines the effects of captopril and nitric oxide, potentially leading to better outcomes. A new formulation of CapNO has been developed that is more stable and may be suitable for clinical trials.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

26.

Angiotensin-converting Enzyme Inhibitors: Can it be a Potential Treatment of Infantile Hemangioma.

Author: GuptaArchika, KureelShiv Narain, PandeyAnand, SinghGurmeet, KumarAkhilesh, ShandilyaGaurav, RaiRahul Kumar, GuptaSurvesh Kumar

IH involution
Allergic reaction
Slow response

Oral captopril, an angiotensin-converting enzyme (ACE) inhibitor, may have a role in the involution of infantile hemangiomas (IH). A prospective study of 18 children with IH found that 9 patients showed excellent response to captopril over 16-18 months, while 4 patients showed good response.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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