Captopril Aspirin

Acetazolamide, allopurinol, aspirin, captopril, carbamazepine, chloramphenicol, chlorpromazine, dapsone, felbamate, gold salts, metronidazole, methimazole, penicillamine, pentoxifylline, phenothiazines, phenytoin, propylthiouracil, quinidine, sulfonamide antimicrobials, sulfonylureas, and ticlopidine... 

Amprenavir, indinavir, nelfinavir, ritonavir, saquinavir Allopurinol Argatroban Aspirin Amoxicilhn Captopril, enalapril... 

ACE INHIBITORS, ANGIOTENSIN II RECEPTOR ANTAGONISTS ASPIRIN t risk of renal impairment. 1 efficacy of captopril and enalapril with high-dose (>100mg/day) aspirin Aspirin and NSAIDs can cause elevation of BP. Prostaglandin inhibition leads to sodium and water retention and poor renal function in those with impaired renal blood flow Monitor renal function every 3-6 months watch for poor response to ACE inhibitors when >100mg/day aspirin is given... 

Enalapril, paracetamol, sotalol, dipyrone, vancomycin, captopril, fluconazole, cefazolin, metoprolol, aspirin, ticlopidine, prednisolone, propranolol, digoxin, sildenafil, furosemide, dexamethasone, carvedilol, ketoprofen, nifedipine, terbinafine, acenocoumarol, spironolactone/urine HPLC DAD Column LiChroCART Purospher STAR, RP-18e (250 x 4 mm, 5 pm) Mobile phase MeOH ACN 0.05 % TFA in water (gradient elution) Detection DAD X = 200 50 nm Adjusted to pH 7.0, protein precipitation LOD 0.01-1.44 pg/mL LOQ 0.04-4.35 pg/mL [72]... 

Aspirin is thought to reduce the antihypertensive effect of captopril (103). 

A post-hoc analysis ot the CATS trial database in patients with acute myocardial intarction suggested that aspirin does not attenuate the acute and long-term ettects ot captopril (111). Because ot the demonstrated benefit on morbidity and mortahty with each agent, textbooks and otficial guidelines do not recommend withholding either aspirin or ACE inhibitors in patients with heart tailure or myocardial intarction. With no sutficient proot ot lack ot interaction, the use ot small doses ot aspirin (100 mg/day or less) is recommended. 

A 72-year-old woman with an anterior Ml was admitted to the hospital 7 days ago and has developed swelling of her lips and tongue, and bradycardia. She also complains of flushing and hallucinations. During the hospital course, the patient was started on metoprolol, captopril, isosorbide dinitrate, aspirin, and morphine. Which of the following adverse drug reactions is mostly likely caused by captopril ... 

KC is a 45-year-old man receiving ampicillin and gentamicin for endocarditis due to Enterococcus faecalis. He has a baseline serum Cr of 1.5 mg/dL secondary to uncontrolled diabetes mellitus. His other medications include furosemide, aspirin, and captopril. During his second week of therapy KC complains of ringing in his ears and a sensation of fullness. Risk factors for ototoxicity in KC include ... 

Noninterfering albuterol, allopurinol, alprenolol, aspirin, atenolol, captopril, carbimazole, clonidine, coloxyl, danthron, diazepam, digoxin, doxepin, glibenclamide, hydralazine, in-domethacin, labetalol, metformin, methyldopa, metoprolol, mianserin, minoxidil, nifedipine, nitrazepam, oxazepam, oxprenolol, pindolol, prazosin, propranolol, senokot, theophylline, trifluoperazine... 

Noninterfering amiloride, acebutolol, acenocoumarol, acetaminophen, aspirin, allopuri-nol, ambroxol, amoxicillin, atenolol, bendroflumethiazide, benzbromarone, bezafibrate, biperiden, bisacodyl, bromazepam, butizide, captopril, cimetidine, ciprofloxacin, clobu-tinol, clonidine, cotinine, diazepam, diclofenac, digitoxin, digoxin, dihydrocodeine, dihy-droergotamine, diltiazem, doxepin, doxycycline, enalapril, erythromycin, fenoterol, furosemide, glibenclamide, heparin, h3qjoxanthine, ibuprofen, indomethacin, isosorbide... 

The antihypertensive efficacy of captopril and enalapril may be reduced by high-dose aspirin in about 50% of patients. Low-dose aspirin (less than or equal to 100 mg daily) appears to have little effect. It is unclear whether aspirin attenuates the benefits of ACE... 

Renal failure has been reported in a patient taking captopril and aspirin. 

Aspirin 600 mg every 6 hours for 5 doses did not signifieantly alter the blood pressure response to a single 25 to 100-mg dose of eaptopril in 8 patients with essential hypertension. However, the prostaglandin response to captopril was blocked in 4 of the 8, and in these patients, the blood pressure response to captopril was blunted. In another study, aspirin 75 mg daily did not alter the antihypertensive effects of captopril 25 mg twice daily in 15 patients with hypertension. ... 

SAVE 2231 patients with left ventricular dysfunction after Ml Not reported Captopril 75 to 150 mg daily 42 months (average) Trend towards greater benefits of captopril when taken with aspirin. 6... 

CATS Early treatment of acute Ml in 298 patients 80 to 100 mg daily Captopril 1 year Benefits of captopril not affected by aspirin. Better prognosis in those on aspirin. 8... 

Meta analysis of AIRE, SAVE, SOLVD and TRACE 12763 patients with left ventricular dysfunction or heart failure with or without Ml Not reported Captopril, enalapril, ramipril, trandolapril 35 months (average) Benefits of ACE inhibitors observed even if aspirin given. 10... 

Meta analysis of CCS-1, CONSENSUS II, GISSI-3, and ISIS-4 Early treatment of Ml in 96712 patients 160 to 325 mg daily Captopril, enalapril, lisinopril 30 days ACE inhibitor reduced 30-day mortality from 15.1 to 13.8%. ACE inhibitor plus aspirin reduced 30-day mortality from 6.7 to 6.3%. II... 

Acute renal failure developed in a woman taking captopril when she started to take aspirin for arthritis. Renal function improved when both were stopped. However, in a re-analysis of data from the Hypertension Optimal Treatment (HOT) study, long-term low-dose aspirin 75 mg daily had no effect on changes in serum creatinine, estimated creatinine clearance or the number of patients developing renal impairment, when compared with placebo. Of 18 790 treated hypertensive patients, 41% receiv an ACE inhibitor. ... 

Low-dose aspirin (less than or equal to 100 mg daily) does not alter the antihypertensive efficacy of captopril and enalapril. No special precautions would therefore seem to be required with ACE inhibitors and these low doses of aspirin. A high dose of aspirin (2.4 g daily) has been reported to interact in 50% of patients in a single study. Aspirin 300 mg daily has been reported to interact in about 50% of patients in another study, whereas 325 mg daily did not interact in further study. Thus, at present, it appears that if an ACE inhibitor is used with aspirin in doses higher than 300 mg daily, blood pressure should be monitored more closely, and the ACE inhibitor dosage raised if necessary. Intermittent use of aspirin should be eonsidered as a possible cause of erratic control of blood pressure in patients on ACE inhibitors. 

Smith SR, Coffman TM, Svetkey LP. Effect of low-dose aspirin on thromboxane production and the antihypertensive effect of captopril. J Am Soc Nephrol (1993) 4,1133-9. 

Viecili PR, Pamplona D, Park M, Silva SR, Ramires JAF, da Luz PL. Anta mism of the acute hemod3mamic effects of captopril in decompensated congestive heart iluie by aspirin administration. BrazJMed Biol Res (2003) 36,771—80. 

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