Captopril side effects

Angiotensin-converting enzyme (ACE) inhibitors such as captopril exert a long-term reno-protective effect. Among other effects, they lower systemic blood pressure and renal plasma flow and effectively reduce urinary protein excretion. Renal delivery of ACE-inhibitors may increase this efficacy and reduce extra-renal side-effects. Renal targeting of an ACE-in-hibitor can also be useful in clarifying the contribution of local ACE inhibition to these reno-protective effects. 

Although the sulfhydryl group of captopril produced superb ACE inhibition, it also caused two side effects which are sometimes seen with sulphur-containing drugs skin rashes and a metallic taste disturbance. In an attempt to overcome these side effects. 

According to Lee et al. (2010), the peptide Gly-Asp-Leu-Gly-Lys-Thr-Thr-Thr-Val-Ser-Asn-Trp-Ser-Pro-Pro-Lys-Try-Lys-Asp-Thr-Pro, derived from big-eye tuna frame protein hydrolysate, showed a strong suppressive effect on the systolic blood pressure of SHRs, while its antihypertensive activity was similar to that of captopril, a commercially available antihypertensive drug. Further, they reported no side effects after the administration of this antihypertensive peptide to rats. In addition, these marine antihypertensive peptides exhibit stronger antihypertensive activity in vivo than in vitro. The exact mechanisms underlying this phenomenon have yet to be identified however, it was suggested that bioactive peptides have a higher tissue affinity and are eliminated more slowly than captopril (Fujita and Yoshikawa, 1999). 

Neutropenia is rare, and occurs more frequently in patients with renal or collagen vascular disease. These side effects are dose-related and might derive from toxic effects caused by the sulfhydryl group (captopril). 

Mechanism uncertain. ACE inhibitors possibly t insulin sensitivity and glucose utilization. Altered renal function may also be factor. ACE inhibitors may t bradykinin levels, which i production of glucose by the liver. Hypoglycaemia is reported as a (rare) side-effect of ACE inhibitors. Suggested that occurrence of hypoglycaemia is greater with captopril than enalapril. Captopril and enalapril are used in the treatment of diabetic nephropathy... 

Most cases have been described in association with the use of enalapiil, captopril and hsinopril (the earti-est registered compounds), but there is no reason to expect that the other ACEI should not have the same risk [56]. These side effects have not been described with the use of angiotensin II receptor antagonists. As these drugs have not been used so long to date, it is to early to conclude whether the ACEI fetopathy is hm-... 

Ms Thomas is a 52-year-old lady of African origin. She has hypertension for which she has been prescribed captopril. Ms Thomas wants to know if she should expect any side effects from this drug. She is particularly worried about her sensitive stomach. What can you tell her about side effects with captopril and is there any other advice you could give her about this medication ... 

Increasing clinical experience with captopril has led to the recognition of certain side effects. Some, such as neutropenia, although rare (0.04-0.06%), occur with captopril as well as other ACE inhibitors, such as enalapril (Table 10-8). Others such as skin rash appear to be somewhat higher with captopril (4-7% vs. 1.5%). Disglusia (taste distur-... 

There is an increased risk of bone marrow suppression with a combined captopril-clozapine regimen, since each agent alone has the capacity to induce this side-effect. 

The sulfhydryl group of captopril proved to be responsible not only for the excelleht ihhibitory activity of the compound but also for the two most common side effects, skin rashes and taste disturbances (e.g., metallic taste and loss of taste). These side effects usually subsided on dosage reduction or discontinuation of captopril. They were attributed to the presehce of the sulfhydryl group, because similar effects had beeh observed with penicillamine, a sulfhydryl containing agent used to treat Wilson s disease and rheumatoid arthritis (22,23). 

Since 1975, researchers at the American company Merck had been working on improvements to captopril, which is associated with a number of undesirable side-effects these are attributed in part to the free mercapto group haemato-... 

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