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Safety and Efficacy of Chronic Therapy with Captopril in Hypertensive Patients: An Update
Author(s) -
WAEBER BERNARD,
GAVRAS IRENE,
BRUNNER HANS R.,
GAVRAS HARALAMBOS
Publication year - 1981
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1981.tb05658.x
Subject(s) - captopril , medicine , blood pressure , adverse effect , rash , angiotensin converting enzyme , lisinopril , side effect (computer science) , anesthesia , pharmacology , programming language , computer science
Captopril, an orally active angiotensin‐converting enzyme inhibitor, has been administered to 81 patients with different types of clinical hypertension. Most of the patients had previously uncontrollable high blood pressure. In order to achieve a satisfactory blood pressure control during long‐term captopril therapy, a concomitant decrease in total body sodium was required in more than half of the patients. During our first two years of clinical experience with this new antihypertensive agent, side effects developed in 46.9 per cent of the patients and necessitated the withdrawal of the drug in 23.4 per cent of all patients. Only a few side effects such as hypotensive or syncopal episodes and cold extremities appeared to be due to the chronic blockade of the renin‐angiotensin system. The most frequent and the most serious adverse reactions such as skin rash, altered taste, pancytopenia, and pemphigus foliaceus seemed to be specifically drug related. The incidence of cutaneous and taste problems was markedly higher in patients with impaired renal function in whom retention of captopril has been previously demonstrated. This suggests that the occurrence of adverse reactions to captopril could be lowered in the future by using smaller daily doses and by titrating them according to the renal function.