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Brand Name :
Capozide
Synonyms :
captopril/hydrochlorothiazide
Class :
ACEI/HCTZ Combos; ACEI/Diuretic Combos
Brand Name :
Capozide
Synonyms :
captopril/hydrochlorothiazide
Class :
ACEI/HCTZ Combos; ACEI/Diuretic Combos
Dosage Forms & Strengths
Tablet
25mg/15mg- captopril/hydrochlorothiazide
25mg/25mg – captopril/hydrochlorothiazide
50mg/15mg – captopril/hydrochlorothiazide
50mg/25mg – captopril/hydrochlorothiazide
25 - 15
mg-- captopril/hydrochlorothiazide
Orally 
every day
Do not exceed 150 mg/50 mg captopril/hydrochlorothiazide
Age <18 years: Safety and efficacy not established
Refer adult dosing
may increase the hypotensive effect of anti-hypertensive agents
may increase the hypotensive effect of anti-hypertensive effects
may have an increased bradycardic effect when combined with ceritinib
may have an increased bradycardic effect when combined with fingolimod
may have an increased bradycardic effect when combined with ponesimod
may have an increased bradycardic effect when combined with siponimod
may increase the hypotensive effect of anti-hypertensive agents
betony along with antihypertensive drugs can lower blood pressure abruptly which is contraindicated
bloodroot along with antihypertensive medications will result in amplified hypotensive effect
may decrease the hypotensive effect when combined with anti-hypertensive agents
may decrease the therapeutic effect when combined with etofylline
may increase the hypertensive effect when combined with androgens
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may increase the effect of antipsychotic agents
may increase the effect of antipsychotic agents
may increase the effect of antipsychotic agents
may increase the effect of antipsychotic agents
may increase the effect of antipsychotic agents
relugolix/​estradiol/​norethindrone
may enhance the hypertensive effect of Androgens
relugolix/estradiol/norethindrone
may enhance the hypertensive effect of Androgens
may enhance the hypertensive effect of Androgens
may enhance the hypertensive effect of Androgens
may enhance the hypertensive effect of Androgens
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antihypertensive agents
may have an increased hypotensive effect when combined with antihypertensive agents
may have an increased hypotensive effect when combined with antihypertensive agents
may have an increased hypotensive effect when combined with hypotensive agents
may have an increased hypotensive effect when combined with hypotensive agents
may have an increased hypotensive effect when combined with hypotensive agents
may have an increased hypotensive effect when combined with hypotensive agents
may have an increased hypotensive effect when combined with hypotensive agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased bradycardic effect when combined with other antihypertensive drugs
may have an increased bradycardic effect when combined with other antihypertensive drugs
may have an increased bradycardic effect when combined with other antihypertensive drugs
may have an increased bradycardic effect when combined with other antihypertensive drugs
may have an increased bradycardic effect when combined with other antihypertensive drugs
They may increase the hypotensive effect when combined with antihypertensive agents
may increase the serum concentration
may increase the serum concentration
may increase the serum concentration
may increase the serum concentration
may increase the serum concentration
may enhance the hyperkalemic effect
may enhance the hyperkalemic effect
may enhance the hyperkalemic effect
may have an increased hypotensive effect when combined with antipsychotic agents
may decrease the antihypertensive effect when combined with antihypertensive agents
may decrease the antihypertensive effect when combined with antihypertensive agents
may decrease the antihypertensive effect when combined with antihypertensive agents
may decrease the antihypertensive effect when combined with antihypertensive agents
may decrease the antihypertensive effect when combined with antihypertensive agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypertensive effect when combined with androgens
may have an increased hypotensive effect when combined with antipsychotic agents
may increase the hypotensive effect of anti-parkinsonism drugs
may increase the hypotensive effect of anti-parkinsonism drugs
may increase the hypotensive effect of anti-parkinsonism drugs
may increase the hypotensive effect of anti-parkinsonism drugs
may increase the hypotensive effect of anti-parkinsonism drugs
may have an increased hypotensive effect when combined with anti-hypertensive agents
may decrease the antihypertensive effect when combined with antihypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may decrease the antihypertensive effect when combined with antihypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may decrease the therapeutic effect when combined with antihypertensive agents
relugolix/​estradiol/​norethindrone
may have an increased hypertensive effect when combined with Androgens
relugolix/estradiol/norethindrone
may have an increased hypertensive effect when combined with Androgens
may have an increased hypertensive effect when combined with Androgens
may have an increased hypertensive effect when combined with Androgens
may have an increased hypertensive effect when combined with Androgens
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with duloxetine
may increase the hypotensive effect of barbiturates
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with levodopa-containing products
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with nitroprusside
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with pholcodine
may increase the hypotensive effect of blood pressure lowering agents
may have an increased hypotensive effect when combined with hypotension-associated agents
may have an increased hypotensive effect when combined with hypotension-associated agents
may have an increased hypotensive effect when combined with hypotension-associated agents
may have an increased hypotensive effect when combined with hypotension-associated agents
may have an increased hypotensive effect when combined with hypotension-associated agents
may have an increased hypotensive effect when combined with antihypertensive agents
may have an increased hypotensive effect when combined with antihypertensive agents
may increase the hypotensive effect of Hypotension-Associated Agents
may reduce the effect of antihypertensive drugs
may reduce the effect of antihypertensive drugs
may reduce the effect of antihypertensive drugs
may reduce the effect of antihypertensive drugs
may reduce the effect of antihypertensive drugs
may have an increased hypertensive effect when combined with hypertension agents
may enhance the hypotensive effect
may enhance the hypotensive effect
may enhance the hypotensive effect
may enhance the hypotensive effect
may enhance the hypotensive effect
It may increase the hypotensive effect when combined with Antihypertensive Agents
may increase the hypotensive effect of Hypotension-Associated Agents
may have an increased hypotensive effect when combined with antihypertensive agents
may have an increased therapeutic effect when combined with antihypertensive agents
may decrease the antihypertensive effect when combined with antihypertensive agents
may increase the hypotensive effect of Antipsychotic Agents
may have an increased bradycardic effect when combined with other antihypertensive drugs
may have an increased bradycardic effect when combined with other antihypertensive drugs
may have an increased bradycardic effect when combined with other antihypertensive drugs
may have an increased bradycardic effect when combined with other antihypertensive drugs
may have an increased bradycardic effect when combined with other antihypertensive drugs
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
estrogens esterified/methyltestosterone            Â
may enhance the hypertensive effect of androgens
They may increase the hypotensive effect when combined with antihypertensive agents
It may increase the hypotensive effect when combined with antihypertensive agents
It may increase the hypotensive effect when combined with antihypertensive agents
It may increase the hypotensive effect when combined with antihypertensive agents
It may increase the hypotensive effect when combined with antihypertensive agents
It may increase the hypotensive effect when combined with antihypertensive agents
It may increase the hypotensive effect when combined with antihypertensive agents
antihypertensive drugs may make terazosin's hypotensive effects worse
may have an increased hypotensive effect when combined with antihypertensive agents
may have an increased hypotensive effect when combined with antihypertensive agents
may have an increased bradycardic effect when combined with ivabradine
loop diuretics: they may increase the hypotensive effect when combined with antihypertensive drugs
loop diuretics: they may increase the hypotensive effect when combined with antihypertensive drugs
loop diuretics: they may increase the hypotensive effect when combined with antihypertensive drugs
prazosin: they may increase the hypotensive effect when combined with antihypertensive agents
may increase the hypotensive effect of Phosphodiesterase 5 Inhibitors
may increase the hypotensive effect of Hypotension-Associated Agents
may diminish the effect of antihypertensive activity
may diminish the effect of antihypertensive activity
may diminish the effect of antihypertensive activity
may diminish the effect of antihypertensive activity
may diminish the effect of antihypertensive activity
may increase the serum concentration
may increase the serum concentration
may increase the serum concentration
may increase the serum concentration
may increase the serum concentration
may increase the serum concentration
may increase the serum concentration
may increase the serum concentration
may increase the serum concentration
may increase the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the serum concentration
may decrease the hypotensive effect of Blood Pressure Lowering Agents
it increases the toxicity of calcium channel blockers cabergoline
oxaceprol decreases the effect of anti-hypertensives
molsidomine: they may decrease the antihypertensive effect of antihypertensive agents
nicergoline: they may decrease the antihypertensive effect of antihypertensive agents
hydralazine: they may decrease the antihypertensive effect of antihypertensive agents
may increase the hypotensive effect of blood pressure lowering agents
may increase the hypotensive effect of blood pressure lowering agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
quinagolide: they may increase the hypotensive effect of antihypertensive agents
may have an increased hypotensive effect when combined with anti-hypertensive agents
may have an increased hypotensive effect when combined with antihypertensive agents
may have an increased hypotensive effect when combined with antihypertensive agents
may have an increased hypotensive effect when combined with antihypertensive agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
an increased risk of hypotension may be seen
moxonidine: it may decrease activities of antihypertensive drugs
ambrisentan: it may decrease activities of antihypertensive drugs
balsalazide: it may decrease activities of antihypertensive drugs
benorilate: it may decrease activities of antihypertensive drugs
benoxaprofen: it may decrease activities of antihypertensive drugs
carvedilol: it may decrease activities of antihypertensive drugs
chlorothiazide: it may decrease activities of antihypertensive drugs
celecoxib: it may decrease activities of antihypertensive drugs
chlorpromazine: it may decrease activities of antihypertensive drugs
amitriptyline: it may decrease activities of antihypertensive drugs
rimiterol: it may decrease activities of antihypertensive drugs
amlodipine: it may decrease activities of antihypertensive drugs
amoxapine: it may decrease activities of antihypertensive drugs
anagrelide: it may decrease activities of antihypertensive drugs
bisoprolol: it may decrease activities of antihypertensive drugs
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
they modify the response of glucose or insulin when taken with manidipine
Actions and Spectrum:
captopril is an angiotensin-converting enzyme (ACE) inhibitor. It works by blocking the action of ACE (it is an enzyme which converts angiotensin I to angiotensin II). Angiotensin II is a potent vasoconstrictor, meaning it causes the blood vessels to narrow and raise blood pressure. By inhibiting ACE, captopril reduces the production of angiotensin II, leading to vasodilation and lower blood pressure.
hydrochlorothiazide is a thiazide diuretic. It works by inhibiting the reabsorption of sodium and chloride in the distal tubule. This leads to a decrease in blood volume and lower blood pressure.
Together, captopril and hydrochlorothiazide work to lower blood pressure through different mechanisms, making them a popular combination therapy for hypertension.
Frequency Defined
Captopril
1-10%
Hypotension (1-3%)
Cough (1-2%)
Dysgeusia (2-4%)
Chest pain (1%)
Hypersensitivity reactions
Hypotension (1-3%)
Hyperkalemia (1-11%)
Palpitations (1%)
Tachycardia (1%)
Pruritis rash (2%)
<1%
ARF if renal artery stenosis
Angioedema
Impotence
Photosensitivity
Neutropenia
Black Box Warning
The black box warning for the combination drug captopril/hydrochlorothiazide (brand name Capozide) is for fetal toxicity.
Contraindication/Caution:
Contraindications:
Caution:
Pregnancy warnings:   
Pregnancy category: C in 1st trimester and D in 2nd and 3rd trimester
Lactation:Â Excreted into human milk is known
Pregnancy Categories:     
Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.
Category B: There were lack of studies on pregnant women and no evidence of risk to the foetus in animal experiments.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: There is no data available for the drug under this category
Pharmacology:
captopril and hydrochlorothiazide are two medications commonly used together to treat hypertension (high blood pressure). captopril is an angiotensin-converting enzyme (ACE) inhibitor, while hydrochlorothiazide is a diuretic.
Pharmacodynamics:
captopril works by inhibiting the action of ACE, a enzyme. This leads to a decrease in the production of angiotensin II, which results in the dilation of blood vessels, reducing blood pressure. captopril also increases the levels of bradykinin, a vasodilator, further reducing blood pressure.
hydrochlorothiazide works by reducing the reabsorption of sodium and water in the kidneys, leading to increased urine output and decreased blood volume. This also helps to lower blood pressure.
The combination of captopril and hydrochlorothiazide produces a synergistic effect, as they work through different mechanisms to lower blood pressure. The two medications are usually taken orally in tablet form and are available in various strengths, depending on the severity of hypertension.
Pharmacokinetics:
Absorption
Both captopril and hydrochlorothiazide are rapidly absorbed from the gastrointestinal tract after oral administration. captopril has a bioavailability of approximately 75%, while hydrochlorothiazide has a bioavailability of around 70%.
Distribution
Both drugs are distributed widely throughout the body, and they are highly bound to plasma proteins. captopril has a volume of distribution of 0.6 L/kg, while hydrochlorothiazide has a volume of distribution of 0.8 L/kg.
Metabolism
captopril is rapidly metabolized in the liver to its active metabolite, captopril disulfide. Hydrochlorothiazide is not extensively metabolized in the liver but is eliminated unchanged in the urine.
Elimination and Excretion
Both drugs are primarily eliminated by the kidneys. The elimination half-life of captopril is approximately 2 hours, while the elimination half-life of hydrochlorothiazide is approximately 6-15 hours.
Administration:
The dosage of captopril/hydrochlorothiazide will depend on the severity of hypertension and the patient’s medical history. The usual starting dose is one tablet (50 mg/25 mg) once daily. If the patient’s blood pressure is not adequately controlled, the dosage may be increased to two tablets (100 mg/50 mg) once daily.
captopril/hydrochlorothiazide should be taken with or without food, at the same time every day. It is important to take this medication regularly and as directed by the doctor.
Patient information leaflet
Generic Name: captopril/hydrochlorothiazide
Why do we use captopril/hydrochlorothiazide?
captopril/hydrochlorothiazide is used to treat hypertension (high blood pressure) in adults. This medication is a combination of two drugs, captopril, an ACE inhibitor, and hydrochlorothiazide, a diuretic.
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