title: Lower than conventional doses of captopril in the initiation of converting enzyme inhibition in patients with severe congestive heart failure.
abstract: Angiotensin converting enzyme (ACE) inhibitors are effective long-term therapy for congestive heart failure, improving symptoms, exercise tolerance, biochemical anomalies, and mortality. Captopril, in doses of up to 150 mg daily is relatively free of serious adverse effects. A test dose of 6.25 mg normally precedes regular therapy in an attempt to avoid first-dose hypotension, which may also be prevented by reduction in diuretic dosage and by the avoidance of over-diuresis leading to volume depletion. We report two patients who, despite the above precautions developed symptomatic first-dose hypotension with 6.25 mg, but were subsequently able to recommence captopril therapy by the initial oral administration of doses as low as 1 mg.
authors.affiliation: Department of Pharmacology and Therapeutics, University of Leicester, England.
authors.forename: R A
authors.initials: RA
authors.lastname: Scott
authors.forename: D B
authors.initials: DB
authors.lastname: Barnett
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D002216:Captopril / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril