Lower than conventional doses of captopril in the initiation of converting enzyme inhibition in patients with severe congestive heart failure.
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.
Scott
R A
RA
Department of Pharmacology and Therapeutics, University of Leicester, England.
Barnett
D B
DB
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
D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril