Drug interactions - summary-

 Precipitation of digitalis toxicity and lithium toxicity by thiazide diuretics.

Hypotensive action of captopril blunted by NSAIDs impairment in glycaemic control by thiazides.

Decreased renal excreation of captopril by probenecid

Hypotensive effect of captopril may be increased by other hypotensives

Hypertension Chronic heart failure

Potentially Life Threatening Reaction:

Hyperkalaemia in patients having renal impairment,

rarely idiosyncratic hypersens reactions like Stevens-Johnson syndrome,

sytemic lupus erythematosus and acute pancreatitis.

Severe hyonatremia.

Skin rashes, dysgeusia,cough, hypochloramic alkalosis,

rarely haemolytic anaemia, thrombocytopenia, jaundice,

pancreatitis noncardiaogenic pulmonary oedema,

hypomagnesaemia leading to fatigue, weakness and paralysis.

Hyperuricaemia, impotence in diabetics, significant reduction in tear production and glucose tolerance and increase in plasma calcium concentration.

Contraindication:

Hypersens, pregnancy and lactation,

anuria and severe renal impairment,

allergy to sulphonamide-related drugs,

collagen vascular disease,

renal artery stenosis.

Special Precaution:

Neonates and children,

elderly patients,

renal disease, liver disease

,diabetes melitus, gout,

hyperlipidaemia,

ECG evidence of LVH and ventricular ectopics.

Indication-

Hypertension Chronic heart failure

Dosage-

Adult- Captopril 25mg + Hydrocholrthiazide 15mg

Initially - one tablet once daily

Daily dose should not exceed 150mg catropril + 50mg hydrochloethiazide