Captopril is a medicine called an ACE inhibitor. ACE inhibitors are a group of medicines that are used for two reasons: to treat high blood pressure and to reduce protein in the urine (proteinuria).
What is captopril used for?
Captopril ACE inhibitor is used in various illnesses, including heart failure, kidney problems and diabetes. ACE stands for ‘angiotensin-converting enzyme’.
Captopril is available in tablet and as an oral solution to be mixed with a drink. The oral solution is not licensed in the UK and, so has to be made as a ‘special’ or imported from abroad. The tablets are soluble in water.
Medicines are often used ‘off label’ in children for a number of reasons, for example limited data available for a specific use in children. This is not necessarily hazardous but should be explained and agreed before use. Your doctor will explain this further to you.
How is captopril oral solution given?
It is usually given three times a day, one hour before meals. The oral solution should be mixed with water or juice and drunk immediately. The bottle of oral solution should only be kept for 28 days, after which any remaining should be returned to the pharmacist and replaced with a new bottle.
Captopril will usually be started at a low dose and gradually increased until the target dose is reached.
Who should not use captopril oral solution?
People with the following conditions should discuss taking captopril oral solution with their doctor.
- Hypersensitivity to captopril or any of the ingredients in the oral solution
- Previous instances of swelling either for no known reason (idiopathic angioedema) or after taking an ACE inhibitor
- Pregnant, could be pregnant, planning to become pregnant or breastfeeding
What are the side effects of captopril?
Allergic reaction
Some people develop an allergic reaction to captopril, which may be mild or severe. Signs of a mild allergic reaction include skin rashes and itching, high temperature, shivering, redness of the face, a feeling of dizziness or a headache. If you see any of these signs, please report them to a doctor or nurse. Signs of a severe allergic reaction include any of the above, as well as shortness of breath or chest pain. If you are in hospital and your child shows signs of a severe allergic reaction, call a doctor or nurse immediately. If you are at home and your child shows signs of a severe allergic reaction, call an ambulance immediately. If your child has a severe reaction to captopril, the subsequent treatment will probably be changed.
Stomach ache with or without sickness
This is temporary and will disappear when the captopril is stopped. If the stomach ache becomes troublesome or lasts for a long time, please tell your doctor or nurse, as the medicine or dosage may need to be changed.
Alteration in taste
Some children may seem to ‘go off’ foods that were previously favourites. Ward staff and dietitians may be able to advise you on improving your child’s appetite. Taste disturbance usually disappears within a few months without need for further treatment.
High blood pressure
This can occasionally happen when starting to take ACE inhibitors so your child will start captopril during a hospital stay so that his or her blood pressure can be monitored closely.
Dry cough
This is sometimes seen in adults, but very seldom in children.
Changes in blood count
This will also be monitored frequently while your child is taking captopril. These effects are usually temporary and disappear when captopril is stopped.
Raised levels of protein in the urine (proteinuria)
This is more common in children with existing kidney problems. Your child’s urine will be tested frequently while he or she is taking captopril.
Other rare side effects include alteration in how well the liver and kidneys work, but these will also be monitored closely during treatment.
Effect on unborn baby
ACE inhibitors including captopril may harm an unborn baby so if your daughter is twelve years old or more, we will ask her about her periods and whether she could be pregnant. If she is sexually active, she should use a reliable form of contraception.
Captopril oral solution and other medicines
Some medicines can react with captopril, altering how well it works. Always check with your doctor or pharmacist before giving your child any other medicines, including herbal or complementary medicines. The following are known to react with captopril:
- some diuretics (water tablets)
- anti-inflammatory medicines
- potassium salts
- lithium
- ciclosporin
Important information about Captopril oral solution
- Keep medicines in a safe place where children cannot reach them.
- Captopril oral solution should be kept in a cool, dry place out of direct sunlight or heat. It does not need to be kept in the fridge.
- If your doctor decided to stop treatment with captopril, return any unused oral solution to the pharmacist. Do not flush it down the toilet or throw it away.
- If your child vomits after a dose of captopril, ring your doctor or nurse for advice. Do not give a second dose.
- If you forget to give your child a dose and it is within a few hours of when the dose was due, give it as soon as you remember. Otherwise, do not give this dose but take the next dose when it is due. Do not give a double dose.
Last reviewed by Great Ormond Street Hospital: December 2009
Ref: 09F0446 © GOSH Trust December 2009
Compiled by the Pharmacy department in collaboration with the Child and Family Information Group
Please read this information in conjunction with any patient information leaflet provided by the manufacturer. However, please note that this information explains about the use of medicines in children and young people so may differ from the manufacturer’s information.
Each person reacts differently to medicines so your child will not necessarily suffer every side effect mentioned. This information does not constitute health or medical advice and will not necessarily reflect treatment at other hospitals. If you have any questions, please ask your doctor. No liability can be taken as a result of using this information.
