Captopril And Hydrochlorothiazide

May cause significant increase in serum potassium. Should only be given for documented hypokalemia and with caution due to risk of hyperkalemia.

Drug Interactions: Captopril : Hypotension—Patients On Diuretic Therapy : Patients on diuretics and especially those in whom diuretic therapy was recently instituted, as well as those on severe dietary salt restrictions or dialysis, may occasionally experience a precipitous reduction of blood pressure usually within the first hour after receiving the initial dose of captopril. The possibility of hypotensive effects with captopril can be minimized by either discontinuing the diuretic or increasing the salt intake approximately one week prior to initiation of treatment with captopril or initiating therapy with small doses (6.25 or 12.5 mg). Agents Having Vasodilator Activity : Data on the effect of concomitant use of other vasodilators in patients receiving captopril for heart failure are not available; therefore, nitroglycerin or other nitrates (as used for management of angina) or other drugs having vasodilator activity should, if possible, be discontinued before starting captopril.

Risk of significant serum potassium elevation. Should only be given for documented hypokalemia and with caution.

Nitritoid reactions (facial flushing, nausea, vomiting, hypotension) have been rarely reported with concomitant injectable gold therapy.

May cause significant increase in serum potassium. Should only be given for documented hypokalemia and with caution due to risk of hyperkalemia.

May cause significant increase in serum potassium. Should only be given for documented hypokalemia and with caution due to risk of hyperkalemia.

Other nitrates used for angina management should be discontinued before captopril initiation; if resumed, use cautiously at lower dosage.

Concomitant use may cause excessive vasodilation. Should be discontinued before starting captopril; if resumed, administer cautiously at lower dosage.

For example, diuretics (e.g., thiazides) may activate the renin-angiotensin-aldosterone system. Agents Increasing Serum Potassium : Since captopril decreases aldosterone production, elevation of serum potassium may occur.

Gold : Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and hypotension) have been reported rarely in patients on therapy with injectable gold (sodium aurothiomalate) and concomitant ACE inhibitor therapy including captopril and hydrochlorothiazide tablets. If a diuretic is also used, it may increase the risk of lithium toxicity (see PRECAUTIONS: Drug Interactions: Hydrochlorothiazide: Lithium ). Hydrochlorothiazide : When administered concurrently the following drugs may interact with thiazide diuretics: Alcohol, Barbiturates, or Narcotics : potentiation of orthostatic hypotension may occur.