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This fixed combination drug may be used as initial therapy or substituted for previously titrated doses of the individual components.
When captopril and hydrochlorothiazide are given together it may not be necessary to administer captopril in divided doses to attain blood pressure control at trough (before the next dose). Also, with such a combination, a daily dose of 15 mg of hydrochlorothiazide may be adequate.
Treatment may, therefore, be initiated with CAPOZIDE (captopril and hydrochlorothiazide) Ò 25 mg/15 mg once daily. Subsequent titration should be with additional doses of the components (captopril, hydrochlorothiazide) as single agents or as CAPOZIDE (captopril and hydrochlorothiazide) Ò 50 mg/15 mg, 25 mg/25 mg, or 50 mg/25 mg (see DOSAGE AND ADMINISTRATION).
In using CAPOZIDE (captopril and hydrochlorothiazide) Ò, consideration should be given to the risk of neutropenia/agranulocytosis (see WARNINGS).
CAPOZIDE (captopril and hydrochlorothiazide) Ò may be used for patients with normal renal function, in whom the risk is relatively low. In patients with impaired renal function, particularly those with collagen vascular disease, CAPOZIDE (captopril and hydrochlorothiazide) Ò should be reserved for hypertensives who have either developed unacceptable side effects on other drugs, or have failed to respond satisfactorily to other drug combinations.
ACE inhibitors (for which adequate data are available) cause a higher rate of angioedema in black than in non-black patients (see WARNINGS: Captopril: Head and Neck Angioedema and Intestinal Angioedema).
DOSAGE AND ADMINISTRATION
DOSAGE MUST BE INDIVIDUALIZED ACCORDING TO PATIENT†S RESPONSE.
CAPOZIDE (captopril and hydrochlorothiazide) Ò may be substituted for the previously titrated individual components.
Alternatively, therapy may be instituted with a single tablet of CAPOZIDE (captopril and hydrochlorothiazide) Ò 25 mg/15 mg taken once daily. For patients insufficiently responsive to the initial dose, additional captopril or hydrochlorothiazide may be added as individual components or by using CAPOZIDE (captopril and hydrochlorothiazide) Ò 50 mg/15 mg, 25 mg/25 mg or 50 mg/25 mg, or divided doses may be used.
Because the full effect of a given dose may not be attained for 6-8 weeks, dosage adjustments should generally be made at 6 week intervals, unless the clinical situation demands more rapid adjustment.
In general, daily doses of captopril should not exceed 150 mg and of hydrochlorothiazide should not exceed 50 mg.
CAPOZIDE (captopril and hydrochlorothiazide) Òshould be taken one hour before meals.
Dosage Adjustment in Renal Impairment†Because captopril and hydrochlorothiazide are excreted primarily by the kidneys, excretion rates are reduced in patients with impaired renal function. These patients will take longer to reach steady-state captopril levels and will reach higher steady-state levels for a given daily dose than patients with normal renal function. Therefore, these patients may respond to smaller or less frequent doses of CAPOZIDE (captopril and hydrochlorothiazide) Ò.
After the desired therapeutic effect has been achieved, the dose intervals should be increased or the total daily dose reduced until the minimal effective dose is achieved. When concomitant diuretic therapy is required in patients with severe renal impairment, a loop diuretic (e.g., furosemide), rather than a thiazide diuretic is preferred for use with captopril; therefore, for patients with severe renal dysfunction the captopril and hydrochlorothiazide combination tablet is not usually recommended. (See WARNINGS: Captopril: Anaphylactoid reactions during membrane exposure and PRECAUTIONS: Hemodialysis.)
CAPOZIDEÒ(captopril and hydrochlorothiazide tablets, USP)
25 mg captopril combined with 15 mg hydrochlorothiazide in bottles of 100 (NDC 49884-815-01).
Tablets are white with distinct orange mottling; they are biconvex rounded squares with quadrisect bars.
25 mg captopril combined with 25 mg hydrochlorothiazide in bottles of 100 (NDC 49884-816-01).
Tablets are peach-colored and may show slight mottling; they are biconvex rounded squares with quadrisect bars.
50 mg captopril combined with 15 mg hydrochlorothiazide in bottles of 100 (NDC 49884-817-01).
Tablets are white with distinct orange mottling; they are biconvex ovals with a bisect bar.
50 mg captopril combined with 25 mg hydrochlorothiazide in bottles of 100 (NDC 49884-818-01).
Tablets are peach-colored and may show slight mottling; they are biconvex ovals with a bisect bar.
Keep bottles tightly closed (protect from moisture); do not store above 30° C (86° F).
Manufactured and Distributed by:
PAR PHARMACEUTICAL, INC.
Spring Valley, NY 10977 USA
FDA revision date: 05/16/06
Last reviewed on RxList: 8/21/2006
This monograph has been modified to include the generic and brand name in many instances.
Additional Capozide Information
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