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LOTENSINE Tablets (Captopril)

Disclaimer: This information is for educational purposes and is not a substitute for professional medical advice. Lotensine is a prescription-only medication that can have significant effects and interactions. Use only as prescribed and monitored by a doctor.


Lotensine (Captopril): A Complete Guide to the ACE Inhibitor

Manufacturer: Kahira Pharm. & Chem. Ind. Co., Cairo, Egypt

Category: Angiotensin-Converting Enzyme (ACE) Inhibitor

Active Ingredient: Captopril (available in 25 mg tablets)

Summary

Lotensine (Captopril) is a medication used to treat hypertension (high blood pressure) and congestive heart failure. As an Angiotensin-Converting Enzyme (ACE) inhibitor, it works by relaxing blood vessels, which lowers blood pressure and makes it easier for the heart to pump blood. It is often used alone or in combination with other antihypertensive agents, particularly thiazide diuretics, with which it has an additive effect.

Mechanism of Action: How Lotensine Works

Lotensine's active ingredient, Captopril, blocks the action of the Angiotensin-Converting Enzyme (ACE). This enzyme is responsible for converting a substance called angiotensin I into angiotensin II. Angiotensin II is a very potent vasoconstrictor (it narrows blood vessels) and also stimulates the release of aldosterone, a hormone that causes the body to retain salt and water. By inhibiting ACE, Lotensine:

  1. Reduces Angiotensin II levels: This causes blood vessels to relax and widen (vasodilation), leading to a drop in blood pressure.
  2. Decreases Aldosterone secretion: This promotes the excretion of sodium and water while causing a slight retention of potassium.

This dual action effectively lowers blood pressure and reduces the workload on the heart in patients with heart failure.

Therapeutic Indications: When is Lotensine Used?

  • Hypertension: For the treatment of high blood pressure, either as a standalone therapy or combined with other agents like diuretics.
  • Congestive Heart Failure: For managing heart failure, typically in patients who have not responded adequately to conventional therapy with diuretics and digitalis.

Dosage and Administration

Important: Dosage must be individualized by a physician. Tablets should be taken approximately 1 hour before meals as food can reduce absorption.

  • Hypertension: The usual starting dose is 25 mg (1 tablet) twice daily. This may be adjusted based on the patient's response.
  • Congestive Heart Failure: The initial dose is often lower (e.g., 6.25 mg to 12.5 mg) and is given 2-3 times daily under close medical supervision. The usual maintenance dose is 25 mg (1 tablet) two or three times daily.
  • First-Dose Precaution: The first dose can cause a significant drop in blood pressure, especially in patients on diuretics or with renal impairment. It is often recommended that the first dose be administered under medical observation.

Key Contraindications, Warnings, and Side Effects

  • Contraindications: Hypersensitivity to Captopril or any other ACE inhibitor; history of angioedema related to previous ACE inhibitor treatment; pregnancy.
  • Key Side Effects:
    • Dry, Persistent Cough: This is a very common class-specific side effect of all ACE inhibitors.
    • First-Dose Hypotension: A sharp drop in blood pressure after the first dose.
    • Hyperkalemia: An increase in serum potassium levels, especially in patients with renal impairment or those taking potassium-sparing diuretics.
    • Taste Disturbances (Dysgeusia): A metallic or altered sense of taste may occur.
    • Skin Rash.
  • Warnings:
    • Renal Function: Use with extreme caution in patients with impaired renal function or bilateral renal artery stenosis. Dosage reduction is required.
    • Angioedema: A rare but serious side effect involving swelling of the face, lips, and throat, which can be life-threatening. Discontinue the drug immediately if this occurs.
    • Neutropenia/Agranulocytosis: A rare but serious drop in white blood cell count, with an increased risk in patients with autoimmune diseases (like lupus) or renal impairment.

Frequently Asked Questions (FAQ)

What is the most common side effect of Lotensine?
A persistent, dry, tickly cough is the most characteristic side effect of Captopril and all other ACE inhibitors. If it becomes bothersome, you should speak to your doctor, who may switch you to a different class of medication (like an ARB).

Why do I need to take Lotensine one hour before meals?
The presence of food in the stomach can reduce the absorption of Captopril by 30-40%. Taking it on an empty stomach ensures that you get the full, intended dose and a more consistent effect.

Can I use salt substitutes while taking Lotensine?
You should be very cautious. Many salt substitutes are high in potassium. Since Lotensine already causes the body to retain potassium, using potassium-rich salt substitutes can lead to dangerously high potassium levels (hyperkalemia). Always consult your doctor before using them.

Sources

  1. Captopril Professional Information - Drugs.com
  2. Captopril - StatPearls, NCBI
  3. Official Product Leaflet for Lotensine.

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