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Neonatal Intensive Care Drug Manual
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| bet | 99/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Captopril
Revision Date : 23-12-2020
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Approved : TC, KOH
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High Risk Medication
Use with caution – a test dose is recommended
An overdose can be fatal – associated with significant seizures, apnoea and renal complications
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Indication :
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Hypertension
Afterload reduction in patients with congestive heart failure
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Dose :
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Oral:
Monitor blood pressure during administration
< 37 weeks
Initial test dose: 10microgam/kg. If tolerated can give 10 microgram/kg every 8 hours Titrate slowly according to response
≥ 37 weeks
Initial test dose: 10-50microgram/kg If tolerated can give 10-50microgram/kg every 8-12 hours Titrate according to response
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Interval :
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8-12 hourly
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Route :
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Oral
Extremely unpalatable – mix well with part of a feed (this is not necessary if being fed by intragastric tube). Separate dose from remainder of feed by 1 hour as feeds may limit absorption
Adverse
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Total Daily Dose :
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< 37 weeks
Maximum 300microgram/ kg in 24 hours
≥ 37 weeks
Maximum of 2000microgram/ kg in 24 hours
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Adverse Reactions:
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Common: cough, hypotension, raised creatinine
Serious: hyperkalaemia, angioedema /anaphylaxis, apnoea, seizures
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Comments :
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- ACE inhibitor functions in cases of presumed hyper-reninaemia.
- High risk of hyperkalaemia if used with potassium sparing diuretics (i.e. spironolactone) or potassium supplementation.
- Pentoxifylline and sildenafil may increase captopril effects
- Monitor Urea and electrolytes (particularly creatinine and potassium)
- Continuous blood pressure monitoring. Neonatal response to captopril is variable and neonates can become profoundly hypotensive even with a small dose
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