Compatibility «Indapamide+Perindopril» and «Captopril»

• Interactions Indapamide+Perindopril with Captopril

  • Dangerous interactions
    • ⓘ The administration of ACE inhibitors to patients with hyponatremia (especially patients with renal artery stenosis) is accompanied by a risk of developing sudden arterial hypotension and/or acute renal failure.
    • ⓘ In chronic heart failure, treatment with ACE inhibitors should begin with the lowest doses, with a possible preliminary reduction in doses of diuretics.
    • ⓘ In the elderly, patients with hypovolemia (in pm receiving diuretics) or impaired renal function, the combined use of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including captopril, may lead to deterioration of renal function, including the possible development of acute renal failure.
    • ⓘ With simultaneous use of a diuretic, the risk of developing side effects of lithium may increase.
    • ⓘ With the simultaneous use of ACE inhibitors (especially in combination with diuretics) and lithium preparations, an increase in the lithium content in the blood serum is possible, and therefore an increase in the cardiotoxic and neurotoxic effects of lithium preparations.
    • ⓘ In patients with risk factors (elderly age, hypovolemia, concomitant use of diuretics, impaired renal function), concomitant use of nonsteroidal anti-inflammatory drugs (including cyclooxygenase inhibitors‑2) and ACE inhibitors (including captopril), can lead to deterioration of renal function, up to acute renal failure.
  • Negative interactions
    • ⓘ The use of indapamide can sum up or potentiate the effect of other antihypertensive drugs.
    • ⓘ In limited controlled studies comparing the effects of indapamide in combination with other antihypertensive drugs with the effects of other antihypertensive drugs used as monotherapy, there were no noticeable changes in the nature or frequency of adverse reactions associated with combination therapy.
    • ⓘ 3 days before the start of treatment with an ACE inhibitor, stop taking diuretics; in the future, if necessary, taking a non-potassium-sparing diuretic can be resumed;.
    • ⓘ if discontinuation of diuretics is not possible, then ACE inhibitor therapy should be started at low doses, followed by a gradual increase in the dose if necessary.
    • ⓘ In all cases, in the first week of taking ACE inhibitors in patients, it is necessary to monitor renal function (creatinine concentration in blood plasma).
    • ⓘ Blood pressure should be monitored and, if necessary, the doses of antihypertensive drugs should be adjusted.
    • ⓘ Patients receiving diuretics, especially with their recent appointment, as well as patients on a diet with strict salt restriction or dialysis, may sometimes experience a sharp decrease in blood pressure, usually within the first hour after taking the initial dose of captopril.
    • ⓘ The antihypertensive effect can be minimized by discontinuing the diuretic, or by increasing salt intake about a week before the start of captopril or starting therapy with small doses of captopril (6.25 or 12.5 mg).
    • ⓘ The effect of captopril is enhanced by the use of antihypertensive drugs that cause the release of renin.
    • ⓘ Other antihypertensive drugs.
    • ⓘ Caution should be exercised when co‑prescribing captopril (without or with a diuretic) and drugs that affect the sympathetic nervous system (for example, ganglioblockers, alpha-blockers).
    • ⓘ NSAIDs, including selective cyclooxygenase‑2 (COX‑2) inhibitors and acetylsalicylic acid in doses of 3 g/day and above, can reduce the antihypertensive effect of diuretics and other antihypertensive agents.
    • ⓘ Perindopril and Captopril belong to the same pharmaceutical group: ACE inhibitors.
  • No interactions
    • ⓘ The sympathetic nervous system may be particularly important in maintaining blood pressure in patients receiving captopril in monotherapy or in combination with diuretics.
    • ⓘ Captopril can be safely used in combination with other antihypertensive drugs (such as beta‑blockers or long-acting 'slow' calcium channel blockers).
  • Positive interactions
    • ⓘ In patients taking diuretics, captopril may potentiate the antihypertensive effect.
  • Unclear interactions
    • ⓘ Hypotension (patients receiving diuretics).
    • ⓘ Diuretics (e.g. thiazide) can activate the RAAS.
    • ⓘ Potassium-sparing (thiazide and 'loop') diuretics.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication of the drug.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 169,994,378 possible combinations of drugs and their components were found 412,530 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2024-12-19

Category - medicine