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CO-ZIDOCAPT is a brand name for Hydrochlorothiazide. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Treatment of essential hypertension This fixed dose combination is indicated in patients whose blood pressure is not adequately controlled by captopril alone or hydrochlorothiazide alone.
Verbatim from this product's MHRA label. Tap a section to expand.
Posology This medicine can be administered as a single daily dose or divided into two daily doses, with or without food, in patients whose blood pressure is not adequately controlled by captopril alone or hydrochlorothiazide alone.
The maximum daily dose should not exceed 50 mg captopril and 25 mg hydrochlorothiazide. 1).
Adults:
Administration of the fixed combination of captopril and hydrochlorothiazide is usually recommended after dose adjustment with the individual components. The usual maintenance dose is 50 mg/25 mg once daily in the morning. When clinically appropriate a direct change from monotherapy to the fixed combination may be considered.
5 mg once daily in the morning. 5 mg once daily.
Paediatric population:
Safety and effectiveness has not been established. Method of administration The tablets are for oral administration. They should be taken in the morning, independently of meals, together with a generous quantity of liquid.
Frequency is defined using the following convention: common (> 1/100, < 1/10), uncommon (> 1/1,000, < 1/100), rare (> 1/10,000, < 1/1,000) and very rare (< 1/10,000). 4), anaemia (including aplastic and haemolytic), thrombocytopenia, lymphadenopathy, eosinophilia, auto-immune diseases and/or positive ANA-titres.
4).
Psychiatric disorders:
Common: sleep disorders Very rare: confusion, depression Nervous system disorders: Common: taste impairment, dizziness Uncommon: headache and paresthesia Rare: drowsiness Very rare: cerebrovascular incidents, including stroke, cerebrovascular insufficiency and syncope Eye disorders: Very rare: blurred vision.
Cardiac disorders:
Uncommon: tachycardia or tachyarrhythmia, angina pectoris, palpitations Very rare: cardiac arrest, cardiogenic shock. 4).
Very rare: glossitis, pancreatitis Hepato-biliary disorders:
Very rare: impaired hepatic function and cholestasis (including jaundice), hepatitis including necrosis, elevated liver enzymes and bilirubin. 4) Very rare: urticaria, Stevens Johnson syndrome, erythema multiforme, photo- sensitivity, erythroderma, pemphigoid reactions and exfoliative dermatitis.
Musculoskeletal, connective tissue and bone disorders:
Very rare: myalgia, arthralgia Renal and urinary disorders: Rare: renal function disorders, including renal failure, polyuria, oliguria, increased urine frequency Very rare: nephrotic syndrome Reproductive system and breast disorders: Very rare: impotence, gynaecomastia General disorders and administration site conditions: Uncommon: chest pain, fatigue, malaise Very rare: fever Investigations: very rare: proteinuria, eosinophilia, increase of serum potassium, decrease of serum sodium, elevation of BUN, serum creatinine and serum bilirubin, decreases in haemo- globin, haematocrit, leucocytes, thrombocytes, positive ANA-titre, elevated ESR, HYDROCHLOROTHIAZIDE Infections and infestations: sialadenitis Neoplasms benign, malignant and unspecified (incl cysts and polyps) Not known: Non-melanoma skin cancer (Basal cell carcinoma and Squamous cell carcinoma) Blood and lymphatic system disorders: leucopenia, neutropenia/agranulocytosis, thrombocytopenia, aplastic anaemia, haemolytic anaemia, bone marrow depression Metabolism and nutrition disorders: anorexia, hyperglycaemia, glycosuria, hyperuricaemia, electrolyte imbalance (including hyponatraemia and hypokalaemia), increases in cholesterol and triglycerides.
CAPTOPRIL
Hypotension:
Rarely hypotension is observed in uncomplicated hypertensive patients. Symptomatic hypotension is more likely to occur in hypertensive patients who are volume and/or sodium depleted by vigorous diuretic therapy, dietary salt restriction, diarrhoea, vomiting, or haemodialysis.
Volume and/or sodium depletion should be corrected before the administration of an ACE inhibitor and a lower starting dose should be considered. As with any antihypertensive agent, excessive blood pressure lowering in patients with ischaemic cardiovascular or cerebrovascular disease may increase the risk of myocardial infarction or stroke.
If hypotension develops, the patient should be placed in a supine position. Volume repletion with intravenous normal saline may be required.
Dual blockade of the renin angiotensin-aldosterone system (RAAS):
There is evidence that the concomitant use of ACE-inhibitors, angiotensin II receptor blockers or aliskiren increase the risk of hypotension, hyperkalaemia and decreased renal function (including acute renal failure). 1). If dual blockade therapy is considered absolutely necessary, this should only occur under specialist supervision and subject to frequent close monitoring of renal function, electrolytes and blood pressure.
ACE-inhibitors and angiotensin II receptor blockers should not be used concomitantly in patients with diabetic nephropathy.
Renovascular hypertension:
There is an increased risk of hypotension and renal insufficiency when patients with bilateral renal artery stenosis or stenosis of the artery to a single functioning kidney are treated with ACE inhibitors. Loss of renal function may occur with only mild changes in serum creatinine.
1. 6). 1). - Concomitant use with sacubitril/valsartan. 5).
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
Other brands of Hydrochlorothiazide in United Kingdom.
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Psychiatric disorders: restlessness, depression, sleep disturbances Nervous system disorders: loss of appetite, paraesthesia, light-headedness Eye disorders: xanthopsia, transient blurred vision, acute myopia and secondary acute angle-closure glaucoma, choroidal effusion (frequency not known) Ear and labyrinth disorders: vertigo Cardiac disorders: postural hypotension, cardiac arrhythmias Vascular disorders: necrotising angiitis (vasculitis, cutaneous vasculitis) Respiratory, thoracic and mediastinal disorders: respiratory distress (including pneumonitis and pulmonary oedema) Gastrointestinal disorders: gastric irritation, diarrhoea, constipation, pancreatitis Hepato-biliary disorders: jaundice (intrahepatic cholestatic jaundice) Skin and subcutaneous tissue disorders: photosensitivity reactions, rash, cutaneous lupus erythematosus-like reactions, reactivation of cutaneous lupus erythematosus, urticaria, anaphylactic reactions, toxic epidermal necrolysis.
1). Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
In these patients, therapy should be initiated under close medical supervision with low doses, careful titration and monitoring of renal function.
Angioedema:
Angioneurotic oedema/angioedema of the extremities, face, lips, mucous membranes, tongue, glottis or larynx may occur in patients treated with ACE inhibitors including captopril. This reaction can occur at any time during treatment.
In these cases, captopril treatment should be discontinued promptly. and appropriate monitoring should be instituted to ensure complete resolution of symptoms prior to dismissing the patient. In those instances where swelling has been confined to the face and lips, the condition generally resolved without treatment, although antihistamines have been useful in relieving symptoms.
Angioneurotic oedema associated with laryngeal oedema may be fatal. 5 ml) and/or measures to ensure a patent airway, should be administered promptly. Black patients receiving ACE inhibitors have been reported to have a higher incidence of angioedema compared to non-blacks.
3). Intestinal angioedema has been reported rarely in patients treated with ACE inhibitors. These patients presented with abdominal pain (with or without nausea or vomiting); in some cases there was no prior facial angioedema and C-1 esterase levels were normal.
The angioedema was diagnosed by procedures including abdominal CT scan, or ultrasound or at surgery and symptoms resolved after stopping the ACE inhibitor. 8). 8). If IAS is suspected, captopril should be discontinued, and appropriate treatment should be initiated.
Cough:
Cough has been reported with the use of ACE inhibitors. Characteristically, the cough is non-productive, persistent and resolves after discontinuation of therapy.
Hepatic failure:
Rarely, ACE inhibitors have been associated with a syndrome that starts with cholestatic jaundice and progresses to fulminant hepatic necrosis and (sometimes) death. The mechanism of this syndrome is not understood. Patients receiving ACE inhibitors who develop jaundice or marked elevations of hepatic enzymes should discontinue the ACE inhibitors and receive appropriate medical follow-up.
Hyperkalaemia:
Elevations in serum potassium have been observed in some patients treated with ACE inhibitors, including captopril. g. heparin and co-trimoxazole, also called trimethoprim/sulfamethoxazole). 5). Aortic and mitral valve stenosis / Obstructive hypertrophic cardiomyopathy / Cardiogenic shock: ACE inhibitors should be used with caution in patients with left ventricular valvular and outflow tract obstruction and avoided in cases of cardiogenic shock and haemodynamically significant obstruction.
Neutropenia/Agranulocytosis:
Neutropenia/agranulocytosis,thrombocytopenia and anaemia have been reported in patients receiving ACE inhibitors, including captopril. In patients with normal renal function and no other complicating factors, neutropenia occurs rarely.
Captopril should be used with extreme caution in […]