Captopril

Also indexed as: Acepril, Alti-Capropril, Apo-Capto, Capoten, Ecopace, Gen-Captopril, Hyteneze, Kaplon, Novo-Captoril, Nu-Capto, Tensopril

Combination drugs: Acezide, Capto-Co, Captozide, Co-Zidocapt

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Captopril is an angiotensin-converting enzyme (ACE) inhibitor—a family of drugs used to treat high blood pressure and some types of heart failure. Captopril is also used to slow the progression of kidney disease in people with diabetes.

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Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, a herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

Beneficial May Be Beneficial: Depletion or interference—The medication may deplete or interfere with the absorption or function of the nutrient. Taking these nutrients may help replenish them.

Zinc
Beneficial May Be Beneficial: Side effect reduction/prevention—Taking these supplements may help reduce the likelihood and/or severity of a potential side effect caused by the medication.

Iron
Avoid Avoid: Adverse interaction—Avoid these supplements when taking this medication because taking them together may cause undesirable or dangerous results.

High-potassium foods*

Potassium supplements*

Salt substitutes*
Supportive interaction

None known
Reduced drug absorption/bioavailability

None known
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An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

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Interactions with Dietary Supplements

Potassium
An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.1 2 3 This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,4 potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others),5 6 7 or large amounts of high-potassium foods at the same time as ACE inhibitors could cause life-threatening problems.8 Therefore, individuals should consult their doctor before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

Zinc
Preliminary research has found significant loss of zinc in urine triggered by taking captopril.9 In this trial, depletion of zinc reduced red blood cell levels of zinc. Although details remain unclear, it now appears that chronic use of captopril may lead to a zinc deficiency.10

It makes sense for people taking captopril long term to consider taking a zinc supplement or a multimineral tablet containing zinc as a precaution. (Such multiminerals usually contain no more than 99 mg of potassium, probably not enough to trigger the above-mentioned interaction.) Supplements containing zinc should also contain copper, to protect against a zinc-induced copper deficiency.

Iron
In a double-blind study of patients who had developed a cough attributed to an ACE inhibitor, supplementation with iron (in the form of 256 mg of ferrous sulphate per day) for four weeks reduced the severity of the cough by a statistically significant 45%, compared with a nonsignificant 8% improvement in the placebo group.11

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References
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