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Safety Advices
বাংলা
English
SAFE
Consuming alcohol with Topril does not cause any harmful side effects.
CONSULT YOUR DOCTOR
Topril is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.
SAFE IF PRESCRIBED
Topril is safe to use during breastfeeding. Human studies suggest that the drug does not pass into the breastmilk in a significant amount and is not harmful to the baby.
UNSAFE
Topril may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
CAUTION
Topril should be used with caution in patients with kidney disease. Dose adjustment of Topril may be needed. Please consult your doctor.
Regular blood pressure monitoring is recommended for dose adjustment. It may cause neutropenia (low white blood cells) and proteinuria in patients with kidney disease.
CAUTION
Topril should be used with caution in patients with liver disease. Dose adjustment of Topril may be needed. Please consult your doctor.
Inform your doctor if you develop any signs and symptoms of jaundice while taking this medicine.
Medicine Overview of Topril 50mg Tablet
Introduction
Topril belongs to a group of medicines known as angiotensin converting enzyme (ACE) inhibitors. It is widely used to treat high blood pressure and heart failure and may be prescribed after a heart attack. It also lowers the chances of having a heart attack or stroke. Topril can be prescribed either alone or in combination with other medicines. It may be taken empty stomach. This medicine should be taken at the same time each day to get the most benefit. It is important to continue taking it regularly even if you feel well or even if your blood pressure is...
... Show moreUses of Topril
- Hypertension (high blood pressure)
- Prevention of heart attack and stroke
- Heart failure
Side effects of Topril
Common
- Decreased blood pressure
- Cough
- Increased potassium level in blood
- Fatigue
- Weakness
- Dizziness
How to use Topril
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Topril may be taken with or without food, but it is better to take it at a fixed time.
How Topril works
Topril is an angiotensin converting enzyme (ACE) inhibitor. It works by reducing stress on the heart and relaxing blood vessel so that blood flows more smoothly and the heart can pump blood more efficiently.
What if you forget to take Topril?
If you miss a dose of Topril, skip it and continue with your normal schedule. Do not double the dose.
Quick Tips
- Topril can make you feel dizzy for the first few days, so rise slowly if you have been sitting or lying down. You can also prefer taking it at bedtime to avoid dizziness throughout the day.
- Let your doctor know about any cough, or throat irritation that does not go away.
- It may increase the level of potassium in blood. Avoid taking potassium supplements and potassium-rich foods such as banana and broccoli.
- Inform your doctor if you are pregnant, planning pregnancy or breastfeeding.
Brief Description
Indication
Hypertension, Congestive heart failure, Post Myocardial infarction, Diabetic nephropathy
Administration
Should be taken on an empty stomach. Take on an empty stomach 1 hr before or 2 hr after meals.
Adult Dose
Adult: PO HTN Initial: 12.5 mg twice daily. Maintenance: 25-50 mg twice daily. Max: 50 mg 3 times/day.
Elderly: Initially, 6.25 mg bid.
Heart failure Initial: 6.25-12.5 mg 2-3 times/day. Max: 50 mg 3 times/day.
Post MI Start 3 days after MI. Initial: 6.25 mg/day, may increase after several wk to 150 mg/day in divided doses if needed and tolerated.
Diabetic nephropathy 25 mg 3 times/day.
Child Dose
Oral
Hypertension
Child: Neonates and infants: 0.15 mg/kg. Max: 6 mg/kg in 2 or 3 divided doses according to response. Childn and adolescents: 0.3 mg/kg. Max: 6 mg/kg in 2 or 3 divided doses according to response.
Heart failure
Child: Initially, 0.25 mg/kg/day, increased up to 2.5 or 3.5 mg/kg/day in 3 divided doses.
Renal Dose
Renal impairment:
CrCl (ml/min)
<10 Initially, 6.25 mg/day. Max: 37.5 mg/day.
10-20 Initially, 12.5 mg/day. Max: 75 mg/day.
21-40 Initially, 25 mg/day. Max: 100 mg/day.
Contraindication
Known hypersensitivity to the drug. Bilateral renal artery stenosis, hereditary angioedema; renal impairment; pregnancy.
Mode of Action
Captopril competitively inhibits the conversion of angiotensin I (ATI) to angiotensin II (ATII), thus resulting in reduced ATII levels and aldosterone secretion. It also increases plasma renin activity and bradykinin levels. Reduction of ATII leads to decreased Na and water retention. This promotes vasodilation and BP reduction.
Precaution
Patients on diuretics or with sodium depletion should discontinue diuretics or increase sodium intake prior to initiation of therapy. Renal impairment, SLE and other autoimmune collagen disorders and during concurrent use of immunosuppressant or leucopenic drugs, monitor WBC count and urinary protein before and during therapy. Lactation. Porphyria. Severe CHF. Discontinue as soon as pregnancy detected; during the second and third trimesters of pregnancy, drugs that act directly on the renin-angiotensin have been associated with fetal injury that includes hypotension, neonatal skull hypoplasia, anuria, reversible or irreversible renal failure, and death Lactation: enters breast milk/not recommended (AAP states compatible with...
... Show moreSide Effect
>10%
Hyperkalemia (1-11%)
1-10%
Hypersensitivity rxns (4-7%),Skin rash (4-7%),Dysgeusia (2-4%),Hypotension (1-2.5%),Pruritus (2%),Cough (0.5-2%),Chest pain (1%),Palpitations (1%),Proteinuria (1%),Tachycardia (1%)
Frequency Not Defined
Cardiac arrest,Orthostatic hypotension,Ataxia,Confusion,Depression,Somnolence,Angioedema,Photosensitivity,Neutropenia,ARF if renal artery stenosis,Renal impairment,Impotence
Potentially Fatal: Neutropenia, usually occurs within 3 mth of starting therapy especially in patients with renal dysfunction or collagen diseases. Hyperkalaemia. Anaphylactic reactions.
Pregnancy Category Note
Pregnancy Category: C; D in 2nd & 3rd trimesters
Discontinue as soon as pregnancy detected; during the second and third trimesters of pregnancy, drugs that act directly on the renin-angiotensin have been associated with fetal injury that includes hypotension, neonatal skull hypoplasia, anuria, reversible or irreversible renal failure, and death
Lactation: enters breast milk/not recommended (AAP states compatible with nursing)
Interaction
Concurrent treatment w/ NSAIDs reduces hypotensive action and increases the risk of nephrotoxicity. Additive hyperkalaemic effect w/ K supplements, K-sparing diuretics, and other drugs (e.g. heparin). May increase risk of leucopenia w/ procainamide, allopurinol, cytostatic or immunosuppressants. May increase risk of lithium toxicity. Increased risk of nitritoid reactions w/ gold (Na aurothiomalate).
Potentially Fatal: Increased risk of hypotension, hyperkalaemia, and changes in renal function (including acute renal failure) w/ aliskiren in diabetic patients.
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