Angiten

Introduction
Angiten 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. Angiten 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 controlled. Most people with high blood pressure do not feel ill, but if you stop taking this medicine, your condition could get worse. Making some changes in your lifestyle will also help lower your blood pressure. These may include regular exercise, losing weight, smoking cessation, reducing alcohol intake, and reducing the amount of salt in your diet as advised by your doctor. The most common side effects of this medicine include feeling dizzy or drowsy, headache, dry cough, fatigue, nausea, vomiting, diarrhea, stomach pain, and low blood pressure. Most of these are temporary and resolve with time. Talk to your doctor if any of the side effects bother you or do not go away. Before taking this medicine, let your doctor know if you have any kidney or liver problems. Pregnant or breastfeeding mothers should also consult their doctor before taking it. Your doctor may check your kidney function, blood pressure and potassium levels in your blood at regular intervals while you are taking this medicine.

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Uses of Angiten
Hypertension (high blood pressure)
Prevention of heart attack and stroke
Heart failure
Side effects of Angiten
Common
Decreased blood pressure
Cough
Increased potassium level in blood
Fatigue
Weakness
Dizziness
How to use Angiten
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. Angiten may be taken with or without food, but it is better to take it at a fixed time.
How Angiten works
Angiten 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 Angiten?
If you miss a dose of Angiten, skip it and continue with your normal schedule. Do not double the dose.
Quick Tips
Angiten 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.

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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.

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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 nursing) _ Side 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.

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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)

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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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