Mylan Phamaceuticals Inc.
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Mylan Phamaceuticals Inc. Drugs
Captopril And Hydrochlorothiazide
DOSAGE MUST BE INDIVIDUALIZED ACCORDING TO PATIENT'S RESPONSE.
Captopril and Hydrochlorothiazide tablets may be substituted for the previously titrated individual components.
Alternatively, therapy may be instituted with a single tablet of Captopril and Hydrochlorothiazide 25 mg/15 mg taken once daily. For patients insufficiently responsive to the initial dose, additional captopril or hydrochlorothiazide may be added as individual components or by using Captopril and Hydrochlorothiazide tablets 50 mg/15 mg, 25 mg/25 mg or 50 mg/25 mg, or divided doses may be used.
Because the full effect of a given dose may not be attained for 6 to 8 weeks, dosage adjustments should generally be made at 6 week intervals, unless the clinical situation demands more rapid adjustment.
In general, daily doses of captopril should not exceed 150 mg and of hydrochlorothiazide should not exceed 50 mg.
Captopril and Hydrochlorothiazide tablets should be taken one hour before meals.
Dosage Adjustment in Renal Impairment
Because captopril and hydrochlorothiazide are excreted primarily by the kidneys, excretion rates are reduced in patients with impaired renal function. These patients will take longer to reach steady-state captopril levels and will reach higher steady-state levels for a given daily dose than patients with normal renal function. Therefore, these patients may respond to smaller or less frequent doses of Captopril and Hydrochlorothiazide.
After the desired therapeutic effect has been achieved, the dose intervals should be increased or the total daily dose reduced until the minimal effective dose is achieved. When concomitant diuretic therapy is required in patients with severe renal impairment, a loop diuretic (e.g., furosemide), rather than a thiazide diuretic is preferred for use with captopril; therefore, for patients with severe renal dysfunction the captopril-hydrochlorothiazide combination tablet is not usually recommended. (See WARNINGS: Captopril: Anaphylactoid Reactions During Membrane Exposure and PRECAUTIONS: Hemodialysis).
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