Side Effects:
Undesirable effects reported for captopril and/or ACE inhibitor include:
Blood and lymphatic disorders:
Very Rare: neutropenia/agranulocytosis, pancytopenia particularly in patients with renal dysfunction, anaemia (including aplastic and haemolytic), thrombocytopenia, lymphadenopathy, eosinophilia, auto-immune diseases and/or positive ANA-titres.
Metabolism and nutrition disorders:
Rare: Anorexia
Very Rare: Hyperkalaemia, hypoglycaemia
Psychiatric disorders:
Common: Sleep disorders.
Very Rare: Confusion, depression.
Nervous system disorders:
Common: Taste impairment, dizziness.
Rare: Drowsiness, headache and paraesthesia.
Very Rare: Cerebrovascular incidents, including stroke, and syncope.
Eye disorders:
Very Rare: Blurred vision.
Cardiac disorders:
Uncommon: Tachycardia or tachyarrhythmia, angina pectoris, palpitations.
Very Rare: Cardiac arrest, cardiogenic shock.
Vascular disorders
Uncommon: Hypotension, Raynaud syndrome, flush, pallor.
Respiratory, thoracic and mediastinal disorders:
Common: Dry, irritating (non productive) cough and dyspnoea.
Very Rare: Bronchospasm, rhinitis, allergic alveolitis / eosinophilic pneumonia.
Gastrointestinal disorders:
Common: Nausea, vomiting, gastric irritations, abdominal pain, diarrhoea, constipation, dry mouth.
Rare: Stomatitis/aphthous ulcerations.
Very Rare: Glossitis, peptic ulcer, pancreatitis.
Hepato-biliary disorders:
Very Rare: Impaired hepatic function and cholestasis. (including jaundice), hepatitis including necrosis, elevated liver enzymes and bilirubin.
Skin and subcutaneous tissue disorders:
Common: Pruritus with or without a rash, rash and alopecia.
Uncommon: Angioedema
Very Rare: Urticaria, Stevens Johnson syndrome, erythema multiforme, photosensitivity, 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:
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 haemoglobin, haematocrit, leucocytes, thrombocytes, positive ANAtitre, elevated ESR.
Intestinal angioedema has also been reported very rarely in patients with ACE inhibitors and should be included in the differential diagnosis of patients on ACE inhibitors presenting with abdominal pain.