Captopril should be discontinued if renal function worsens acutely. Other types of renal disease can actually improve during captopril therapy. The dose of captopril should be adjusted in patients with renal impairment. Captopril should be used with caution patients with hyperkalemia. ACE inhibitors can elevate serum potassium concentrations and could worsen pre-existing condition.
Hyperkalemia is associated with serious cardiac arrhythmias.
The metabolism of captopril may be decreased in patients with hepatic disease. Monitoring and dosage adjustments may be necessary in patients with hepatic impairment. Captopril therapy can produce angioedema, which can be fatal. Captopril is contraindicated in patients with a history of ACE inhibitor-induced angioedema, hereditary angioedema, or idiopathic angioedema. Hypoglycemia has occurred when captopril was added to either glyburide or biguanide therapy.