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Updated 11 February 2013

Cilazapril

Cilazapril is an angiotensin-converting enzyme (ACE) inhibitor prescribed for the treatment of high blood pressure.

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Cilazapril is the active ingredient of Inhibace.

Clilazapril is also one of multiple active ingredients found in Inhibace Plus (cilazapril + hydrochlorothiazide).

General Information

Cilazapril is an angiotensin-converting enzyme (ACE) inhibitor prescribed for the treatment of high blood pressure. It causes blood vessels to relax and widen, thereby reducing high blood pressure.

This medication is not a cure for high blood pressure, but is effective in keeping it under control. For it to be effective you must take it regularly. High blood pressure declines slowly and it may take a few weeks for cilazapril to reach it full effect. Keep taking this medicine during this period, even if you are feeling better, or fail to notice any improvement.

Cilazapril can be used on its own, or in combination with certain other medication for high blood pressure. It is often effectively combined with diuretics. In black patients cilazapril is significantly less effective if not prescribed together with a diuretic.

The first couple of doses of this medication may cause a sudden drop in blood pressure, which may cause dizziness or blackouts when you suddenly get up. It is therefore advisable to be resting when starting treatment and to lie down for 2 hours afterwards.

The use of cilazapril is often associated with a dry and persistent cough. Should you notice an irritating cough while being treated with this drug it is advised to contact you doctor.

Cilazapril should be avoided during pregnancy, especially the second and third trimester. Speak to your doctor about the use of this drug if you are planning to get pregnant, as it may cause harm to the unborn baby.

How does cilazapril work?

Cilazapril works by preventing the conversion of angiotensin I, a chemical in your blood, to a more powerful version, Angiotensin II. Angiotensin II has a narrowing effect on blood vessels, thereby increasing blood pressure. Angiotensin II furthermore stimulates the production aldosterone, a hormone which promotes salt (sodium) retention in the body, an action which increases blood pressure.

By inhibiting the forming of angiotensin II, cilazapril lowers blood pressure and thereby decreases the workload on the heart.

Fast facts

Drug schedule: Schedule 3

Available as: Cilazapril is available as tablets.

What does it do? Lowers blood pressure.

Overdose risk: Medium

Dependence risk: Low

Is cilazapril available as a generic? No

Is cilazapril available on prescription only? Yes

User information

Dietary advice: Cilazapril can be taken with or without food. Its blood pressure lowering effect is enhanced by taking a low salt diet.

Stopping this medicine: Use cilazapril as prescribed by your doctor, and do not discontinue treatment before speaking to your prescriber. Suddenly stopping the drug may cause you blood pressure to increase dangerously. Dosage should be deceased gradually as directed by your doctor.

Prolonged use: No problems are expected. Your doctor may perform periodic tests of the blood and urine, should the need arise.

Special precautions

Consult your doctor before using this drug if:

  • You have a kidney disease
  • You have a heart condition which your doctor is not aware of
  • You are allergic to ACE-inhibitor drugs
  • You are taking other medication
  • You are pregnant or planning to become pregnant.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: This medication is not intended for use in children under the age of 7. Dosage needs to be adjusted.

Elderly: Dosage may need to be adjusted according to kidney function and other medical conditions.

Driving and hazardous work: Caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.

Alcohol: Avoid concomitant use of alcohol with this medication as it may increase the possibility of dizziness.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Dizziness

x

x

Headache

x

x

Dry cough

x

x

Nausea

x

x

Diarrhoea

x

x

Rash/itch

x

x

Muscle cramps

x

x

Swelling of face, lips, tongue or throat

x

x

Swelling of arms and legs

x

x

Difficulty swallowing

x

x

Abdominal pain with/without nausea/vomiting

x

x

Interactions

Drug interactions

Allopurinol

Possible allergic reactions

Anaesthetics

Enhanced blood pressure lowering effect

Other medication for high blood pressure

Enhanced blood pressure lowering effect

Ciclosporin

Increased risk of potassium toxicity

Lithium

Increased risk of lithium toxicity

Non-steroidal anti-inflammatory drugs

Effect on blood pressure is impaired.

Potassium supplements

Increased risk of potassium toxicity

Rifampicin

May increase blood pressure.

Food interactions

A diet high in salt may increase blood pressure.

Disease interactions

Consult your doctor before using this drug if you have a kidney disease, a heart condition of which your doctor is not aware of, or if you are allergic to ACE-inhibitor drugs.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention. Symptoms of an overdose may include dizziness and/or fainting.

Recommended dosage

High blood pressure: 1.25 - 5 mg/day as a single dose or in divided doses.

 
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