Captopril
| Evidence Level: L5 | Predicted Indications: 3 |
Table of Contents
Captopril: ACE inhibitor → malignant hypertensive renal disease
One-Sentence Summary
Captopril is an angiotensin-converting enzyme (ACE) inhibitor that is currently marketed in Australia. The TxGNN model predicts it may be useful for malignant hypertensive renal disease, with a score of 0.9928. No clinical trials are registered for this prediction, and the only publication retrieved is a single diagnostic case report, so evidence is limited to the model prediction.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | malignant hypertensive renal disease |
| TxGNN Prediction Score | 0.9928 |
| Evidence Level | L5 |
| Australia Market Status | Listed on the PBS Schedule (1 of 1 items) – TGA (ARTG) registration status is not included in this data |
| Number of PBS Items | 1 (valid: 1) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism-of-action data for captopril is not available in the data compiled for this report. Captopril is, however, a member of the ACE inhibitor class. These drugs reduce production of angiotensin II, a key effector of the renin-angiotensin system (RAS).
Malignant hypertension with renal injury is a condition in which RAS activation is thought to play a role in driving blood pressure and kidney damage. That gives a plausible mechanistic link to RAS blockade.
This link is theoretical. The only retrieved publication is a case report in which a positive captopril renography led to the discovery of a renal cell carcinoma. It is a diagnostic report and does not show that captopril treats malignant hypertensive renal disease.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 28902735 | 2017 | Case report | Clinical Nuclear Medicine | A positive captopril renography, which usually indicates renin-dependent hypertension from renal artery stenosis, was instead caused by a large chromophobe renal cell carcinoma. Hypertension resolved after nephrectomy. This is diagnostic, not therapeutic, evidence. |
Australia Market Information
| ARTG Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| ARTG 8760C | Capoten | Oral solution 5 mg per mL, 95 mL | Not recorded in the local data |
Safety Considerations
Drug Interactions (the data compiled for this report lists 100 interactions; the first 20 are summarised here):
- Moderate:
- Corticosteroids: hydrocortisone, dexamethasone, betamethasone, budesonide, triamcinolone
- Glucose-lowering agents: metformin, alogliptin, canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, exenatide, acetohexamide, chlorpropamide
- Others: bupropion, morphine, acetylsalicylic acid, dronabinol
- Minor: aluminium hydroxide, calcium carbonate
No warning or contraindication text from the TGA-approved Product Information is available in the data compiled for this report. Please refer to the TGA-approved Product Information (PI) for full safety information.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction score is high, but there are no registered clinical trials, and the single retrieved publication is a diagnostic case report that does not test captopril as a treatment. The evidence level is L5 (model prediction only).
To proceed, the following is needed:
- Clinical or observational studies that directly examine ACE inhibition in malignant hypertensive renal disease
- Detailed mechanism of action data
- Safety review based on the TGA-approved Product Information, including renal function and potassium monitoring in this population
- Confirmation of the approved indication text for the Australian product
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.