Captopril is a new drug effective both in the treatment of hypertension and in the management of refractory congestive heart failure. Neutropenia was observed early in the clinical testing of captopril,1-6 causing the Food and Drug Administration to limit its use in the treatment of hypertension in severely affected patients. However, with added experience, it has become apparent that the risk of neutropenia is different among various patient groups. For patients with uncomplicated hypertension, neutropenia is infrequent and represents no greater a risk than exists with other commonly used drugs. In contrast, for patients with renal dysfunction, particularly those who also have a collagen-vascular disease, neutropenia is a risk that must be carefully balanced by potential therapeutic benefits.
These conclusions are based on an analysis of all cases of captopril-associated neutropenia published or reported to the drug's manufacturer as of July 1982, and also on an assessment of more
Cooper RA. Captopril-Associated Neutropenia: Who Is at Risk? Arch Intern Med. 1983;143(4):659–660. doi:10.1001/archinte.1983.00350040049004
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