Drug interactions
Bupivacaine + Captopril
Severity: Moderate
Bupivacaine and Captopril: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Neuraxial bupivacaine blocks sympathetic tone and can cause hypotension, and patients on ACE inhibitors may have exaggerated drops in blood pressure during anesthesia. Systemic effects from local infiltration are minimal.
What this interaction means in plain words
Bupivacaine and Captopril can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Bupivacaine belongs to Central Nervous System; Captopril belongs to Cardiovascular.
Why it happens
Additive hypotension from sympathetic blockade with spinal or epidural bupivacaine and ACE inhibition.
What to do
Inform the anesthesia team of ACE inhibitor use and monitor blood pressure closely during neuraxial block. Treat hypotension with fluids or vasopressors.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Captopril
- Aliskiren + Captopril Contraindicated
- Captopril + Sacubitril / valsartan Contraindicated
- Captopril + Sacubitril-valsartan Contraindicated
- Amifostine + Captopril Major
- Amiloride + Captopril Major
- Amlodipine-hydrochlorothiazide-valsartan + Captopril Major
Other interactions of Bupivacaine
- Bupivacaine + Bupivacaine implant Major
- Amlodipine-benazepril + Bupivacaine Moderate
- Benazepril + Bupivacaine Moderate
- Bupivacaine + Bupivacaine liposome Moderate
- Bupivacaine + Dofetilide Moderate
- Bupivacaine + Iloprost Moderate
Frequently asked questions
Can I take Bupivacaine with Captopril?
MediHelp rates the interaction as moderate. Bupivacaine and Captopril can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Neuraxial bupivacaine blocks sympathetic tone and can cause hypotension, and patients on ACE inhibitors may have exaggerated drops in blood pressure during anesthesia. Systemic effects from local infiltration are minimal.
How serious is the interaction between Bupivacaine and Captopril?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Inform the anesthesia team of ACE inhibitor use and monitor blood pressure closely during neuraxial block. Treat hypotension with fluids or vasopressors.
What other medicines interact with Captopril?
MediHelp also lists interactions of Captopril with, for example, Aliskiren, Sacubitril / valsartan, Sacubitril-valsartan. The full list is on the Captopril page.
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