Captopril is a specific competitive inhibitor of angiotensin I-converting enzyme (ACE). During an episode of AD, 25mg of captopril is recommended for sublingual administration.
From one pre-post study (n=26) (Esmail et al. 2002), captopril was safe and effective in 4 out of 5 episodes for AD management. This prospective open labelled study and numerous experts’ opinion suggest the use of the captopril as a primary medication in management of AD (Consortium for Spinal Cord Medicine 2001; Frost 2002; Anton & Townson 2004).
- There is level 4 evidence (from one pre-post study) (Esmail et al. 2002) for the use of captopril in the acute management of AD in SCI.
Preliminary evidence suggests that captopril is effective for the management of AD in SCI.