Cilazapril belongs to the family of medications known as ACE inhibitors. It is used to treat high blood pressure and congestive heart failure. Cilazapril controls blood pressure and reduces symptoms of congestive heart failure by relaxing blood vessels and by making the heart pump more efficiently.

For treatment of high blood pressure, cilazapril may be used alone or in combination with diuretics (water pills) known as thiazide diuretics (e.g., hydrochlorothiazide) when one medication has not been found to control blood pressure satisfactorily.

For treatment of congestive heart failure, cilazapril is used in addition to digoxin or thiazide diuretics or both.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The usual recommended doses range from 2.5 mg to 10 mg once daily, depending on the condition being treated as well as the person's kidney and liver function. The initial starting dose may be as low as 0.5 mg once daily. Cilazapril should be taken at the same time each day, with or without food.

The dose range for treatment of high blood pressure is 2.5 mg to 10 mg once daily.

The dose range for congestive heart failure is 2.5 mg to 5 mg once daily taken.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

This medication is available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms listed here. The forms available for the specific brand you have searched are listed under "What form(s) does this medication come in?"

1 mg
Each yellow, oval-shaped, single-scored, biconvex, film-coated tablet, imprinted "CIL 1", contains cilazapril 1 mg as cilazapril monohydrate. Nonmedicinal ingredients: cornstarch, hydroxypropyl methylcellulose, iron oxide, lactose, sodium stearyl fumarate, talc, and titanium dioxide.

2.5 mg
Each pinkish-brown, oval-shaped, single-scored, biconvex, film-coated tablet, imprinted "CIL 2.5", contains cilazapril 2.5 mg as cilazapril monohydrate. Nonmedicinal ingredients: cornstarch, hydroxypropyl methylcellulose, iron oxide, lactose, sodium stearyl fumarate, talc, and titanium dioxide.

5 mg
Each reddish-brown, oval-shaped, single-scored, biconvex tablet, imprinted "CIL 5", contains cilazapril 5 mg as cilazapril monohydrate. Nonmedicinal ingredients: cornstarch, hydroxypropyl methylcellulose, iron oxide, lactose, sodium stearyl fumarate, talc, and titanium dioxide.

Some medications may have other generic brands available. Always ask your doctor or pharmacist about the safety of switching between brands of the same medication.

Cilazapril should not be taken by anyone who:

• is allergic to cilazapril or to any ingredients of this medication
• is pregnant
• has a history of angioedema (a serious allergic reaction which causes the area around the throat and tongue to swell) after taking any ACE inhibitors
• has ascites (swollen abdomen due to liver problems)

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• cough (dry, persistent)
• diarrhea
• headache
• loss of taste
• nausea
• unusual tiredness
• weakness (loss of energy)

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Stop taking the medication and seek immediate medical attention if any of the following occur:

• difficulty swallowing or breathing (sudden)
• swelling of face, mouth, hands, or feet (signs of angioedema)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Angioedema: Angioedema is a serious allergic reaction that causes the area around the face, throat, and tongue to swell. It may occur with use of cilazapril. If you experience swelling of the face, tongue, or throat, stop taking cilazapril at once and get immediate medical attention. Other ACE inhibitors should not be taken in the future. People who have had angioedema caused by other substances may be at increased risk of angioedema while receiving cilazapril.

Cough: ACE inhibitors such as this medication may cause you to develop a dry, persistent cough within hours of the first dose to weeks or months after starting therapy. The cough usually resolves within 4 weeks of stopping this medication. Talk to your doctor if you develop a persistent, intolerable cough.

Fluid and electrolyte balance: Increases in blood levels of potassium occur for some people who take this medication. This rarely causes problems, but potassium levels should be monitored by your doctor. People with kidney disease or diabetes are at a higher risk of having increased blood potassium while taking cilazapril. These people should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Infection: Report any signs of infection such as sore throat or fever to your doctor.

Kidney function: Changes in kidney function have been noticed in certain people (e.g., people with narrowed blood vessels in their kidneys, or those with severe congestive heart failure). The use of diuretics (water pills) may further increase risk of kidney problems in those at risk for this problem. Let your doctor know if you notice any decreases in urine output or increases in the swelling of lower limbs, suggesting accumulation of fluid due to decreased urination.

Liver disease: This medication may worsen liver disease. People with liver disease or decreased liver function should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Low blood pressure: Occasionally, blood pressure drops too low after taking cilazapril. This usually happens after the first or second dose, or when the dose is increased. It is more likely to occur for people who take water pills, have a salt-restricted diet, are on dialysis, are suffering from diarrhea or vomiting, or have been sweating excessively and not drinking enough liquids. If low blood pressure causes you to faint or feel lightheaded, contact your doctor.

Pregnancy: This medication should not be taken by pregnant women. If you become pregnant, stop taking cilazapril at once and contact your doctor.

Breast-feeding: This medication passes into breast milk. This medication should not be taken by breast-feeding women. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of cilazapril have not been established for children. Its use by this age group is not recommended.

There may be an interaction between cilazapril and any of the following:

• allopurinol
• cyclosporine
• diuretics (e.g., hydrochlorothiazide, furosemide)
• insulin
• medications that lower blood pressure (e.g., beta-blockers such as propranolol or metoprolol)
• medications that increase potassium levels (e.g., potassium supplements, spironolactone, amiloride, triamterene, and salt substitutes containing potassium)
• nonsteroidal anti-inflammatory medications (NSAIDs; e.g., ibuprofen, indomethacin, naproxen)
• oral antidiabetes medication
• rituximab
• tetracyclines (e.g., tetracycline, minocycline, doxycycline)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.