Cilazapril - Effects | Dose | Use

This article was medically reviewed by M.Pharm, Marko Tanaskovic on August 12, 2018. To read more about an author, click here.

Cilazapril is the medicine from the group of medicines called ACE inhibitors (angiotensin converting enzyme inhibtors). This medicine works by expanding the blood vessels and therefore reduce blood pressure.

It is used to treat high blood pressure and heart failure.


Cilazapril should not be used during pregnancy and breastfeeding because it may harm your baby.

This drug cannot be used in patients who are allergic to cilazapril or other similar medicines such as:

  • enalapril,
  • ramipril,
  • captopril,
  • perindopril,
  • quinapril and others.

It cannot be used in patients with low blood pressure (hypotension). In these patients Cilazapril may cause a life-threatening hypotension.

Do not get up suddenly from a lying position, because then you may experience so-called orthostatic hypotension (dizziness when getting up to quickly from a lying position). If the patient loses consciousness, it is necessary to place the patient on a bed and raise his arms and legs.

Cilazapril cannot be used in patients with heart valve damage or aortic stenosis (narrowing of the aorta).

It cannot be used in patients with high level of potassium in the blood (hyperkalaemia). This medicament may increase potassium levels in the blood which can be life-threatening for these patients. High levels of potassium in the blood lead to heart disorders (heart arrhythmias).

Some of the medicines, as well as Cilazapril, can increase potassium level in the blood such as:

  • Diclofenac (Diklofen),
  • Ibuprofen (Brufen),
  • Ketoprofen,
  • Flurbiprofen,
  • Meloxicam (Movalis),
  • Spironolactone,
  • Traimteren,
  • Amiloride.

Concomitant use of Cilazapril tablets with these medicines can lead to dangerous increase of the potassium level in the blood and cardiac arrhythmias (irregular heartbeat).

It must be used with great caution in patients with kidney or liver disorders.

If you are planning surgery, tell your doctor that you are using Cilazapril.

Use during pregnancy and breast-feeding

It should not be used during pregnancy because it may harm the fetus.

Avoid breast-feeding while using this drug. Instead of breastfeeding your baby, you can give your baby formula milk.

How to use

The treatment should begin with lower doses (Cilazapril 1 mg). Dose can be gradually increased until you reach the desired effect. Usual dose to treat high blood pressure is 2.5 mg-5 mg per day. It should be taken once a day, every day at the same time.

Initial dose in the treatment of heart failure is 0.5 mg per day, for one week. The dose should be then increased up to 2.5 mg per day.

In patients with liver or kidney disorders, the dose should be reduced.

Cilazapril can be taken regardless of food, although it is recommended to take an hour before a meal.

Swallow the tablet whole. Do not crush or chew the tablet, because it can decrease the efficacy of Cilazapril.

It cannot be used in combination with the alcoholic beverages, because alcohol affects the efficacy of Cilazapril.

Use with other medicines (Interactions)

Cilazapril cannot be used in combination with the following medicines:

  • Non-steroidal anti-inflammatory medicines, used to treat pain and rheumatism such as:
    • diclofenac (Diklofen),
    • ibuprofen (Brufen),
    • ketoprofen,
    • flurbiprofen,
    • sulindac,
    • meloxicam and others. Concomitant use of these medicines can lead to dangerous arrhythmias (irregular heartbeat).
  • Potassium preparations. Concomitant use of Cilazapril tablets with these preparations can lead to the dangerous arrhythmias (irregular heartbeat).
  • Potassium-sparing diuretics (water pills), such as:
    • spironolactone,
    • traimteren,
    • amiloride. Concomitant use of these medicines can lead to dangerous increase in potassium level in the blood and dangerous arrhythmias.
  • Lithium, used to treat depression. Concomitant use of these medicines with lithium may lead to increasing lithium level in the blood.
  • Tricyclic antidepressants, used to treat depression such as:
    • amitriptyline,
    • nortriptyline,
    • imipramine and others.
  • Gold preparations, used in the treatment of rheumatism. Concomitant use of Cilazapril tablets with these preparations leads to following side effects:
    • nausea,
    • vomiting,
    • low blood pressure.
  • Ephedrine, pseudoephedrine. These medicines may decrease the efficacy of Cilazapril tablets.
  • Medicines used to treat diabetes such as insulin.

Tell your doctor about all medications and herbal medicines you are taking.

Cilazapril side effects

Cilazapril may cause the following side effects:

  1. dry cough (occurs very often),
  2. nausea (occurs frequently),
  3. vomiting,
  4. diarrhea,
  5. abdominal pain,
  6. loss of appetite,
  7. taste changes,
  8. dizziness,
  9. headache (occurs frequently),
  10. chest pain,
  11. rapid heartbeat (tachycardia),
  12. hypotension (low blood pressure),
  13. dry mouth,
  14. photosensitivity (increased sensitivity to sunlight),
  15. low white blood cell count (leucopenia),
  16. low blood platelet count (thrombocytopenia),
  17. muscle pain,
  18. joint pain,
  19. impotence,
  20. gynecomastia (breast enlargement in men),
  21. redness,
  22. allergy and others.

Tell your doctor if you experience any side effect.

Information on this website are provided for educational purposes only and are not intended for medical advice, diagnosis or treatment.

If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional.

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