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Captopril-Associated Cholestatic Jaundice

JAVED RAHMAT, M.D.; RICHARD L. GELFAND, M.D.; MICHAEL C. GELFAND, M.D.; JAMES F. WINCHESTER, M.D.; GEORGE E. SCHREINER, M.D.; and HYMAN J. ZIMMERMAN, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Michael C. Gelfand, M.D.; Division of Nephrology, Georgetown University Hospital, Room 2218, 3800 Reservoir Road, N.W.; Washington, DC 20007.


Washington, D.C.


© 1985 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1985;102(1):56-58. doi:10.7326/0003-4819-102-1-56
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Captopril, the competitive inhibitor of angiotensin-converting enzyme, is of considerable benefit in difficult-to-manage forms of hypertension. Its use has been associated with various untoward effects, but hepatic injury has not been widely reported. We treated a patient with captopril-associated cholestatic jaundice; a review of cases reported to the drug manufacturer and a review of the literature showed 13 additional cases of hepatic injury associated with captopril. In 9 of these the jaundice was categorized as cholestatic, and in 4 of the remaining 5 as mixed cholestatic-hepatocellular. These findings show that jaundice may be an idiosyncratic side effect of captopril, and that captopril-associated jaundice characteristically has strongly cholestatic features.

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