Frågedatum: 2001-10-15
RELIS database 2001; id.nr. 17763, DRUGLINE
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Can captopril (Capoten) cause enlargement of lymph nodes or thyroid gland?



Fråga: Can captopril (Capoten) cause enlargement of lymph nodes or thyroid gland?

Sammanfattning: There were two case reports suggesting captopril-related reversible lymphadenopathy with enlarged lymph nodes found in the literature. In addition, there are seven reports on captopril-associated lymphadenopathy in the WHO-database on adverse drug reactions. No information about captopril-induced effects on thyroid gland were found.

Svar: In FASS 2001, lymphadenopathy is described as a rare side effect of the angiotensin-converting enzyme (ACE) inhibitor captopril (1), but despite an extended literature search only sparse information about captopril-related effects on the lymphatic system was found. There are two case reports describing reversible lymphadenopathy in patients treated with captopril (2). A 37-year-old woman developed unspecified adenitis with painful enlarged lymph nodes in the groins, left axilla, and the neck after six weeks of treatment with captopril (300 mg daily). The symptoms disappeared within two weeks after discontinuation of treatment. A 47-year-old man got painful palpable lymph nodes in the groins, left axilla, and the back of the right knee after three months treatment with captopril (150 mg daily). The lymph nodes were not palpable one week after discontinuation of treatment (2). In the international WHO-database on adverse drug reactions, seven reports on captopril-related lymphadenopathy and another 16 reports on lymphadenopahy associated with other ACE inhibitors were found (3). It should be noted that the WHO database does not include a homogeneous evaluation of reported cases due to differences among reporting countries.

The producer of Capoten could not add any information about lymphadenopathy as a side effect of captopril (4).

No information about captopril-related effects on thyroid gland were found in the literature. In the WHO-database there are, however, two reports on thyroid disorder caused by the ACE-inhibitors lisinopril and ramipril respectively (3).

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