Previously sublingual captopril was given to lower blood pressure in the emergency room. But several cases of large cerebral stroke are reported and it is no longer used worldwide. But in developing countries and peripheral rural areas, it is still used by those physicians who don’t have the means to get the latest information, either electronically, online or via post. In Pakistan Institute of Medical Sciences, In the department of general medicine, in the period of 1 year, I have seen 12 patients with a major stroke in my department who had taken sublingual captopril prior to presentation. 4 out of 12 passed away. Today again a lady presented with a major stroke and she was on sublingual captopril on need basis for her hypertension, she had stroke 2 times in the past and this was her 3rd presentation and this time she couldn’t recover. Dr. Rauf Niazi, while rounding urged on banning the captopril sublingual use.
Sublingual captopril may drastically and suddenly lower the blood pressure which causes a sudden drastic decrease in blood flow to the brain and result in infarction. Sometimes patient able to recover and sometimes he can not especially when he also had got his routine blood pressure medications with suboptimal response.
Sublingual Captopril (Capoten) causes Major stroke and may cause death. No longer recommended.
