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Q:

Isn't Captopril a diuretic and therefore something we should avoid?

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Dr David Goldfarb answers: Captopril (brand name Capoten) is not really a diuretic, though it may increase urine output in some patients, especially with heart disease, and can potentiate the effect of some diuretics. It lowers blood pressure and has beneficial effects on the kidneys for people with decreased kidney function and a tendency to progressively lose kidney function (like diabetes), which most people with cystinuria don't have. It also happens to have a sulfhydryl group, which combines with the sulfhydryl groups in cystine to help solubilize the latter. The literature on its benefit is very spotty, with claims both ways. It's reasonable to use it though its effect is probably small and my own feeling is that urinary cystine levels should be measured to show the benefit or its not worth continuing. But if you think its helping continue it anyway! It is absolutely contraindicated in women who might conceive while taking it. It won't affect your ability to conceive later, it ... more
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