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Fosinopril information from DrugsUpdate  

See Available Brands of Fosinopril in India

P - Contraindicated in pregnancy
L - Contraindicated in lactation
LI - Lab *

Fosinopril is an angiotensin converting enzyme (ACE) inhibitor used for the treatment of hypertension and some types of chronic heart failure. Fosinopril is the only phosphonate-containing ACE inhibitor marketed. It is marketed by Bristol-Myers Squibb under the trade name Monopril.

Pharmacodynamics

Serum ACE activity was inhibited by ≥ 90% at 2 to 12 hours after single doses of 10 to 40 mg of Fosinopril. At 24 hours, serum ACE activity remained suppressed by 85%, 93%, and 93% in the 10, 20, and 40 mg dose groups, respectively.

Pharmacokinetics

Fosinopril competitively inhibits ACE from converting angiotensin I to angiotensin II resulting in decreased levels of angiotensin II which causes increased plasma renin activity and reduced aldosterone secretion. It also reduces sodium and water retention. By these mechanisms, fosinopril produces hypotensive effect.


Absorption 36% is absorbed from the GI tract (oral); peak plasma concentrations after 3 hr (fosinoprilat).


Distribution Protein-binding: >95% (fosinoprilat).


Metabolism Rapidly and completely hydrolysed to fosinoprilat (active metabolite) in GI mucosa and liver.


Excretion Urine and faeces. Elimination half-life: 11.5 hr (hypertensive patients), 14 hr (patients with heart failure).

Fosinopril Indications / Fosinopril Uses

Information Not Available

Fosinopril Adverse Reactions / Fosinopril Side Effects

Dizziness, orthostatic hypotension, palpitation, headache, weakness, fatigue, hyperkalaemia, chest pain, musculoskeletal pain, dry cough, nausea, vomiting, dyspepsia, diarrhoea. Potentially Fatal: Cerebrovascular accident, rhythm disturbances, palpitations, hypotension, syncope, rashes, oedema, hypersensitivity reactions, angioedema.

Precautions

Information Not Available

Special Precautions

Severely impaired renal function; hyperkalaemia, hypovolaemia, collagen vascular diseases, valvular stenosis; before, during or immediately after anaesthesia, unilateral renal artery stenosis.

Other Drug Interactions

Co-admin with diuretics may cause an excessive reduction of BP. Antacids may impair absorption of fosinopril. Potentially Fatal: Potassium loss caused by potassium-sparing diuretics or potassium supplements can increase the risk of hyperkalaemia. Increased serum lithium levels and toxicity.

Other Interactions

Information Not Available

Dosage

Oral Hypertension Adult: Initially, 10 mg once daily at bedtime. Maintenance: 10-40 mg once daily. In patients on diuretic therapy, diuretic should be withdrawn, if possible, a few days before starting fosinopril and restarted later if needed. Oral Heart failure Adult: Initially, 10 mg once daily. May increase gradually. Max: 40 mg once daily. For patients at high risk of hypotension, 5 mg once daily may be given as an initial dose.

Food(before/after)

Should be taken on an empty stomach. (Best taken 1 hr before meals. May be taken w/ meals to reduce GI discomfort.)

List of Contraindications

Fosinopril and Pregnancy

Contraindicated in pregnancy Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus. In 2nd & 3rd trimesters: Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective)

Fosinopril and Lactation

Contraindicated in lactation

Fosinopril and Children

The antihypertensive effects of Fosinopril have been evaluated in a double-blind study in pediatric patients 6 to 16 years of age. The pharmacokinetics of Fosinopril have been evaluated in pediatric patients 6 to 16 years of age (see CLINICAL PHARMACOLOGY, Pharmacokinetics and Metabolism). Fosinopril was generally well tolerated and adverse effects were similar to those described in adults.

Fosinopril and Geriatic

Clinical studies of Fosinopril sodium did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Fosinopril and Other Contraindications

Hypersensitivity, idiopathic or hereditary angioedema, history of angioedema related to previous treatment with an ACE inhibitor. Bilateral renal artery stenosis. Pregnancy (2nd and 3rd trimesters), lactation.

Storage

Oral Store at 20-25 ℃

Lab interference

Oral Store at 20-25 ℃

Fosinopril brands in India:

Fosinace Fovas

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