fosinopril sodium, Monopril
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: fosinopril sodium
BRAND NAME: Monopril
DRUG CLASS AND MECHANISM: Fosinopril is in a class of drugs called angiotensin converting enzyme (ACE) inhibitors. ACE inhibitors are used for treating high blood pressure, heart failure and for preventing kidney failure due to high blood pressure and diabetes. Other ACE inhibitors include enalapril (Vasotec), quinapril (Accupril), captopril (Capoten), ramipril (Altace), benazepril (Lotensin), lisinopril (Zestril, Prinivil), moexipril (Univasc) and trandolapril (Mavik). ACE is an enzyme in blood which controls the formation of angiotensin II, a chemical that circulates in blood and causes constriction of arteries and veins. Constriction of arteries and veins elevates blood pressure. ACE inhibitors inhibit ACE and block the formation of angiotensin II. By blocking the formation of angiotensin II, fosinopril relaxes the arteries and veins and lowers blood pressure. By reducing blood pressure, fosinopril also reduces the work that the heart must do to pump blood through the arteries and veins. This improves the output of blood from the heart especially when the heart is failing. The FDA approved fosinopril in May 1991.
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 10, 20, and 40 mg
STORAGE: Tablets should be stored between 15-30 C (59-86 F).
PRESCRIBED FOR: Fosinopril is used for treating high blood pressure. Its blood pressure lowering effect can be further enhanced by adding a diuretic medication ("water pill") such as hydrochlorothiazide. Fosinopril also is used for the treatment of congestive heart failure, a condition in which the heart is not able to pump enough blood, and fluid collects within the body. In patients with congestive heart failure, the ACE inhibitor class of medications has been shown to reduce symptoms and hospitalization and to improve survival. After a heart attack, ACE inhibitors improve the function of the damaged heart and reduce symptoms and hospitalizations due to congestive heart failure.
DOSING: The recommended adult dose for treating hypertension or heart failure is 10-40 mg once or twice daily. The maximum dose is 80 mg daily. Fosinopril is generally prescribed once daily, although some patients may need two doses per day. Patients with reduced kidney function need lower doses since their kidneys do not eliminate fosinopril from the body as well as normal kidneys. Fosinopril may be taken with or without food.
DRUG INTERACTIONS: Combining fosinopril with potassium supplements, potassium containing salt substitutes, or potassium-conserving diuretics such as amiloride (Moduretic), spironolactone (Aldactone), and triamterene (Dyazide, Maxzide), can lead to dangerously high blood levels of potassium (hyperkalemia) since fosinopril has a tendency to reduce the excretion of potassium. Fosinopril should not be taken at the same time as aluminum or magnesium-based antacids, such as simethicone (Mylanta, Gas-X, etc.) or Maalox since these antacids bind fosinopril and decrease the amount of fosinopril that is absorbed from the intestine. Patients should take antacids and fosinopril at least two hours apart.
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