GENERIC NAME: fosinopril sodium
BRAND NAME: Monopril
DRUG CLASS AND MECHANISM: Angiotensin converting enzyme
(ACE) is
the enzyme in blood which controls the formation of angiotensin
II, a
chemical in blood that causes constriction of arteries and
veins.
Constriction of arteries and veins elevates blood pressure.
Fosinopril is
in a class of drugs called ACE inhibitors which 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.
PRESCRIPTION: yes
GENERIC AVAILABLE: no
PREPARATIONS: Tablets (white-to-off-white): 10mg
(biconvex-diamond-shaped); 20mg (oval)
STORAGE: Tablets should be stored between 15
and 30°C (86°F).
PRESCRIBED FOR: Fosinopril is used in 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 in the treatment of
congestive heart failure, a condition in which the heart is not
able to
pump enough blood. 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: 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: Although the combination of ACE
inhibitors
and diuretics is generally a favorable one (see above),
fosinopril (and
other ACE inhibitors) can work "too well" with
diuretics and
cause an excessive drop in blood pressure. This can cause
symptoms of
weakness, dizziness, and light-headedness. This is most likely
to occur
when patients already taking a diuretic start taking an ACE
inhibitor.
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.
It is recommended that fosinopril not be taken at the same
time as
aluminum or magnesium-based antacids, such as Mylanta or
Maalox, since
these antacids decrease the amount of fosinopril that is
absorbed from the
intestine. Patients should take antacids and fosinopril at
least two hours
apart. Fosinopril can cause an increase in the amount of
lithium in the
body in patients taking lithium, sometimes causing lithium-
associated side
effects.
PREGNANCY: ACE inhibitors, including fosinopril, can be
harmful
to the fetus and should not be taken by pregnant women.
NURSING MOTHERS: Fosinopril is secreted in breast milk
and is
not recommended for nursing mothers.
SIDE EFFECTS: Fosinopril is generally well tolerated.
The most
common side effects are headache, cough, dizziness, diarrhea,
fatigue,
nausea, vomiting, complaints of sexual dysfunction, and
abnormal liver
tests. Impairment of kidney function has been reported with ACE
inhibitors, especially in patients with severe heart failure or
kidney
disease. In rare instances, low white blood cell counts have
been reported
with the use of captopril, another ACE inhibitor. (Low white
blood cells
increase a patient's risk of infections.)
Last Editorial Review: 12/31/1997
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- ACE Inhibitors - Read about ACE inhibitors like Altace, lisinopril, enalapril, ramparil, Zestril and more. Information includes side effects, drug interactions, and pregnancy safety information.
- Kidney Failure - Learn about kidney failure, in which the body has fluid retention, risen blood pressure, toxin build up and lack of red blood cells. Symptoms include fatigue, nausea, and apetite loss.
- lisinopril, Zestril, Prinivil - Explains the medication lisinopril (Zestril, Prinivil) an ACE inhibitor drug used to treat elevated blood pressure and heart failure.
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