fosinopril sodium, Monopril

  • Pharmacy Author:
    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: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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What is fosinopril sodium, and how does it work (mechanism of action)?

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.

Is fosinopril sodium available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for fosinopril sodium?

Yes

What are the side effects of fosinopril sodium?

Fosinopril is generally well tolerated. The most common side effects are:

Sexual dysfunction and abnormal liver tests also occur. Impairment of kidney function has been reported with ACE inhibitors, especially in patients with severe heart failure or kidney disease.

Other important and serious side effects, although rare, include:

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What is the dosage for fosinopril sodium?

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.

Which drugs or supplements interact with fosinopril sodium?

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.

Fosinopril can cause an increase in the amount of lithium (Eskalith, Lithobid) in the body in patients taking lithium, sometimes causing lithium-associated side effects.

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, Medipren, Nuprin, PediaCare Fever, etc.), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effects of ACE inhibitors on blood pressure. Combining fosinopril or other ACE inhibitors with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who are elderly, volume-depleted (including those on diuretic therapy), or with poor kidney function may result in reduced kidney function, including kidney failure. These effects usually are reversible. Nitritoid reactions (symptoms include facial flushing, nausea, vomiting, and hypotension) may occur when injectable gold sodium aurothiomalate (Myochrysine), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors, including fosinopril.

Is fosinopril sodium safe to take if I'm pregnant or breastfeeding?

ACE inhibitors, including fosinopril, can be harmful to the fetus and should not be taken by pregnant women.

Fosinopril is secreted in breast milk and is not recommended for nursing mothers.

What else should I know about fosinopril sodium?

What preparations of fosinopril sodium are available?

Tablets: 10, 20, and 40 mg

How should I keep fosinopril sodium stored?

Tablets should be stored between 15-30 C (59-86 F).

Reference: FDA Prescribing Information

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Summary

Fosinopril sodium (Monopril) is an ACE inhibitor drug prescribed for the treatment of high blood pressure, congestive heart failure, and post-heart attack treatment. Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking any medication.

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Reviewed on 5/15/2015
References
Reference: FDA Prescribing Information

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