Fosinopril Sodium(foh sin’ oh pril)
Monopril
PREGNANCY CATEGORY D
Drug Classes
ACE inhibitor
Antihypertensive
Therapeutic Actions
Renin, synthesized by the kidneys, is released into the circulation where it acts on a plasma precursor to produce angiotensin I, which is converted by ACE to angiotensin II, a potent vasoconstrictor that also causes release of aldosterone from the adrenals; fosinopril blocks the conversion of angiotensin I to angiotensin II, leading to decreased BP, decreased aldosterone secretion, an increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synthesis may be involved in the antihypertensive action.
Indications
Treatment of hypertension, alone or in combination with thiazide-type diuretics
Management of heart failure as adjunctive therapy
Contraindications and Cautions
Contraindicated with allergy to fosinopril or other ACE inhibitors; pregnancy.
Use cautiously with impaired renal or hepatic function, hyperkalemia, salt or volume depletion, lactation.
Available Forms
Tablets—10, 20, 40 mg
Dosages
Adults
Hypertension: Initial dose, 10 mg PO daily. Maintenance dose, 20–40 mg/day PO as a single dose or two divided doses. In patients receiving diuretic therapy, begin fosinopril therapy with 10 mg. Do not exceed maximum dose of 80 mg.
Heart failure: Initially, 10 mg/day PO; observe for 2 hr for hypotension. If patient has moderate to severe renal failure, 5 mg/day PO. Do not exceed maximum dose of 40 mg/day.
Pediatric patients
Safety and efficacy not established.
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