Moexipril(mo ex’ ah pril)
Univasc
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. Both of these actions increase BP; moexipril blocks the conversion of angiotensin I to angiotensin II, leading to decreased BP, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synthesis may also be involved in the antihypertensive action.
Indications
Treatment of hypertension, alone or in combination with other antihypertensives such as thiazide-type diuretics
Contraindications and Cautions
Contraindicated with allergy to ACE inhibitors, impaired renal function, HF, salt or volume depletion, history of ACE inhibitor-induced angioedema, lactation, pregnancy.
Use cautiously with hepatic impairment and in elderly patients.
Available Forms
Tablets—7.5, 15 mg
Dosages
Adults
Patients not receiving diuretics: Initially, 7.5 mg PO daily, given 1 hr before a meal; for maintenance, 7.5–30 mg PO daily or in one to two divided doses 1 hr before meals.
Patients receiving diuretics: Discontinue diuretic for 2 or 3 days before beginning moexipril; follow dosage listed above, if BP is not controlled, diuretic therapy may be added. If diuretic cannot be stopped, start moexipril therapy with 3.75 mg and monitor for symptomatic hypotension.
Pediatric patients
Safety and efficacy not established.
Geriatric patients and patients with renal impairment
Excretion is reduced in renal failure; use with caution. If CrCl 40 mL/min or less, start with 3.75 mg PO daily, adjust up to a maximum of 15 mg/day.
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