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CARDIOVASCULAR SYSTEM › AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM › ACE INHIBITORS, PLAIN › ACE inhibitors, plain
fosinopril
C09AA09
Forms & Strengths
- Oral tablets: 10 mg
- Oral tablets: 20 mg
- Oral tablets: 40 mg
Adult Dosing
- Hypertension: Initial 10-20 mg once daily; maintenance 10-40 mg daily as single or divided doses
- Heart Failure: Initial 10 mg once daily, titrated up to target 40 mg once daily as tolerated
Pediatric Dosing
- Safety and efficacy not established in pediatric patients
Indications
- Hypertension (monotherapy or in combination with other antihypertensives)
- Adjunctive therapy in heart failure
Mechanism of Action
- Competitive inhibition of angiotensin-converting enzyme (ACE), preventing conversion of angiotensin I to angiotensin II
- Decreases vasoconstriction and aldosterone secretion, lowering blood pressure and reducing cardiac workload
Contraindications
- History of angioedema related to previous ACE inhibitor therapy
- Hereditary or idiopathic angioedema
- Concomitant use with aliskiren in patients with diabetes mellitus
- Co-administration with sacubitril/valsartan (wait at least 36 hours after stopping)
Adverse Reactions
- Dizziness
- Headache
- Cough (dry, persistent)
- Hypotension
- Hyperkalemia
- Elevated serum creatinine
- Angioedema
Drug Interactions
- Potassium-sparing diuretics and potassium supplements (increased risk of hyperkalemia)
- Lithium (decreased renal clearance, leading to lithium toxicity)
- NSAIDs (may diminish antihypertensive effect and worsen renal function)
- Dual blockade of the renin-angiotensin system with ARBs or aliskiren (increased risk of hypotension, hyperkalemia, and renal impairment)
Curated Content: Needs Vetting Before Put to Clinical Use