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CARDIOVASCULAR SYSTEM › AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM › ACE INHIBITORS, COMBINATIONS › ACE inhibitors and diuretics
fosinopril and diuretics
C09BA09
Forms & Strengths
- Fosinopril sodium/Hydrochlorothiazide 10mg/12.5mg oral tablet
- Fosinopril sodium/Hydrochlorothiazide 20mg/12.5mg oral tablet
Adult Dosing
- Initial: 1 tablet daily, titrated based on clinical response
- Maximal dose: 20mg fosinopril / 25mg hydrochlorothiazide once daily
- Switch to combination therapy only after individual titration of components
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
Indications
- Treatment of hypertension, particularly in patients not adequately controlled on monotherapy
Mechanism of Action
- Fosinopril: ACE inhibitor preventing conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion
- Hydrochlorothiazide: Thiazide diuretic inhibiting sodium reabsorption in the distal renal tubules, increasing excretion of sodium, chloride, and water
Contraindications
- Hypersensitivity to fosinopril, other ACE inhibitors, sulfonamides, or any component
- History of angioedema related to previous ACE inhibitor therapy
- Hereditary or idiopathic angioedema
- Anuria
- Concomitant use with aliskiren in patients with diabetes mellitus
Adverse Reactions
- Dizziness
- Fatigue
- Cough
- Orthostatic hypotension
- Electrolyte disturbances (hypokalemia, hyponatremia, hyperuricemia)
- Hyperkalemia
- Elevated serum creatinine
- Angioedema
Drug Interactions
- Potassium-sparing diuretics and potassium supplements: increased risk of severe hyperkalemia
- Lithium: reduced lithium clearance leading to potential toxicity
- NSAIDs: potential attenuation of antihypertensive effect and increased risk of renal impairment
- Antidiabetic agents: thiazides may alter glucose tolerance, requiring dose adjustment
- Other antihypertensive agents: additive hypotensive effects
Curated Content: Needs Vetting Before Put to Clinical Use