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Fosinopril

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Fosinopril, Monopril

  • See Also
  1. ACE Inhibitor
  • Indications
  1. See ACE Inhibitor
  • Mechanism
  1. See ACE Inhibitor
  2. Phosphinic acid-containing Angiotensin Converting Enzyme (ACE) inhibitor
  3. Fosinopril is a prodrug, converted to its active form Fosinoprilat via hydrolysis by esterases
  • Dosing
  • Adults
  1. Adequate 24 hour Blood Pressure control may require twice daily dosing
  2. Hypertension
    1. Start 10 mg orally daily or divided twice daily
      1. Start 5 mg orally daily if elderly, renal dysfunction or concurrent Diuretic
    2. Target 20 mg to 40 mg/day
    3. Maximum 80 mg/day (no added benefit for doses >40 mg/day)
  3. Congestive Heart Failure (CHF)
    1. Start 5 to 10 mg orally daily
    2. Target 20-40 mg/day
    3. Maximum: 40 mg/day
  4. Diabetic Nephropathy (not FDA approved)
    1. Take 10 to 20 mg orally daily
  • Dosing
  • Children (age 6 to 16 years old, weight >=50 kg)
  1. Contraindicated in age <6 years old or weight <50 kg
  2. Hypertension
    1. Give 5 to 10 mg orally daily
  • Supplied
  1. Available as scored tablets (10 mg) and unscored tablets (20 and 40 mg)
  • Metabolism
  1. Excretion both renal and hepatic
  • Adverse Effects
  1. See ACE Inhibitor
  • Safety
  1. See ACE Inhibitor
  2. Pregnancy Category X
  3. Avoid in Lactation
  • Resources
  1. Fosinopril (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=736fe52f-69fb-48b2-b1c5-f06531878538
  • References
  1. (2016) Presc Lett, Resource #321151, ACE Inhibitor Antihypertensive Dose Comparison
  2. (2020) Med Lett Drugs Ther 62(1598): 73-80
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 68-9
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia