See Supplemental Patient Information
- Angioedema involving the extremities, face, lips, mucous membranes, tongue, glottis or larynx has been reported in patients treated with ACE inhibitors. If airway obstruction occurs, institute emergency therapy with epinephrine. Use with extreme caution in patients with hereditary angioedema
- Significant hypotension may occur after first dose, especially in patients with severe salt or volume depletion or those with CHF. Start therapy under close medical supervision in these patient groups
- ACE inhibitors can cause fetal morbidity/mortality if administered to pregnant women. When pregnancy is detected, discontinue therapy as soon as possible
- Captopril, another angiotensin converting enzyme inhibitor, has been shown to cause agranulocytosis and bone marrow depression. Risk increases with renal function impairment, CHF, SLE or other collagen vascular disease; significance unknown for fosinopril. Monitor WBCs in patients with collagen-vascular disease, especially if the disease is associated with impaired renal function
- Assess heart failure patients for evidence of worsening failure (evaluation of peripheral edema, shortness of breath). Increase in weight (eg, 2 pounds in 1 day or 5 pounds in 1 wk), worsening edema, shortness of breath are signs of worsening of heart failure
- Rarely, ACE inhibitors can cause cholestatic jaundice progressing to fulminant hepatic necrosis and (sometimes) death. Discontiune therapy if marked elevations of hepatic enzymes occur
- Monitor BUN/Cr at baseline, then periodically, or more frequently if CHF, renal artery stenosis
- Monitor electrolytes and BP periodically
- Monitor WBC with differential count at baseline if collagen vascualr disease and renal impairment
Cautions: Use cautiously in
- Renal impairment
- Renal artery stenosis
- Severe hepatic impairment
- CAD
- Severe CHF
- Aortic stenosis
- Cerebrovascular disease
- Collagen vascular disease
- Hypotension
- Hyponatremia
- Volume depletion
- Severe CHF
- Hypertrophic cardiomyopathy
- Elderly patients
- Black patients
Supplemental Patient Information
- Instruct patients not to use potassium supplements or salt substitutes containing potassium without consulting the physician
Pregnancy Category:C (D in second and third trimesters)
Breastfeeding: Safety unknown, alternate drugs might be preferred, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 1 June 2010).
US Trade Name(s)
US Availability
fosinopril (generic)
Monopril
Canadian Trade Name(s)
Canadian Availability
fosinopril (generic)
Monopril
UK Trade Name(s)
UK Availability
fosinopril (generic)
Straril
Australian Trade Name(s)
Australian Availability
fosinopril (generic)
Fosipril, Monace, Monopril
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Monopril 40 MG TABS [Bottle] (B-M SQUIBB U.S. (PRIMARY CARE))
60 mg = $97.99
180 mg = $279.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
