Adult Dosing
Hypertension
Patients not receiving diuretics
- Initial: 7.5 mg/day PO 1 hr before meals
- Titrate: May be increased to 30 mg/day divided qd-bid
- Max: 60 mg/day
Patients receiving diuretics
- Initial: 3.75 mg/day PO 1 hr before meals
- Titrate: Make subsequent adjustments according to blood pressure response
- Note: Discontinue diuretic therapy before starting therapy, if not possible then follow the starting doses mentioned above
Heart failure (Non-FDA Approved)
- Note that similar dosing to that used for hypertension is typically used for this indication
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
Renal Dose Adjustment (Based on CrCl)
40 mL/min: Start 3.75 mg PO qd. Max: 15 mg/day
Hepatic Dose Adjustment
- Hepatic impairment: Use with caution; dose adjustments not defined
- ACE inhibitors can cause fetal/neonatal morbidity/mortality when used in pregnancy during the second and third trimesters. Discontinue drug as soon as possible once pregnancy detected [US Black Box Warning]
- 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. If pregnancy is detected, discontinue therapy as soon as possible
- ACE inhibitors can cause cholestatic jaundice progressing to fulminant hepatic necrosis and sometimes death. Discontinue 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 vascular disease and renal impairment
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Renal artery stenosis
- CAD
- Hypotension
- Aortic stenosis
- Cerebrovascular disease
- Collagen vascular disease
- Hypotension
- Hyponatremia
- Volume depletion
- Severe CHF
- Hypertrophic cardiomyopathy
- Black patients
- Elderly patients
Pregnancy Category:C (first trimester); D (second and third trimesters)
Breastfeeding: Safety unknown. An alternate drug 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 3 June 2011). Manufacturer advises caution.
Pricing data from www.DrugStore.com in U.S.A.
- Univasc 15 MG TABS [Bottle] (SCHWARZ PHARMA)
30 mg = $85.99
90 mg = $229.96 - Univasc 7.5 MG TABS [Bottle] (SCHWARZ PHARMA)
30 mg = $61.99
90 mg = $164.97
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.
