Contraindicated in:
- Hypersensitivity
- Bilateral renal artery stenosis
- History of angioedema with previous use of ACE inhibitors
- OB: Can cause injury or death of fetus – if pregnancy occurs, discontinue immediately..
- Concurrent use with aliskiren in patients with diabetes or moderate-to-severe renal impairment (CCr <60 mL/min)
- Lactation: Discontinue drug or use formula.
Use Cautiously in:
- Patients with renal impairment, hypovolemia, hyponatremia, and concurrent diuretic therapy
- Black patients (monotherapy for hypertension less effective, may require additional therapy; higher risk of angioedema)
- Surgery/anesthesia (hypotension may be exaggerated)
- Women of childbearing potential
- Pedi: Children <6 yr (safety not established)
- Geri: Initial dose ↓ recommended.
Exercise Extreme Caution in:
- Family history of angioedema.
CNS: dizziness, fatigue, headache, insomnia, weakness.
Resp: cough.
CV: hypotension, chest pain, edema.
GI: abdominal pain, diarrhea, nausea, vomiting.
GU: erectile dysfunction, impaired renal function.
Derm: rash.
F and E: hyperkalemia.
MS: muscle cramps.
Resp: dyspnea.
Misc: ANGIOEDEMA.
Therapeutic Classification: antihypertensives
Pharmacologic Classification: ace inhibitors
Absorption: 36% absorbed following oral administration.
Distribution: Crosses the placenta; enters breast milk in small amounts.
Protein Binding: 99.4%.
Metabolism/Excretion: Converted by the liver and GI mucosa to fosinoprilat, the active metabolite: 50% excreted in urine, 50% in feces.
Half-life: 12 hr.
(effect on BP — single dose†)
†Full effects may not be noted for several weeks.
6 yr and >50 kg): Hypertension — 5–10 mg once daily.