II. Indications
- See ACE Inhibitor
III. Mechanism
- See ACE Inhibitor
- Phosphinic acid-containing Angiotensin Converting Enzyme (ACE) inhibitor
- Fosinopril is a prodrug, converted to its active form Fosinoprilat via hydrolysis by esterases
IV. Dosing: Adults
- Adequate 24 hour Blood Pressure control may require twice daily dosing
-
Hypertension
- Start 10 mg orally daily or divided twice daily
- Start 5 mg orally daily if elderly, renal dysfunction or concurrent Diuretic
- Target 20 mg to 40 mg/day
- Maximum 80 mg/day (no added benefit for doses >40 mg/day)
- Start 10 mg orally daily or divided twice daily
-
Congestive Heart Failure (CHF)
- Start 5 to 10 mg orally daily
- Target 20-40 mg/day
- Maximum: 40 mg/day
-
Diabetic Nephropathy (not FDA approved)
- Take 10 to 20 mg orally daily
V. Dosing: Children (age 6 to 16 years old, weight >=50 kg)
- Contraindicated in age <6 years old or weight <50 kg
-
Hypertension
- Give 5 to 10 mg orally daily
VI. Supplied
- Available as scored tablets (10 mg) and unscored tablets (20 and 40 mg)
VII. Metabolism
- Excretion both renal and hepatic
VIII. Adverse Effects
- See ACE Inhibitor
IX. Safety
- See ACE Inhibitor
- Pregnancy Category X
- Avoid in Lactation
X. Resources
XI. References
- (2016) Presc Lett, Resource #321151, ACE Inhibitor Antihypertensive Dose Comparison
- (2020) Med Lett Drugs Ther 62(1598): 73-80
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 68-9
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
Images: Related links to external sites (from Bing)
Related Studies
fosinopril (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
FOSINOPRIL SODIUM 10 MG TAB | Generic | $0.17 each |
FOSINOPRIL SODIUM 20 MG TAB | Generic | $0.17 each |
FOSINOPRIL SODIUM 40 MG TAB | Generic | $0.21 each |
FOSINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB | Generic | $0.32 each |
FOSINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB | Generic | $0.65 each |
Ontology: Fosinopril (C0118168)
Definition (NCI) | A phosphinic acid-containing angiotensin-converting enzyme (ACE) inhibitor with antihypertensive activity. As an ester prodrug, fosinopril is hydrolysed by esterases to its active metabolite fosinoprilat. Fosinoprilat specifically and competitively inhibits angiotensin-converting enzyme thereby decreasing the formation of the potent vasoconstrictor angiotensin II, resulting in diminished vasopressor activity. In addition, angiotensin II-mediated aldosterone secretion by adrenal cortex is decreased, which results in a decrease of sodium retention and an increase in water outflow. |
Definition (MSH) | A phosphinic acid-containing angiotensin-converting enzyme inhibitor that is effective in the treatment of hypertension. It is a prodrug that is converted to its active metabolite fosinoprilat. |
Concepts | Pharmacologic Substance (T121) , Organophosphorus Compound (T115) |
MSH | D017328 |
SnomedCT | 108569005, 372510000 |
LNC | LP171400-7 |
English | Fosenopril, Fosinopril, L-Proline, 4-cyclohexyl-1-(((2-methyl-1-(1-oxopropoxy)propoxy)(4-phenylbutyl)phosphinyl)acetyl)-, (1(S*(R*)),2alpha,4beta)-, fosinopril, Fosinopril [Chemical/Ingredient], FOSINOPRIL, Fosinopril (product), Fosinopril (substance) |
Swedish | Fosinopril |
Czech | fosinopril |
Finnish | Fosinopriili |
Russian | FOSENOPRIL, FOSINOPRIL, ФОСЕНОПРИЛ, ФОСИНОПРИЛ |
Japanese | ホセノプリル, ホシノプリル |
Italian | Fosenopril, Fosinopril |
Polish | Fozynopryl, Fosenopryl |
Spanish | fosinopril (producto), fosinopril (sustancia), fosinoprilo, fosinopril, Fosenopril, Fosinopril |
French | Fosénopril, Fosinopril |
German | Fosenopril, Fosinopril |
Portuguese | Fosenopril, Fosinopril |
Ontology: Monopril (C0728957)
Concepts | Amino Acid, Peptide, or Protein (T116) , Organophosphorus Compound (T115) , Pharmacologic Substance (T121) |
MSH | D017328 |
English | monopril, Monopril, Staril, Bristol Myers Squibb Brand of Fosinopril Sodium, Bristol-Myers Squibb Brand of Fosinopril Sodium, Fosinorm, Newace |