Drug Index


Mechanism :

Fosinopril is a phosphonic acid-containing ester prodrug that belongs to the angiotensin-converting enzyme (ACE) inhibitor class of medications. It is rapidly hydrolysed to fosinoprilat, its principle active metabolite. Fosinoprilat inhibits ACE, the enzyme responsible for the conversion of angiotensin I (ATI) to angiotensin II (ATII). ATII regulates blood pressure and is a key component of the renin-angiotensin-aldosterone system (RAAS).

Indication :

  • Mild to moderate hypertension

Contraindications :

Hypersensitivity, ACE inhibitor angioedema, Hereditary angioedema, Idiopathic angioedema.

Dosing :

Under 50 kg:
0.1-0.6 mg/kg orally once daily.
Over 50 kg:
5-10 mg orally once a day initially, Max: 40 mg/day.

Adverse Effect :

Common Reactions: Fatigue, hypotension, dizziness, cough, musculoskeletal pain, hyperkalemia, nausea/vomiting, elevated BUN, creatinine, photosensitivity, hyperuricemia.

Serious Reactions: Anaphylactoid reactions, neutropenia agranulocytosis, pancreatitis, Stevens-Johnson syndrome.

Interaction :

Potassium: Combining fosinopril with potassium supplements, potassium containing salt substitutes, or potassium-conserving diuretics such as amiloride, spironolactone and triamterene, can lead to dangerously high blood levels of potassium (hyperkalemia) since fosinopril tends to reduce the excretion of potassium.

Aluminium or Magnesium: Fosinopril should not be taken at the same time as aluminium or magnesium-based antacids, such as simethicone or Maalox since these antacids bind fosinopril and decrease the amount of fosinopril that is absorbed from the intestine.

Antacids: Patients should take antacids and fosinopril at least two hours apart.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function. Start with low dose
<10Dose as in normal renal function. Start with low dose

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in GFR<10 mL/min
HDNot dialysed. Dose as in GFR<10 mL/min
HDF/High fluxUnlikely to be dialysed. Dose as in GFR<10 mL/min
CAV/VVHDUnlikely to be dialysed. Dose as in GFR=10–20 mL/min

Hepatic Dose :

Fosinopril clearance is approximately one-half in patients with hepatic impairment. Treatment should be initiated at a lower dose.
03/21/2024 01:06:42 Fosinopril
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