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MONOPRIL
generic name: fosinopril
Pharmacological category:
Hypotensive agent
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Reviews |
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Fosinopril |
Stroke. 2005 Mar;36(3):649-53.
Epub 2005 Feb 03.
Effects of fosinopril and pravastatin on carotid intima-media
thickness in subjects with increased albuminuria.
Asselbergs FW, van Roon AM, Hillege HL, de Jong PE, Gans
RO, Smit AJ, van Gilst WH; PREVEND IT Investigators.
Department of Clinical Pharmacology, University of Groningen, Antonius
Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
BACKGROUND AND PURPOSE: Elevated urinary albumin excretion (UAE) is associated
with an increased carotid intima-media thickness (IMT). Because angiotensin-converting
enzyme inhibitors as well as statins have been shown to lower UAE and the
progression of IMT, we assessed the effects of fosinopril and pravastatin
on carotid IMT in subjects with an increased UAE (15 to 300 mg/24 h). METHODS:
IMT was measured at the posterior wall of the left common carotid artery
using radio-frequency signal analysis obtained by M-mode ultrasonography.
642 subjects were double-blind randomized to fosinopril 20 mg or matching
placebo and to pravastatin 40 mg or matching placebo and were available
for intention-to-treat analysis. RESULTS: Mean age was 51+/-11 years, 65%
were male, the median UAE was 22.5 (15.5 to 40.8) mg/24 h, and the mean
IMT at baseline was 0.77+/-0.18 mm. The overall progression rate of IMT
in 4 years was 0.037+/-0.006 mm. No significant difference in IMT progression
was found between fosinopril, pravastatin, or matching placebo. IMT after
4 years was predicted by IMT at baseline, age, gender, pulse pressure, and
low-density lipoprotein cholesterol levels. Furthermore, a higher incidence
of clinical events was observed in subjects with an IMT >1 mm after a
mean follow-up of 46+/-7 months (hazard ratio, 3.13; 95% confidence interval,
1.59 to 6.16; P=0.001). CONCLUSIONS: In subjects with an increased UAE,
treatment with fosinopril and pravastatin showed no significant effect on
carotid IMT. Furthermore, an IMT <1 mm at baseline is an important indicator
for event-free survival
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Am Fam Physician. 2002 Aug 1;66(3):461-8.
Using ACE inhibitors appropriately.
Bicket
DP.
Family Practice Residency Program, University of Pittsburgh Medical
Center-McKeesport, Pennsylvania 15132, USA.
When first introduced in 1981, angiotensin-converting enzyme (ACE) inhibitors
were indicated only for treatment of refractory hypertension. Since then,
they have been shown to reduce morbidity or mortality in congestive heart
failure, myocardial infarction, diabetes mellitus, chronic renal insufficiency,
and atherosclerotic cardiovascular disease. Pathologies underlying these
conditions are, in part, attributable to the renin-angiotensin-aldosterone
system. Angiotensin II contributes to endothelial dysfunction. altered renal
hemodynamics, and vascular and cardiac hypertrophy. ACE inhibitors attenuate
these effects. Clinical outcomes of ACE inhibition include decreases in
myocardial infarction (fatal and nonfatal), reinfarction, angina, stroke,
end-stage renal disease, and morbidity and mortality associated with heart
failure. ACE inhibitors are generally well tolerated and have few contraindications.
(Am Fam Physician 2002;66:473.)
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Fundam Clin Pharmacol. 2002 Oct;16(5):353-60
FOSIDIAL: a randomised placebo controlled trial of the
effects of fosinopril on cardiovascular morbidity and mortality in haemodialysis
patients. Study design and patients' baseline characteristics
Zannad F, Kessler M, Grunfeld JP, Thuilliez C; FOSInopril
in DIALysis Investigators
Hypertension and Preventive Cardiology Division, Department of Cardiovascular
disease, and Centre d'Investigations Cliniques INSERM-CHU, Toul, France.
The prevalence of end stage renal disease (ESRD) is growing in western countries.
Patients with ESRD are more frequently elderly and diabetic and are exposed
to very high cardiovascular morbidity and mortality. The main aim of the
FOSIDIAL study is to assess the efficacy and safety of fosinopril, an angiotensin
converting enzyme (ACE) inhibitor, in reducing the mortality and cardiovascular
events in haemodialysis patients presenting with left ventricular hypertrophy.
A total number of 397 patients are included in the study. They are aged
50-80 years (average 66.7 years) and have been undergoing haemodialysis
for 4.8 years. All have left ventricular hypertrophy with cardiac mass index
> 100 g/m2 in women and > 130 g/m2 in men, measured within 3 months
prior to inclusion. Baseline cardiac mass index is 174 g/m2. After a 2 week
placebo period, the patients are randomised into two groups receiving either
fosinopril 5-20 mg/day, or a placebo for a duration of 24 months. The target
dose is reached at the sixth, seventh or eighth week of treatment. Depending
on tolerance, 300 patients reached the maximum recommended dose. Patients
are subsequently assessed clinically every 3 months until the end of the
study. The primary outcome is a composite endpoint of fatal and nonfatal
major cardiovascular events. Secondary endpoints are individual cardiovascular
events, event-free survival, overall mortality and all-cause hospitalisations.
The trial began in October 1998. All patients were included by December
2000 and follow-up is ongoing. The last visit for the last patient is scheduled
for 30 December 2002. We report here on the study design and the baseline
characteristics of the study population. |
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Drug information |
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| GENERIC NAME: fosinopril
sodium
BRAND NAME: Monopril
DRUG CLASS AND MECHANISM: Angiotensin converting enzyme
(ACE) is the enzyme in blood which controls the formation of angiotensin
II, a chemical in blood that causes constriction of arteries and veins.
Constriction of arteries and veins elevates blood pressure. Fosinopril
is in a class of drugs called ACE inhibitors which inhibit ACE and block
the formation of angiotensin II. By blocking the formation of angiotensin
II, fosinopril relaxes the arteries and veins and lowers blood pressure.
By reducing blood pressure, fosinopril also reduces the work that the
heart must do to pump blood through the arteries and veins. This improves
the output of blood from the heart.
PREPARATIONS: Tablets (white-to-off-white): 10mg (biconvex-diamond-shaped);
20mg (oval)
STORAGE: Tablets should be stored between 15 and 30°C
(86°F).
PRESCRIBED FOR: Fosinopril is used in treating high
blood pressure. Its blood pressure lowering effect can be further enhanced
by adding a diuretic medication ("water pill") such as hydrochlorothiazide.
Fosinopril also is used in the treatment of congestive heart failure,
a condition in which the heart is not able to pump enough blood. In patients
with congestive heart failure, the ACE inhibitor class of medications
has been shown to reduce symptoms and hospitalization and to improve survival.
After a heart attack, ACE inhibitors improve the function of the damaged
heart and reduce symptoms and hospitalizations due to congestive heart
failure.
DOSING: Fosinopril is generally prescribed once daily,
although some patients may need two doses per day. Patients with reduced
kidney function need lower doses since their kidneys do not eliminate
fosinopril from the body as well as normal kidneys Fosinopril may be taken
with or without food.
DRUG INTERACTIONS: Although the combination of ACE inhibitors
and diuretics is generally a favorable one (see above), fosinopril (and
other ACE inhibitors) can work "too well" with diuretics and
cause an excessive drop in blood pressure. This can cause symptoms of
weakness, dizziness, and light-headedness. This is most likely to occur
when patients already taking a diuretic start taking an ACE inhibitor.
Combining fosinopril with potassium supplements, potassium containing
salt substitutes, or potassium-conserving diuretics such as amiloride
(Moduretic), spironolactone (Aldactone), and triamterene (Dyazide, Maxzide),
can lead to dangerously high blood levels of potassium.
It is recommended that fosinopril not be taken at the same time as aluminum
or magnesium-based antacids, such as Mylanta or Maalox, since these antacids
decrease the amount of fosinopril that is absorbed from the intestine.
Patients should take antacids and fosinopril at least two hours apart.
Fosinopril can cause an increase in the amount of lithium in the body
in patients taking lithium, sometimes causing lithium- associated side
effects.
PREGNANCY: ACE inhibitors, including fosinopril, can
be harmful to the fetus and should not be taken by pregnant women.
NURSING MOTHERS: Fosinopril is secreted in breast milk
and is not recommended for nursing mothers.
SIDE EFFECTS: Fosinopril is generally well tolerated.
The most common side effects are headache, cough, dizziness, diarrhea,
fatigue, nausea, vomiting, complaints of sexual dysfunction, and abnormal
liver tests. Impairment of kidney function has been reported with ACE
inhibitors, especially in patients with severe heart failure or kidney
disease. In rare instances, low white blood cell counts have been reported
with the use of captopril, another ACE inhibitor. (Low white blood cells
increase a patient's risk of infections.)
Caution! Before starting
to take this medicine, it is vital that you should consult your doctor!
Do not use it on your own initiative, without medical advice. |
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Order now ! |
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MONOPRIL
Generic name: Fosinopril
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Dosage |
Packing |
Price |
Pay now |
10 mg |
28 tab |
USD 29.00 |
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20 mg |
28 tab |
USD 32.00 |
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