FOSINOPRIL BRANDS IN KENYA
Monopril® , Bristol-Myers Squibb
Fosinopril Mode Of Action:
ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor substance, angiotensin II. Angiotensin II also stimulates aldosterone secretion by the adrenal cortex. Inhibition of ACE results in decreased plasma angiotensin II, which leads to decreased vasopressor activity and to decreased aldosterone secretion. The latter decrease may result in a small increase of serum potassium.
FOSINOPRIL INDICATIONS:
Hypertension
Fosinopril is indicated in adults for the treatment of hypertension. Fosinopril may be used alone as initial therapy or in combination with other antihypertensive agents . The antihypertensive effects of fosinopril and diuretics used concomitantly are approximately additive.
Heart Failure
Fosinopril is indicated for adults for the treatment of heart failure in combination with a non-potassium sparing diuretic and where appropriate, digitalis. In these patients, fosinopril improves symptoms and exercise tolerance, reduces severity of heart failure and decreases the frequency of hospitalisation for heart failure.
FOSINOPRIL CONTRAINDICATIONS:
Fosinopril is contraindicated in patients who are hypersensitive to this product or to any other angiotensin-converting enzyme inhibitor (e.g., a patient who has experienced angioedema with any other ACE inhibitor therapy).
Do not co-administer fosinopril with aliskiren in patients with diabetes.
FOSINOPRIL DRUG INTERACTIONS:
Patients on diuretics, especially those with intravascular volume depletion, may occasionally experience an excessive reduction of blood pressure after initiation of therapy with fosinopril.
Coadministration of fosinopril with potassium sparing diuretics, potassium supplements, potassium-containing salt substitutes or other drugs that raise serum potassium levels may result in hyperkalemia. Monitor serum potassium in such patients.
Increased serum lithium levels and symptoms of lithium toxicity have been reported in patients receiving ACE inhibitors during therapy with lithium.
Coadministration of an antacid (aluminum hydroxide, magnesium hydroxide, and simethicone) with fosinopril reduced serum levels and urinary excretion of fosinoprilat as compared with fosinopril administrated alone, suggesting that antacids may impair absorption of fosinopril. Therefore, if concomitant administration of these agents is indicated, dosing should be separated by 2 hours.
Nitritoid reactions (symptoms include facial flushing, nausea, vomiting, and hypotension) have been reported rarely in patients on therapy with injectable gold (sodium aurothiomalate) and concomitant ACE inhibitor therapy including fosinopril sodium.
In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including fosinopril, may result in deterioration of renal function, including possible acute renal failure.
Patients taking concomitant mTOR inhibitor (e.g. temsirolimus) therapy may be at increased risk for angioedema.
Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy.
Concomitant use of ACE inhibitors with sacubitril/valsartan is contraindicated as this increases the risk of angioedema
Concomitant administration of immunosuppressants with fosinopril may lead to an increased risk of leukopenia.
Fosinopril may cause a false low measurement of serum digoxin levels with assays using the charcoal absorption method for digoxin. Other kits which use the antibody coated-tube method may be used instead. Therapy with fosinopril should be interrupted for a few days before carrying out tests for parathyroid function.
FOSINOPRIL ADVERSE DRUG REACTIONS:
General: Chest pain, edema, weakness, excessive sweating.
Cardiovascular: Angina/myocardial infarction, cerebrovascular accident, hypertensive crisis, rhythm disturbances, palpitations, hypotension, syncope, flushing, claudication.
Orthostatic hypotension occurred in 1.4% of patients treated with fosinopril monotherapy. Hypotension or orthostatic hypotension was a cause for discontinuation of therapy in 0.1% of patients.
Dermatologic: Urticaria, rash, photosensitivity, pruritus.
Endocrine/Metabolic: Gout, decreased libido.
Gastrointestinal: Pancreatitis, hepatitis, dysphagia, abdominal distention, abdominal pain, flatulence, constipation, heartburn, appetite/weight change, dry mouth.
Hematologic: Lymphadenopathy.
Immunologic: Angioedema .
Musculoskeletal: Arthralgia, musculoskeletal pain, myalgia/muscle cramp.
Nervous/Psychiatric: Memory disturbance, tremor, confusion, mood change, paresthesia, sleep disturbance, drowsiness, vertigo.
Respiratory: Bronchospasm, pharyngitis, sinusitis/rhinitis, laryngitis/hoarseness, epistaxis. A symptom-complex of cough, bronchospasm, and eosinophilia has been observed in two patients treated with fosinopril.
Special Senses: Tinnitus, vision disturbance, taste disturbance, eye irritation.
Urogenital: Renal insufficiency, urinary frequency.
Reporting of suspected adverse reactions:
The PPB Department of Pharmacovigilance was set up with a vision to develop, implement and continuously upgrade an appropriate system for detecting, reporting, and monitoring adverse drug reactions (ADRs) and other relevant problems with medicines in Kenya. The department strives to ensure the safety and efficacy of pharmaceutical products in Kenya.
Reporting suspected adverse reactions after authorization of the medicinal product are important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals/ Patients are encouraged to report any suspected adverse reactions via Pharmacovigilance Yellow Form, pv@pharmacyboardkenya.org or clicking below button:
Where to get Fosinopril in Kenya
Fosinopril can be purchased with a valid Prescription from Registered  Chemists in Kenya
Price/ Cost of Fosinopril In Kenya
Fosinopril in Kenya
Fosinopril in Kenya
Clinical | Pharmacokinetic data
Pregnancy Category:
Routes of Administration: Oral
Bioavailability: ~36%
Protein Binding: 87% (fosinoprilat)
Metabolosim: Hepatic, GIT mucosa (to fosinoprilat)
Onset of Action:
Elimination Half life: 12 hours (fosinoprilat)
Excretion: Renal
Legal Status | Dosage forms & Strengths
Prescription Category:
Prescription only Medicine (POM) , â„ž-only
Narcotic Drugs and Psychotropic Substances (Control ) Act Schedule:
This Drug is not Subject to DDA drugs Act
Dosage Forms | Strengths:
Tablets
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Drug Images
References/ Citation:
- Pilote L, Abrahamowicz M, Eisenberg M, Humphries K, Behlouli H, Tu JV (May 2008). “Effect of different angiotensin-converting-enzyme inhibitors on mortality among elderly patients with congestive heart failure”. CMAJ. 178 (10): 1303–11.