Home Drug Guide Fosinopril Sodium

Drug Guide

Generic Name

Fosinopril Sodium

Brand Names Monopril

Classification

Therapeutic: Antihypertensive

Pharmacological: ACE Inhibitor (Angiotensin-Converting Enzyme Inhibitor)

FDA Approved Indications

  • Hypertension
  • Heart failure (adjunctive therapy)

Mechanism of Action

Fosinopril inhibits angiotensin-converting enzyme, decreasing the conversion of angiotensin I to angiotensin II, leading to vasodilation, decreased blood volume, and reduced blood pressure.

Dosage and Administration

Adult: Initial dose typically 10-40 mg daily, single or divided doses. Dose adjustments based on response.

Pediatric: Limited data; not generally recommended for children.

Geriatric: Start at lower dose due to increased risk of hypotension and renal impairment.

Renal Impairment: Adjust dose based on renal function; monitor renal function closely.

Hepatic Impairment: Use caution; dose adjustment may be necessary, monitor hepatic function.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed including crossing the placental barrier.

Metabolism: Biotransformed in the liver (less extensive than other ACE inhibitors).

Excretion: Excreted primarily via urine and feces.

Half Life: Approximately 12 hours.

Contraindications

  • History of angioedema related to previous ACE inhibitor therapy
  • Hereditary or idiopathic angioedema
  • Bilateral renal artery stenosis
  • Hypersensitivity to fosinopril or other ACE inhibitors

Precautions

  • Pregnancy (teratogenic effects), Pregnant women should discontinue use; use only if clearly needed during pregnancy after evaluating risks.
  • History of renal impairment, Hyperkalemia, Renal artery stenosis, Volume depletion

Adverse Reactions - Common

  • Cough (Common)
  • Dizziness, hypotension (Common)
  • Headache (Common)
  • Fatigue (Common)

Adverse Reactions - Serious

  • Angioedema (Rare)
  • Elevated serum potassium (hyperkalemia) (Rare)
  • Renal function deterioration (Rare)

Drug-Drug Interactions

  • Diuretics, especially potassium-sparing ones
  • Other antihypertensives
  • Potassium supplements
  • Lithium
  • NSAIDs

Drug-Food Interactions

  • Limited data, but salt substitutes containing potassium should be used cautiously.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, renal function (BUN, serum creatinine), and serum electrolytes (potassium). Watch for signs of angioedema.

Diagnoses:

  • Ineffective tissue perfusion related to hypotension
  • Risk for electrolyte imbalance
  • Risk for renal insufficiently

Implementation: Administer drug as prescribed; monitor vital signs and labs frequently, especially at initiation and dose changes.

Evaluation: Assess blood pressure for therapeutic effect; monitor for adverse effects; evaluate renal function and electrolytes periodically.

Patient/Family Teaching

  • Take medication exactly as prescribed, at the same time each day.
  • Report signs of angioedema (swelling of face, lips, tongue, difficulty breathing).
  • Avoid potassium-rich salt substitutes unless directed by healthcare provider.
  • Notify healthcare provider if pregnancy is planned or suspected.
  • Monitor blood pressure regularly.

Special Considerations

Black Box Warnings:

  • Pregnancy—fetal injury and death when used during pregnancy.

Genetic Factors: Genetic variations can affect ACE inhibitor metabolism and response.

Lab Test Interference: May cause falsely elevated serum potassium and creatinine levels.

Overdose Management

Signs/Symptoms: Severe hypotension, reflex tachycardia.

Treatment: Discontinue medication; provide supportive care, monitor vital signs, administer IV fluids if needed, and consider vasopressor therapy.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable for at least 24 months when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.