Home Drug Guide Moexipril Hydrochloride and Hydrochlorothiazide

Drug Guide

Generic Name

Moexipril Hydrochloride and Hydrochlorothiazide

Brand Names Uniretic, Moexipril Hydrochloride and Hydrochlorothiazide

Classification

Therapeutic: Antihypertensive

Pharmacological: ACE inhibitor and thiazide diuretic combination

FDA Approved Indications

  • Hypertension

Mechanism of Action

Moexipril is an angiotensin-converting enzyme (ACE) inhibitor that decreases angiotensin II, leading to vasodilation and decreased aldosterone secretion. Hydrochlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, increasing the excretion of sodium, chloride, and water.

Dosage and Administration

Adult: Typically one tablet once daily, titrated as needed based on blood pressure response.

Pediatric: Not approved for pediatric use.

Geriatric: Start at lower doses due to potential for increased sensitivity and risk of hypotension.

Renal Impairment: Use caution; dosage adjustments may be necessary.

Hepatic Impairment: Use with caution; monitor closely.

Pharmacokinetics

Absorption: Well absorbed from the gastrointestinal tract.

Distribution: Widely distributed; crosses the placenta but not significantly into breast milk.

Metabolism: Moexipril is a prodrug converted in the liver; hydrochlorothiazide is minimally metabolized.

Excretion: Excreted primarily via the kidneys.

Half Life: Moexipril approximately 2 hours; active metabolite approximately 3-6 hours; hydrochlorothiazide approximately 6-15 hours.

Contraindications

  • History of angioedema related to previous ACE inhibitor therapy.
  • Concomitant use with aliskiren in patients with diabetes or renal impairment.
  • Allergy to sulfonamides (hydrochlorothiazide).

Precautions

  • Pregnancy (category D), lactation, bilateral renal artery stenosis, electrolyte disturbances, history of hypersensitivity to sulfonamides.

Adverse Reactions - Common

  • Dizziness (Common)
  • Hypotension (Common)
  • Hypokalemia or Hyperkalemia (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Angioedema (Rare)
  • Hepatic failure (Rare)
  • Electrolyte disturbances leading to arrhythmias (Rare)
  • Neutropenia or agranulocytosis (Rare)

Drug-Drug Interactions

  • Other antihypertensives, potassium-sparing diuretics, lithium, nonsteroidal anti-inflammatory drugs (NSAIDs).

Drug-Food Interactions

  • Excessive potassium intake may increase risk of hyperkalemia.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, renal function, serum electrolytes.

Diagnoses:

  • Risk for hypotension
  • Electrolyte imbalance

Implementation: Administer as prescribed, monitor BP and labs regularly, educate patient about symptoms of hypotension and electrolyte disturbances.

Evaluation: Assess for desired blood pressure reduction and absence of adverse effects.

Patient/Family Teaching

  • Take medication consistently, even if feeling well.
  • Report signs of angioedema, persistent cough, hyperkalemia.
  • Avoid potassium supplements and salt substitutes containing potassium.
  • Notify provider if pregnant or planning to become pregnant.

Special Considerations

Black Box Warnings:

  • Pregnancy: can cause injury and death to the developing fetus (discontinue as soon as pregnancy is detected).

Genetic Factors: Sensitivity varies based on genetic background affecting drug metabolism and response.

Lab Test Interference: Hydrochlorothiazide may interfere with glucose and uric acid measurements.

Overdose Management

Signs/Symptoms: Severe hypotension, electrolyte disturbances.

Treatment: Discontinue medication, supportively manage hypotension with IV fluids or vasopressors as needed, monitor electrolytes closely.

Storage and Handling

Storage: Store at room temperature away from moisture, heat, and light.

Stability: Stable in original container for at least 24 months.

🛡️ 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.