Description
Fosinopril 10 mg Pharmacodynamics.
ACE inhibitor, has antihypertensive, vasodilatory, diuretic and potassium-saving effects. Reduces the formation of angiotensin II from angiotensin I, which leads to a decrease in total peripheral vascular resistance (TPR) and systemic blood pressure (BP). It suppresses aldosterone synthesis and inhibits tissue ACE. The hypotensive effect is also due to inhibition of bradykinin metabolism, which has a pronounced vasodilator effect. BP reduction is not accompanied by changes in circulating blood volume (CVC), cerebral and renal blood flow, blood supply of internal organs, skeletal muscles, skin, myocardial reflex activity. In arterial hypertension and left ventricular (LV) hypertrophy, treatment leads to a decrease in its mass and septal wall thickness. Long-term treatment does not lead to metabolic disorders. After oral administration, the hypotensive effect develops within 1 h, reaches a maximum after 3-6 h and lasts for 24 h. In heart failure, positive effects of Fosinopril are achieved mainly due to inhibition of renin-angiotensin-aldosterone system (RAAS). Suppression of ACE leads to a decrease of both preload and postload on the myocardium. The drug increases exercise tolerance and reduces the severity of heart failure.
Indications
Arterial hypertension (in monotherapy or in combination therapy);
Chronic heart failure (as part of combined therapy).
Contraindications
Hypersensitivity to fosinopril or to other components of Fosinopril 10 mg;
Pregnancy;
Lactation period (breast-feeding);
Lactose intolerance, lactase deficiency and glucose-galactose malabsorption syndrome;
Hereditary or idiopathic angioedema;
Angioneurotic edema against the background of ACE inhibitor therapy (history);
Under 18 years of age (safety and efficacy have not been studied);
Concomitant use with aliskiren and aliskiren-containing drugs in patients with diabetes mellitus and/or moderate to severe renal impairment (CK less than 60 ml/min).
Dosage and administration method
- Orally. The drug dosage should be chosen individually.
- Arterial hypertension. Recommended starting dose is 10 mg
- 1 time per day. The dose should be adjusted depending on the dynamics of BP decrease. Usual dose is 10 to 40 mg once a day. In the absence of sufficient hypotensive effect, additional prescription of diuretics is possible.
- If treatment with fosinopril is initiated against ongoing therapy with diuretics, the initial dose should not exceed 10 mg with careful medical monitoring of the patient.
- Chronic heart failure. The recommended initial dose is
- 5 mg once or twice daily (fosinopril in 10 mg tablets with a rice or in 5 mg tablets may be used). Depending on the therapeutic efficacy, the dose may be increased at weekly intervals up to a maximum of 40 mg once daily.
- Arterial hypertension and heart failure with impaired renal or hepatic function. As this medicine is eliminated from the body by two routes (through the intestine with bile and kidney), it is usually not required to reduce doses in patients with impaired renal or hepatic function.
- Elderly patients. There are no differences in efficacy and safety of drug treatment of patients aged 65 years and older and younger patients. However, it is impossible to exclude greater susceptibility to the drug in some elderly patients due to the possible overdose phenomena because of its slow excretion.
- The maximum daily dose for oral administration is 40 mg.