Moexipril hydrochloride
Moexipril hydrochloride (Univasc)
Moexipril hydrochloride
(moh- EX-ih-prill)
Pregnancy Category: C (first trimester), D (second and third trimesters) Univasc (Rx)

Classification: Angiotensin-converting enzyme inhibitor

See Also: See also Angiotensin-Converting Enzyme Inhibitors .

Action/Kinetics: Converted in the liver to the active moexiprilat. Onset: 1-2 hr. Peak effect: 3-6 hr. Duration: 24 hr. Food decreases absorption of the drug. t 1/2, moexiprilat: 2-9 hr. About 50% is bound to plasma protein. Active metabolite is excreted through both the urine and feces.

Uses: Treatment of hypertension alone or in combination with thiazide diuretics.

Contraindications: In those with a history of angioedema as a result of previous treatment with ACE inhibitors.

Special Concerns: Use with caution during lactation, in clients with impaired renal function or renal artery stenosis, hyperkalemia, CHF, severe hepatic impairment, and volume depletion. Those who are salt or volume depleted are at a greater risk of developing hypotension. Safety and efficacy have not been determined in children.

Side Effects: GI: Abdominal pain, N&V;, diarrhea, dysgeusia, constipation, dry mouth, dyspepsia, pancreatitis, hepatitis, changes in appetite, weight changes. CNS: Insomnia, sleep disturbances, headache, dizziness, fatigue, drowsiness/sleepiness, malaise, nervousness, anxiety, mood changes. CV: Chest pain, hypotension, palpitations, angina pectoris, CVA, MI orthostatic hypotension, rhythm disturbances, peripheral edema. Respiratory: Cough, bronchospasm, dyspnea, URI, pharyngitis, rhinitis. GU: Oliguria, urinary frequency, renal insufficiency. Dermatologic: Flushing, rash, diaphoresis, photosensitivity, pruritus, urticaria, pemphigus. Musculoskeletal: Myalgia, arthralgia. Miscellaneous: Angioedema, neutropenia, syncope, anemia, tinnitus, flu syndrome, pain.

Drug Interactions: Diuretics / Excessive hypotension Lithium / Serum lithium levels lithium toxicity Potassium-sparing diuretics / Hyperkalemic effect of moexipril Potassium supplements / Hyperkalemic effect of moexipril

How Supplied: Tablet: 7.5 mg, 15 mg

Dosage
?Tablets Hypertension.
Initial, adults not receiving diuretics: 7.5 mg 1 hr before meals once daily. Dose is adjusted depending on response. Maintenance: 7.5-30 mg daily in one or two divided doses 1 hr before meals. Initial, adults receiving diuretics: Discontinue diuretic 2-3 days before beginning moexipril at a dose of 7.5 mg. If BP is not controlled, diuretic therapy can be resumed. If diuretic cannot be discontinued, give moexipril in an initial dose of 3.75 mg once daily 1 hr before meals. In those with impaired renal function, start with 3.75 mg once daily if C _CR is less than 40 mL/min/1.73 m ². The dose may be increased to a maximum of 15 mg/day.