Moexipril


Generic Medicine Info
Indications and Dosage
Oral
Hypertension
Adult: Initially, 7.5 mg once daily, 1st dose preferably at bedtime to avoid precipitous fall in BP. Maintenance: 7.5-30 mg/day in 2 divided doses if control w/ single dose admin is insufficient. Patients on diuretics: Initially, 3.75 mg once daily.
Elderly: Initially, 3.75 mg once daily.
Renal Impairment
CrCl Dosage
≤40 Initially, 3.75 mg once daily. Max: 15 mg once daily.
Hepatic Impairment
Initially, 3.75 mg once daily.
Administration
Should be taken on an empty stomach. Take 1 hr before meals.
Contraindications
History of hypersensitivity or angioedema related to previous treatment w/ ACE inhibitors. Hereditary/idiopathic angioneurotic oedema. Concomitant use w/ aliskiren in patients w/ DM. Pregnancy.
Special Precautions
Collagen vascular disease, hypovolaemia, renal artery stenosis (unilateral or bilateral), aortic or mitral valve stenosis, volume and/or salt depletion. Renal impairment. Lactation. Elderly.
Adverse Reactions
Cough, flu syndrome, pharyngitis, headache, dizziness, fatigue, flushing and rash. GI disturbances, myalgia, hyperkalaemia, hyponatraemia and hypotension.
Potentially Fatal: Anaphylactic reactions and angioedema. Fulminant hepatic necrosis.
Patient Counseling Information
May impair ability to drive or operate machinery.
Monitoring Parameters
Monitor BP, renal function, serum creatinine and K. Consider periodic monitoring of WBC in patients w/ collagen vascular disease and renal disease.
Overdosage
Symptoms: Severe hypotension, shock, stupor, bradycardia, electrolyte disturbances and renal failure. Management: Frequently monitor creatinine and serum electrolytes. Admin of absorbents if ingestion is w/in 1 hr. Consider angiotensin II infusion and/or IV catecholamines. Atropine should be used in the treatment of bradycardia or extensive vagal reactions. Pacemaker may also be considered.
Drug Interactions
Additive hyperkalaemic effects w/ K-sparing diuretics, K supplements, and other hyperkalaemic drugs. Concurrent treatment w/ NSAIDs reduces hypotensive action and increases the risk of nephrotoxicity. May increase nitritoid reactions of gold (Na aurothiomalate).
Potentially Fatal: Increased risk of hypotension, hyperkalaemia, and changes in renal function w/ aliskiren in patients w/ DM.
Food Interaction
Food may reduce absorption. May worsen HTN w/ licorice.
Action
Description: Moexipril, a prodrug of moexiprilat, is a competitive inhibitor of ACE. It prevents the conversion of angiotensin I to angiotensin II causing an increase in plasma renin activity and a reduction in aldosterone secretion. This promotes vasodilation and BP reduction.
Onset: Peak effect: 1-2 hr.
Duration: >24 hr.
Pharmacokinetics:
Absorption: Rapidly but incompletely absorbed from the GI tract. Reduced in the presence of food. Bioavailability: Approx 13% (moexiprilat). Time to peak plasma concentration: Approx 1.5 hr (moexiprilat).
Distribution: Volume of distribution: Approx 180 L (moexiprilat). Plasma protein binding: Moexipril (90%); moexiprilat (50-70%).
Metabolism: Metabolised to moexiprilat (active metabolite) in the GI mucosa and liver.
Excretion: Via urine (as moexiprilat, unchanged drug and other metabolites) and faeces (some moexiprilat). Elimination half-life: Approx 12 hr (moexiprilat).
Storage
Store between 20-25°C. Protect from excessive moisture.
References
Anon. Moexipril. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 25/11/2013.

Buckingham R (ed). Moexipril Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 25/11/2013.

McEvoy GK, Snow EK, Miller J et al (eds). Moexipril. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 25/11/2013.

Moexipril Hydrochloride. U.S. FDA. https://www.fda.gov/. Accessed 25/11/2013.

Wickersham RM. Moexipril Hydrochloride. Facts and Comparisons [online]. St. Louis, MO. Wolters Kluwer Clinical Drug Information, Inc. https://www.wolterskluwercdi.com/facts-comparisons-online/. Accessed 25/11/2013.

Disclaimer: This information is independently developed by MIMS based on Moexipril from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 MIMS. All rights reserved. Powered by MIMS.com
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