| MOEXIPRIL HYDROCHLORIDE
Classifications: angiotensin-converting enzyme (ace) inhibitor; antihypertensive; Therapeutic: antihypertensive, ace inhibitor
Pregnancy Category: C first trimester; D second and third trimester
7.5 mg, 15 mg tablets
ACE inhibitor that results in decreased conversion of angiotensin I to angiotensin II. Results in decreased vasopressor
activity and aldosterone secretion. Lowering angiotensin II plasma levels results in blood pressure decreases and plasma
renin activity increases.
ACE inhibition and decreased aldosterone secretion are responsible for its antihypertensive effect.
CHF, left ventricular dysfunction.
Hypersensitivity to moexipril; history of angioedema related to an ACE inhibitor; pregnancy [(category C) first trimester;
(category D) second and third trimesters], lactation.
Hypersensitivity to any other ACE inhibitor; renal impairment, renal artery stenosis, volume-depleted patients; hypertensive
patient with CHF; history of autoimmune disease; severe liver dysfunction; immunosuppressed patients; hyperkalemia; patients
undergoing surgery/anesthesia; preexisting neutropenia; concurrent lithium therapy. Safety and efficacy in children are
Route & Dosage
Adult: PO 7.5 mg once/d, may increase up to 30 mg/d in divided doses
Clcr ≤40 mL/min: start with 3.75 mg q.d. (also if patient is volume depleted or
- Give 1 h before or 2 h after meals. Food greatly reduces absorption of moexipril.
- May need to reduce starting dose 50% in patients with possible volume depletion or a history of renal insufficiency.
- Store at 15°30° C (59°86° F).
Adverse Effects (≥1%)CNS:
drowsiness, sleep disturbances, nervousness, anxiety, mood changes. CV:
Hypotension, chest pain, angina, peripheral edema, MI,
palpitations, arrhythmias. Endocrine:
Hyperkalemia. GI: Diarrhea
, nausea, dyspepsia, abdominal pain, taste disturbances, constipation
, vomiting, dry mouth, pancreatitis
Urinary frequency, increased BUN and serum creatinine
. Hematologic: Neutropenia
, hemolytic anemia
Cough, pharyngitis, rhinitis, flu-like symptoms
. Skin: Angioedema
(rare), rash, flushing.
may exacerbate cough. nsaid
s may reduce antihypertensive effects. May increase lithium
levels and toxicity
. potassium supplements
and potassium-sparing diuretics
may increase risk of hyperkalemia. Food:
Food greatly reduces absorption of moexipril.
Readily absorbed from GI tract; approximately 13% of active metabolite
reaches systemic circulation; absorption greatly
reduced by food. Onset:
1 h. Duration:
24 h. Distribution:
Approximately 50% protein bound. Metabolism:
In liver to moexiprilat (active metabolite
13% in urine, 53% in feces. Half-Life:
Assessment & Drug Effects
- Monitor closely for systematic hypotension that may occur within 13 h of first dose, especially in those with high
blood pressure, on a diuretic or restricted salt intake, or otherwise volume depleted.
- Monitor BP and HR frequently during initiation of therapy, whenever a diuretic is added, and periodically throughout therapy.
- Determine trough BP (just before next dose) before dose adjustments are made.
- Lab tests: Monitor serum electrolytes, WBC with differential, Hct and Hgb, UA, and kidney and liver function tests periodically
- Supervise therapeutic response closely in patients with CHF.
Patient & Family Education
- Report to physician immediately swelling around face or neck or in extremities.
- Report S&S of hypotension (e.g., dizziness, weakness, syncope); nonproductive cough; skin rash; flu-like symptoms; jaundice;
irregular heartbeat or chest pains; and dehydration from vomiting, diarrhea, or diaphoresis.
- Consult physician before using potassium-containing salt substitutes.