"Fosinopril" is an angiotensin converting enzyme inhibitor. The drug has a hypotensive effect, which allows it to be used separately at high blood pressure and as part of complex therapy. In addition, the drug has a natriuretic, vasodilating and cardioprotective effect, it is used in combination with other medicines during the treatment of heart failure.
Pharmacological properties of Fosinopril
The drug "Fosinopril" in the body takes the form of an active metabolite, which inhibits the angiotensin-converting enzyme. The drug reduces the rate of formation of angiotensin 2, normalizes systemic blood pressure, positively affects the state of blood vessels.
The activity of the angiotensin-converting enzyme when using 10, 20 and 40 mg of the drug is significantly reduced on average in 7 hours (not faster than 2 hours, but no later than 12 hours after taking the medicine). Throughout the day, it remains reduced by 7-15%.
“Fosinopril” tablets make it possible to exclude myocardial hypertrophy and dilatation of the left ventricle, in the presence of such conditions they contribute to their elimination. The drug inhibits the formation of aldosterone, which is carried out in the adrenal glands, increases activity in the kallikrein-kinin system, stabilizes the content of bradykinin in tissues and blood. Thanks to the therapy based on the use of Fosinopril, the liberalization of substances that improve the blood supply to the kidneys, have a natriuretic, vasodilating effect increases. The medication helps to reduce the production of arginine-vasopressin and endothelin − 1, the action of which is vasoconstrictive.
With a decrease in pressure (diastolic, systolic), orthostatic reactions and postural tachycardia do not develop, bcc does not change. There are no changes in the reflex activity of the myocardium, renal and cerebral blood flow. There is no violation of the blood supply to the skin, internal organs, skeletal muscle tissue.
As the instructions for use show, Fosinopril, used in a single dose, has a hypotensive effect, which manifests itself most pronounced after about five hours. The effect obtained is preserved for a day, which allows you to constantly maintain normal blood pressure values. For the manifestation of the maximum possible effect, it takes several weeks to pass.
During treatment with Fosinopril for hypertension, it is possible to improve the body's response to a rapid decrease in systemic blood pressure. With complex therapy using thiazide diuretics and Fosinopril, a more pronounced antihypertensive effect occurs. If it is necessary to cancel Fosinopril, the withdrawal syndrome does not develop, it is absent even when the cancellation is abrupt. The drug improves the patient's condition with severe chronic heart failure, and the body's response to physical activity.
Regarding the manifestation of mutagenic and genotoxic properties during the treatment with the drug "Fosinopril", the instruction displays their absence. However, the use of cytotoxic doses leads to some abnormalities associated with chromosomal aberrations. Studies in mice and rats have shown that a daily dose of no more than 400 mg / kg does not cause signs of carcinogenicity. Due to the use of higher doses, omental lipomas often appeared in male rats. Daily doses of the drug up to 60 mg / kg in rats did not cause disorders associated with the implementation of reproductive function. When the drug was administered to pregnant rats (daily dose up to 400 mg / kg per day) and rabbits (daily dose up to 40 mg / kg), intoxication occurred, the drug negatively affected the course of pregnancy.
The absorption of “Fozinopril” is described by the instructions for use as slow, decreasing even more due to food intake. Due to the implementation of the presystemic metabolism, bioavailability is negligible (36%). "Fosinopril" is hydrolyzed, this process occurs in the blood, liver and gastrointestinal membrane, due to its implementation, fosinoprilat is formed, which is an active metabolite. The maximum level of medication in the body is detected on average three hours after its use. Half-life occurs in 12-15 hours. Communication with plasma is almost complete - up to 98%, the volume of distribution is small.
The medication does not violate the limits of the placental and blood-brain barriers, during the treatment period it is present in breast milk. With cirrhosis (alcoholic, biliary), clearance decreases, hydrolysis proceeds more slowly. With renal failure, there is a violation of the normal excretion of active diacid metabolites, the drug can accumulate in the body. The use of dialysis to remove the drug "Fozinopril" from the body displays the instructions for use as an action that does not lead to the desired result.
Indications for use of the drug "Fozinopril"
"Fosinopril" is prescribed for heart failure and hypertension. In the first case, the drug is the basis of additional therapy, in the second case it is used for the implementation of complex therapy and monotherapy.
Treatment with Fosinopril
Usually tablets are drunk once or twice a day at the same time. In the treatment of hypertension, it is first recommended to use 10 mg of the drug, later 20-40 mg. With combined treatment, when in addition to Fosinopril, a diuretic is used, 10 mg of the drug is taken. In this case, constant monitoring of blood pressure is required, the maximum possible dose of the drug is 80 mg per day. If you have missed taking the drug, the next dose is not doubled. The treatment is carried out using the doses recommended by the doctor, it is impossible to take a larger or smaller volume of the drug and increase the frequency of its use, nor can Fosinopril be discontinued without consulting a doctor.
Before taking the medicine "Fosinopril", the instruction recommends checking the degree of increase in blood pressure. When prescribing treatment, various clinical circumstances are taken into account, the doctor should regularly monitor the patient's condition.
To minimize the risk of developing symptomatic hypertension, small doses of the drug are recommended before bedtime. Antihypertensive treatment is canceled seven days before the start of Fozinopril therapy. If diuretic treatment was previously carried out, then in order to reduce the risk of symptomatic hypotension, the water-salt balance is adjusted, the dose of the diuretic is significantly reduced, in some cases, the drug is completely stopped (4-7 days before the first dose of “Fozinopril”).
After a myocardial infarction, therapy with the Fosinopril means allows to start the application in three days. During the treatment period, regular blood pressure measurement and verification of the peripheral blood picture are required (they are checked before therapy, monitored for 3-6 months of therapy, then they are checked annually, more frequent monitoring may be necessary if neutropenia is highly likely). In addition, it is necessary to control body weight, check the condition of the kidneys and the level of creatinine, potassium in the plasma, protein, and urea nitrogen level. During therapy, you need to follow a diet.
Patients in whom hypertension is malignant in nature, increase the dose of the drug gradually (every day), taking into account changes in blood pressure, until the effect is maximum.
Contraindications to taking the drug "Fozinopril"
When prescribing Fozinopril tablets, indications for use are considered simultaneously with contraindications. The drug is not used with hypersensitivity to its components and to other similar drugs. The medication is not prescribed for patients under the age of 18 years and pregnant women, breast-feeding women. Contraindication is severe renal failure. Contraindications include angioneurotic edema (idiopathic, hereditary), both present at the time of administration of the drug, and those that have a history of severe hyperkalemia, hypotension.
Pregnancy
“Fosinopril” tablets are forbidden to use during pregnancy, since drugs of this type can lead to developmental disorders and fetal death.
If pregnancy has occurred during the period of therapy, a quick withdrawal of the drug is required. In such cases, an ultrasound scan is performed to detect harm to the fetus.
In a newborn whose mother was treated with Fosinopril during pregnancy, hyperkalemia, hypotension, and oliguria can be detected. If oliguria has developed, it is important to support renal perfusion and regularly check blood pressure. In case of impaired renal function and in order to normalize blood pressure, a blood transfusion or dialysis can be performed.
Restrictions on the use of the drug "Fosinopril"
In case of severe autoimmune diseases, it is necessary to take into account the ratio of benefits and possible risks during treatment with Fozinopril. Instructions for use, reviews reflect the need to consider risk and benefit in the following cases:
- Ischemic heart disease;
- the patient has a transplanted kidney;
- gout;
- diabetes;
- history of angioedema;
- chronic obstructive pulmonary disease;
- hyperkalemia with an indicator of more than 5.5 mmol / l;
- desensitization;
- cirrhosis;
- obstructive changes accompanied by a violation of the outflow of blood from the heart (aortic stenosis, mitral);
- severe heart failure;
- adhering to a diet that provides for a limited intake of salt or a minimum amount of sodium in food;
- hyponatremia;
- leukopenia, thrombocytopenia;
- some procedures (dialysis, anesthesia), operations;
- atherosclerosis obliterans, in which the lower extremities are affected;
- dehydration;
- renal failure of creatinine above 300 μmol / l;
- elderly age;
- hepatitis;
- problems with cerebral and coronary circulation;
- stenosis;
- conditions in which bcc is reduced.
Side effects from the drug "Fozinopril"
The reviews and instructions available for the Fosinopril medication reflect the likelihood of developing some side effects. Disorders in the hematopoietic system and the cardiovascular system may occur. Possible changes in the activity of the nervous system, digestive, development of disturbances in the functioning of the senses. In some patients, there is a change in laboratory parameters and adverse reactions, the manifestation of which affects the skin, musculoskeletal system. Respiratory and urogenital disorders may occur. Among the other negative reactions of the body are hyperhidrosis, weight loss, chills, fever, angioedema, the development of infectious or inflammatory processes in the lymph nodes in the body, lymphadenopathy, exacerbation of gout. Any problems during treatment should be reported to the doctor. A high risk of side effects is associated with improper use of the drug.
Overdose of the drug "Fosinopril"
In the treatment with the drug "Fosinopril" reviews show the likelihood of developing an overdose as a result of exceeding the recommended doses. An overdose is accompanied by an acute manifestation of hypotension, renal failure, stupor, shock, bradycardia, and a violation of the water-electrolyte balance.
A dose reduction or drug withdrawal is performed, the stomach is washed and the patient is given a sorbent to drink. It is necessary that a person takes a horizontal position, it is important to implement measures aimed at increasing the BCC. Symptomatic therapy is also required. Hemodialysis in this case does not give the desired effect.
Medicinal interaction of the drug "Fosinopril"
The likelihood of hyperkalemia is highest when using drugs that contain potassium, salt substitutes, cyclosporine, potassium supplements, and potassium-sparing diuretics.
The effect of the drug becomes more pronounced when using other drugs that have a hypotensive effect, and alcohol. A weaker effect than expected is present as a result of the use of substances that activate the renin-angiotensin-aldosterone system, estrogen, NSAIDs and sympathomimetics. In such cases, you must refuse to take these funds or replace "Fosinopril." Analogs are selected by the attending physician. You can find out about the possibility of combining the drug with other medicines from a specialist.
Analogs, synonyms of the drug "Fosinopril"
"Fosinopril" has synonyms and analogues. Synonyms include Fosinopril-Teva, Monopril. Of the drugs in this group, Fosinopril-OBL and Fosicard are produced. From synonyms you can choose "Fozinal", "Fozinotek."
When treatment with Fozinopril does not allow treatment instructions, synonyms or analogues are prescribed by a specialist for therapy. Analogs are presented by “Berlipril”, “Renitek”, “Ramipril”, “Moex”, “Lisinopril”. The famous analogues also include Prestarium, Enap and Enapril. Of the analogues, Tritace, Akkupro, Captopril can be assigned. Perhaps treatment using Hartil or Preness.
If the use of the drug "Fosinopril" prohibits the use of the drug, choose analogues or synonyms, the specialist decides.
Reviews on the drug "Fosinopril"
It is important to choose the right antihypertensive medicine for the patient, taking into account the characteristics of his body. If the drug "Fosinopril" is suitable for a person, the pressure decreases effectively and side effects do not occur. According to reviews, there is a stabilization of blood pressure, improving overall health. If negative reactions of the body are observed, then they are weakly expressed, mainly these are disturbances in taste, flushing, coughing.
High blood pressure can lead to serious problems associated with damage to important organs, so you need to carry out the necessary therapy in time and study the description of the Fosinopril medication, analogues, and read other useful information.