Fosinopril: instructions for use. "Fosinopril": indications for use, reviews, analogues

"Fosinopril" is an inhibitor of the enzyme converting angiotensin. The drug has antihypertensive effect, which makes it possible to apply it at high arterial pressure separately and as part of complex therapy. In addition, the drug has natriuretic, vasodilating and cardioprotective effect, it is used in conjunction with other medications during the treatment of heart failure.

Pharmacological properties of Fosinopril

The drug "Fosinopril" in the body takes the form of an active metabolite, which has a depressing effect on the angiotensin-converting enzyme. The drug reduces the rate of formation of angiotensin 2, normalizes systemic BP, positively affects the state of the vessels.

Angiotensin-converting enzyme activity when using 10, 20 and 40 mg of the drug is significantly reduced on average 7 hours (no faster than 2 hours, but no later than 12 hours after taking the drug). During the day, it remains reduced by 7-15%.

Tablets "Fosinopril" allow excluding hypertrophy of the myocardium and dilatation of the left ventricle, in the presence of such conditions 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 bradykinin in tissues and blood. Thanks to therapy based on the use of "Fosinopril", the liberation of substances that improve the blood supply of the kidneys, have a natriuretic, vasodilating action. The drug helps to reduce the production of arginine-vasopressin and endothelin-1, the action of which is vasoconstrictive.

With a decrease in pressure (diastolic, systolic), no orthostatic reactions and postural tachycardia develop, the BCC does not change. There are no changes in the reflex activity of the myocardium, the blood flow of the renal and cerebral blood. There is no violation of blood supply to the skin, internal organs, skeletal muscle tissue.

As the instructions for use show, "Fosinopril", used in a single dose, has an antihypertensive effect, which manifests itself most conspicuously after about five hours. The effect is preserved for 24 hours, which allows to maintain the normal blood pressure indices at all times. To manifest the maximum possible effect, it takes several weeks.

During treatment with "Fozinopril" in hypertension, it is possible to improve the body's response to a rapid decrease in systemic blood pressure. When complex therapy with thiazide diuretics and the drug "Fosinopril" is more pronounced antihypertensive effect. If it is necessary to cancel Fosinopril, the withdrawal syndrome does not develop, it is absent even in the event that the abolition is carried out abruptly. The drug improves the patient's condition in case of severe cardiac failure of a chronic form, as well as the body's response to physical stress.

Regarding the manifestation of mutagenic and genotoxic properties during the treatment with the drug "Fosinopril", the instruction shows their absence. However, the use of cytotoxic doses leads to some disorders associated with chromosomal aberrations. Studies carried out on mice and rats showed that a daily dose of the drug, not exceeding 400 mg / kg, does not cause signs of carcinogenicity. Due to the use of higher doses, glandular 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 realization of the reproductive function. When the medication was administered to pregnant rats (daily dose 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.

Absorption of the drug "Fosinopril" instructions for use describes how slow, decreasing even more due to food intake. Due to the implementation of presystemic metabolism, bioavailability is negligible (36%). "Fosinopril" is hydrolyzed, this process occurs in the blood, liver and gastrointestinal tract, as a result of its realization, fosinoprilat is formed, which is an active metabolite. The maximum level of medication in the body is found on average three hours after its application. Half-life occurs in 12-15 hours. The connection with plasma is almost complete - up to 98%, the volume of distribution is small.

The drug does not violate the limits of placental and blood-brain barrier, during treatment is present in the composition of breast milk. With cirrhosis (alcoholic, biliary), clearance decreases, hydrolysis proceeds more slowly. With renal failure, there is a disruption of the normal excretion of active diacid metabolites, the drug can accumulate in the body. The use of dialysis for the removal of the drug "Fosinopril" from the body displays an instruction for use as an action that does not lead to the desired result.

Indications for the use of the drug "Fosinopril"

"Fosinopril" is prescribed for heart failure and hypertension. In the first case, the drug is the basis of additional therapy, in the second it is used for complex therapy and monotherapy.

Treatment with Fosinopril

Usually, pills are drunk one or two times a day at the same time. In the treatment of hypertension, it is recommended first to use 10 mg of the drug, later - 20-40 mg. When combined treatment, when in addition to "Fosinopril" diuretic is used, take 10 mg of the drug. In this case, constant monitoring of blood pressure is required, the maximum possible dose of the drug is 80 mg per day. If the drug was missed, the next dose is not doubled. Treatment is performed with the use of the doses of the remedy recommended by the doctor, you can not take a larger or smaller amount of the drug and increase the frequency of its use, and you can not perform the abolition of Fosinopril without consulting a doctor.

Before taking the medicine "Fosinopril", the instruction recommends checking the degree of BP increase. When appointing 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, a small dose of the drug is recommended before bedtime. Antihypertensive treatment is canceled seven days before the start of therapy with Fosinopril. If previously conducted diuretic treatment, then to reduce the risk of symptomatic hypotension, adjust the water-salt balance, the dose of the diuretic is significantly reduced, in some cases, the drug is completely stopped (4-7 days before the first dose of "Fosinopril").

After myocardial infarction with Fozinopril, the instruction manual allows you to start after three days. During the period of treatment, regular BP measurement and checking of the peripheral blood pattern are required (check before therapy, monitor for 3-6 months of therapy, then check annually, more frequent monitoring may be necessary if there is a high probability of neutropenia). In addition, it is necessary to control the body weight, check the kidneys and the level of creatinine, potassium in the plasma, protein, the level of urea nitrogen. During the therapy, you must follow a diet.

Patients whose hypertension is malignant, the dose of the drug is increased gradually (every day), taking into account the changes in blood pressure, until the effect is maximum.

Contraindications to taking the drug "Fosinopril"

When prescribing Fosinopril tablets, indications for use are considered simultaneously with contraindications. The drug is not used for hypersensitivity to its components and to other similar drugs. Medication is not prescribed to patients under 18 years of age and pregnant women, women breastfeeding. Contraindication is a serious kidney failure. Contraindications include angioneurotic edema (idiopathic, hereditary) as present at the time of prescribing, and those that are in history, pronounced hyperkalemia, hypotension.

Pregnancy

Tablets "Fosinopril" instructions for use prohibits use during pregnancy, since medications of this type can lead to developmental disorders and fetal death.

If pregnancy occurred during the implementation of therapy, rapid withdrawal of the drug is required. In such cases, an ultrasound is performed to identify the harm to the fetus.

In a newborn whose mother was treated with Fosinopril during pregnancy, hyperkalaemia, hypotension, oliguria can be detected. If oliguria has developed, it is important to provide support for renal perfusion and to regularly check blood pressure. If there is a violation of the kidneys and for the normalization of blood pressure, blood transfusion or dialysis may be performed.

Limitations to the use of the drug "Fosinopril"

In case of severe autoimmune diseases, it is necessary to take into account the ratio of benefit and possible risk during treatment with Fosinopril. Instructions for use, reviews show the need to take risks and benefits into account in the following cases:

• IHD;
• The patient has a transplanted kidney;
• gout;
• diabetes;
• Angioedema in history;
• Obstructive pulmonary disease of chronic form;
• Hyperkalemia at a rate 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);
• Heart failure of severe course;
• Compliance with a diet that provides for a limited intake of salt or the minimum amount of sodium in the food consumed;
• Hyponatremia;
• Leukopenia, thrombocytopenia;
• Some procedures (dialysis, anesthesia), surgery;
• Obliterating atherosclerosis, in which the lower extremities are affected;
• dehydration;
• Renal insufficiency of creatinine above 300 μmol / l;
• elderly age;
• hepatitis;
• Problems with cerebral and coronary circulation;
• stenosis;
• The states under which the bcc is reduced.

Side effects from the drug "Fosinopril"

The "Fosinopril" medications available for the drug show the probability of developing some side effects. There may be abnormalities in the system of hematopoiesis and the cardiovascular system. Possible changes in the activity of the nervous system, digestive, the development of disturbances in the work of the senses. Some patients experience changes in laboratory parameters and adverse reactions, which manifestations affect the skin, the musculoskeletal system. There may be abnormalities in the respiratory and urogenital system. Among other negative reactions of the body - hyperhidrosis, weight loss, chills, fever, angioedema, edema in the body of infectious processes or inflammatory processes in the lymph nodes, lymphadenopathy, exacerbation of gout. Any problems during the treatment period 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"

When treatment with the drug "Fosinopril" reviews show the likelihood of an overdose as a result of exceeding the recommended doses. Overdose is accompanied by acute manifestations of hypotension, renal failure, stupor, shock, bradycardia, violation of water-electrolyte balance.

Dose reduction or drug withdrawal is made, the stomach is washed and the sorbent is given to the patient. It is necessary that a person take 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.

The drug interaction of the drug "Fozinopril"

The likelihood of hyperkalemia is highest when using drugs that contain potassium, salt substitutes, cyclosporine, additives with potassium, potassium-sparing diuretics.

The effect of the drug becomes more pronounced when using other drugs that have an antihypertensive effect, and alcohol. A weaker effect than expected is due to the use of substances that activate the renin-angiotensin-aldosterone system, estrogens, NSAIDs and sympathomimetics. In such cases, you must refuse to take these funds or replace "Fosinopril". Analogues are chosen by the attending physician. The possibility of combining the drug with other medicines can be obtained from a specialist.

Analogs, synonyms of the drug "Fosinopril"

"Fosinopril" has synonyms and analogues. To synonyms belong "Fozinopril-Teva", "Monopril". From the preparations of this group are produced "Fosinopril-OBL", "Fozikard". From synonyms you can choose "Fozinal", "Fosinotek".

When the use of Fosinopril does not allow the instruction to use, synonyms or analogues are prescribed by a specialist for therapy. Analogues are represented by "Berlipril", "Renitek", "Ramipril", "Moyex", "Lizinopril". To the well-known analogues also belong "Pre-Starium", "Enap" and "Enapril". From analogues, Tritace, Akkupro, and Captopril can be appointed. Possible treatment with the use of "Hartil" or "Prenessa".

If the use of the drug Fosinopril is prohibited, instructions for use, analogues or synonyms are chosen, the specialist decides.

Reviews about the drug "Fosinopril"

It is important to choose the right antihypertensive drug 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. As the reviews show, there is a stabilization of blood pressure, improving overall health. If negative reactions of the body are observed, then they are weakly expressed, mainly it is a violation of taste sensations, tides, cough.

High pressure can lead to serious problems associated with the defeat of important organs, so you need to make the necessary therapy on time and study the description of the drug "Fosinopril", analogues, to get acquainted with other useful information.