moexipril hydrochloride
CLINICAL USE
Angiotensin-converting enzyme inhibitor:Hypertension
DOSE IN NORMAL RENAL FUNCTION
3.75–30 mg daily
PHARMACOKINETICS
Molecular weight                           :535 %Protein binding                           :50 %Excreted unchanged in urine     : 1 Volume of distribution (L/kg)       :183 litreshalf-life – normal/ESRD (hrs)      :12 (of active metabolite)/Increased DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
20–40 Start with low dose and adjust according to response 10 to 20     : Start with low dose and adjust according to response <10           : Start with low dose and adjust according to response DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Unknown dialysability. Dose as in GFR <10 mL/min HD                     :Unknown dialysability. Dose as in GFR <10 mL/minHDF/high flux   :Unknown dialysability. Dose as in GFR <10 mL/minCAV/VVHD      :Unknown dialysability. Dose as in GFR 10 to 20 mL/min IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs Anaesthetics: enhanced hypotensive effect Analgesics: antagonism of hypotensive effect and increased risk of renal impairment with NSAIDs; hyperkalaemia with ketorolac and other NSAIDsCiclosporin: increased risk of hyperkalaemia and nephrotoxicity Diuretics: enhanced hypotensive effect; hyperkalaemia with potassium-sparing diuretics Epoetin: increased risk of hyperkalaemia; antagonism of hypotensive effect Lithium: reduced excretion (possibility of enhanced lithium toxicity) Potassium salts: increased risk of hyperkalaemia Tacrolimus: increased risk of hyperkalaemia and nephrotoxicity ADMINISTRATION
Reconstition
– Route
Oral Rate of Administration
–Comments
– OTHER INFORMATION
Moexipril is a prodrug that is converted to an active metabolite, moexiprilatClose monitoring of renal function during therapy is necessary in those with renal insufficiencyRenal failure has been reported in association with ACE inhibitors, mainly in patients with severe congestive heart failure, renal artery stenosis, or post renal transplantHigh incidence of anaphylactoid reactions has been reported in patients dialysed with high-flux polyacrylonitrile membranes and treated concomitantly with an ACE inhibitor. This combination should therefore be avoidedHyperkalaemia and other side effects are more common in patients with impaired renal functionMoexipril hydrochloride.
See how to identify renal failure stages according to GFR calculation
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