Fosinopril Dosage

Medically reviewed by Drugs.com. Last updated on Jun 26, 2023.

Applies to the following strengths: 10 mg; 20 mg; 40 mg

Usual Adult Dose for Hypertension

Initial dose: 10 mg orally once a day alone or in combination with a diuretic
Maintenance dose: 20 to 40 mg orally once a day; some patients may have further response at 80 mg once a day

Comments:

Dosages should be adjusted according to blood pressure response at peak (2 to 6 hours post dose) and trough (about 24 hours after dosing) blood levels.
Consider dividing the daily dose in patients where the trough response is inadequate.
Stop the diuretic 2 to 3 days prior to beginning therapy with this drug; it may be resumed at a later time if clinically indicated.
If stopping the diuretic is not possible, careful medical supervision is recommended for several hours until blood pressure has stabilized.

Uses: For the treatment of hypertension alone or in combination with other medications

Usual Adult Dose for Congestive Heart Failure

Initial dose: 10 mg orally once a day
Target dose range: 20 to 40 mg orally once a day
Maximum dose: 40 mg orally once a day

Comments:

Patients should be observed under medical supervision for at least 2 hours following the initial dose until blood pressure stabilizes.
Dosages should be increased over a several week period based on tolerability.
The presence of hypotension, orthostasis, or azotemia early in dose titration should not preclude further careful dose titration; consider dose reducing concomitant diuretic.

Use: For the management of heart failure as adjunctive therapy when added to conventional therapy including diuretics with or without digitalis

Usual Pediatric Dose for Hypertension

6 to 16 years:
Greater than 50 kg: 5 to 10 mg orally once a day as monotherapy
Less than 50 kg: Appropriate dose not available

Renal Dose Adjustments

Heart Failure:

Moderate to severe renal dysfunction: Initial dose: 5 mg orally once a day

Liver Dose Adjustments

Data not available

Dose Adjustments

Heart failure patients with vigorous diuresis:

Initial dose: 5 mg orally once a day

Precautions

US BOXED WARNING: FETAL TOXICITY:

When pregnancy is detected, this drug should be discontinued as soon as possible.
Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.

Safety and efficacy have not been established in patients younger than 6 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Storage requirements:

Keep bottle tightly closed to protect from moisture.

Monitoring:
Cardiovascular: Monitor blood pressure for response to therapy periodically.
Hematologic: Periodically monitor white blood cell counts in patients with collagen-vascular disease and/or renal disease.
Renal: Monitor renal function prior to initiating and periodically during therapy.

Patient advice:

Advise patients to immediately report any signs or symptoms of angioedema (breathing difficulty or swelling of face, eyes, lips, or tongue) and to stop taking this drug until consulting a physician.
Tell patients to promptly report any sign of infection (e.g., sore throat, fever), which may be a sign of neutropenia.
Caution patients to consult their physician if excessive perspiration, dehydration, vomiting, or diarrhea occurs as it may lead to excessive blood pressure reduction due to reduced fluid volume.
Advise patients against using potassium-sparing diuretics, potassium supplements or potassium-containing salt substitutes without consulting their physician.
Caution heart failure patients against rapid increases in physical activity.
Females of childbearing age should be informed of the consequences of exposure to this drug during pregnancy; ask these patients to report pregnancies as soon as possible.