DrugindexOnline^{2nd edition}

Generic name: Fosinopril sodium
Brand names: Monopril

Why is Monopril prescribed?

Monopril is a high blood pressure medication known as an ACE inhibitor. It is effective when used alone or in combination with other medications for the treatment of high blood pressure. Monopril is also prescribed for heart failure.

Monopril works by preventing the conversion of a chemical in your blood called angiotensin I into a more potent substance that increases salt and water retention in your body. Monopril also enhances blood flow in your circulatory system.

Most important fact about Monopril

You must take Monopril regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Monopril; and you must continue taking it even if you are feeling well. Monopril does not cure high blood pressure; it merely keeps it under control.

How should you take Monopril?

Monopril is best taken 1 hour before meals; but it can be taken with food if it upsets your stomach.

Take Monopril exactly as prescribed by your doctor.

--If you miss a dose...

Suddenly stopping Monopril could cause your blood pressure to increase. If you forget to take a dose, take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Store Monopril at room temperature in a tightly closed container to protect the medication from moisture.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Monopril.

WHEN TAKEN FOR HIGH BLOOD PRESSURE

• More common side effects may include:
  Cough, dizziness, nausea, vomiting

WHEN TAKEN FOR HEART FAILURE

• More common side effects may include:
  Chest pain, cough, dizziness, low blood pressure, muscle and bone pain

Why should Monopril not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Monopril or other ACE inhibitors such as Accupril or Zestril, you should not take Monopril. Make sure that your doctor is aware of any drug reactions that you have experienced.

Special warnings about Monopril

If you develop a sore throat or fever, you should contact your doctor immediately. It could indicate a more serious illness.

If you develop swelling of your face, lips, tongue or throat, or arms and legs, or have difficulty swallowing, you should stop taking Monopril and contact your doctor immediately. You may need emergency treatment.

Make sure your doctor knows about any kidney or liver problems you may have. If you notice your skin or the whites of your eyes turning yellow, stop taking Monopril and contact your doctor immediately.

Your kidney function should be monitored while you are taking Monopril for either high blood pressure or heart failure. If you have heart failure and your kidneys are not functioning properly, you may develop low blood pressure. Also, certain blood tests may be needed if you have a disease of the connective tissue.

If you are taking high doses of a diuretic along with Monopril, you may develop excessively low blood pressure.

You may experience light-headedness while taking Monopril, especially during the first few days of therapy. If this occurs, notify your doctor. If you actually faint, discontinue the use of Monopril and notify your doctor immediately.

Do not use potassium-containing salt substitutes or potassium supplements without consulting your doctor.

If you have heart failure, Monopril should be started under close medical supervision. Your doctor should continue to monitor your progress for the first 2 weeks of treatment and whenever your dosage is increased.

Excessive sweating, dehydration, severe diarrhea, or vomiting could lead to excessive loss of water and cause your blood pressure to drop dangerously. Take precautions to avoid excessive water loss while exercising.

This drug should be used with caution if you are on dialysis. There have been reports of extreme allergic reactions during dialysis in people taking ACE inhibitors such as Monopril. There have also been reports of severe allergic reactions in people given bee or wasp venom to protect against stings.

Possible food and drug interactions when taking Monopril

If Monopril is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Monopril with the following:

Antacids such as Mylanta and Maalox
Lithium (Eskalith, Lithobid)
Potassium preparations such as K+10 and K-Lyte
Potassium-sparing diuretics such as Moduretic and Aldactone
Thiazide diuretics such as Diucardin and Diuril

Special information if you are pregnant or breastfeeding

ACE inhibitors such as Monopril have been shown to cause injury and even death in the developing baby when used in pregnancy during the second or third trimesters. If you are pregnant your doctor should discontinue the use of Monopril as soon as possible. If you plan to become pregnant and are taking Monopril, contact your doctor immediately to discuss the potential hazard to your unborn child. Monopril appears in breast milk and could affect a nursing infant. If Monopril is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Monopril is finished.

Recommended dosage

ADULTS

High Blood Pressure

The usual initial dose is 10 milligrams, taken once a day, either alone or when added to a diuretic. Dosage, after blood pressure is adjusted, should be 20 to 40 milligrams a day in a single dose. For some patients, the doctor may divide the daily total into several smaller doses.

Diuretic use should, if possible, be stopped before using Monopril. If not, your physician may give an initial dose of 10 milligrams under his supervision before any further medication is prescribed.

Heart Failure

The usual starting dose is 10 milligrams once a day, with diuretics and possibly digitalis. Your doctor will gradually increase the dose to one that works for you--usually between 20 milligrams daily and the maximum dose of 40 milligrams per day. If your kidneys are impaired you will probably start with a dose of 5 milligrams.

CHILDREN

The safety and effectiveness of Monopril have not been established in children.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

The primary effect of a Monopril overdose is likely to be a sudden drop in blood pressure.