High Blood Pressure / Hypertension

Moexipril Hydrochloride

By Cardiologist on September 7th, 2010

(British Approved Name Modified, US Adopted Name, rINNM)

Drug Nomenclature

INNs in main languages (French, Latin, Russian, and Spanish):

Adverse Effects, Treatment, and Precautions

As for ACE inhibitors.

Interactions

As for ACE inhibitors.

Pharmacokinetics

Moexipril acts as a prodrug of the diacid moexiprilat, its active metabolite. After oral doses moexipril is rapidly but incompletely absorbed and is metabolised to moexiprilat in the gastrointestinal mucosa and liver. Absorption is reduced in the presence of food. The bio-availability of moexiprilat is about 13% after oral doses of moexipril, and peak plasma concentrations of moexiprilat are reached in about 1.5 hours. Both moexipril and moexiprilat are moderately bound to plasma proteins. Moexipril is excreted mainly in the urine as moexiprilat, unchanged drug, and other metabolites; some moexiprilat may also be excreted in the faeces. The functional elimination half-life of moexiprilat is about 12 hours.

Uses and Administration

Moexipril is an ACE inhibitor. It is used in the treatment of hypertension. Moexipril owes its activity to moexiprilat, to which it is converted after oral doses. The haemodynamic effects are seen about 1 hour after an oral dose and the maximum effect occurs after about 3 to 6 hours, although the full effect may not develop for 2 to 4 weeks during chronic dosing. Moexipril is given orally as the hydrochloride.

In the treatment of hypertension, the usual initial dose of moexipril hydrochloride is 7.5 mg once daily. Since there may be a precipitous fall in blood pressure in some patients when starting therapy with an ACE inhibitor, the first dose should preferably be given at bedtime. An initial dose of 3.75 mg once daily, given under close medical supervision, is suggested for patients who are taking a diuretic; if possible the diuretic should be withdrawn 2 or 3 days before moexipril is started and resumed later if necessary. An initial dose of 3.75 mg once daily is also recommended for patients with renal or hepatic impairment and for the elderly. The usual maintenance dose is 7.5 to 30 mg daily, which may be given in 2 divided doses if control is inadequate with a single dose.

Administration in renal impairment. In patients with renal impairment (creatinfne clearance 40 mL/mfnute or less) an initial dose of moexipril hydrochloride 3.75 mg is given; in the United States of America (US and USA) it is required that the maximum dose in such patients should not exceed 15 mg daily.

Preparations

Proprietary Preparations

Austria: Fempress;

Czech Republic: Moex;

France: Moex;

Germany: Fempress;

Greece: Tensotec †;

Hong Kong: Moex;

Ireland: Perdix †;

Israel: Perdix;

Italy: Femipres;

Malaysia: Tensotec †;

Philippines: Univasc;

Poland: Cardiotensin;

Portugal: Tensotec;

Russia: Moex;

Turkey: Univasc;

United Kingdom (UK): Perdix;

United States of America (US and USA): Univasc.

Multi-ingredient

Austria: Fempress Plus;

Germany: Fempress Plus;

Italy: Enulid; Femipres Plus;

Philippines: Uniretic;

Russia: Moex Plus;

United States of America (US and USA): Uniretic.

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