Monopril (Fosinopril Sodium)

Fosinopril is an ACE inhibitor used in the management of cardiovascular conditions that involve the renin‑angiotensin system.

• Hypertension: reduces elevated blood pressure, decreasing risk of stroke and myocardial infarction.
• Heart failure: improves cardiac output and symptoms by decreasing afterload and fluid retention.
• Post‑myocardial infarction: helps prevent ventricular remodeling and subsequent heart failure when used as part of standard therapy.

• Fosinopril is a prodrug that is converted to the active metabolite fosinoprilat, which binds to the active site of angiotensin‑converting enzyme (ACE). By inhibiting ACE, it blocks the conversion of angiotensin I to the potent vasoconstrictor angiotensin II, leading to vasodilation, reduced aldosterone secretion, and decreased sodium and water retention, thereby lowering blood pressure and easing cardiac workload and improves overall cardiovascular function.

Fosinopril may be associated with a range of adverse reactions, which are categorized by frequency and severity.

Common Side Effects

• Cough: dry, persistent cough.
• Dizziness: especially upon standing.
• Hyperkalemia: elevated blood potassium levels.

Serious or Rare Side Effects

• Angioedema: swelling of face, lips, tongue or airway.
• Severe hypotension: marked drop in blood pressure.
• Acute renal failure: sudden loss of kidney function.

When prescribing or dispensing Monopril, consider the following precautions.

• Monitor blood pressure: check regularly to avoid excessive hypotension.
• Assess renal function: periodic serum creatinine and electrolytes are recommended.
• Check potassium levels: hyperkalemia risk especially with potassium‑sparing diuretics.
• Avoid use in patients with known ACE inhibitor‑induced angioedema.
• Pregnancy: use only if clearly needed, as safety data are limited.
• Store at ambient temperature: keep below 25°C, protect from moisture and light in original container.

Fosinopril can interact with several medicines; awareness of the interaction level guides management.

Major Interactions (Avoid)

• Aliskiren: concurrent use with ACE inhibitors is contraindicated in diabetes or renal impairment.
• Potassium‑sparing diuretics or supplements: may cause dangerous hyperkalemia.
• NSAIDs: can reduce antihypertensive effect and worsen renal function.

Moderate Interactions (Monitor Closely)

• Lithium: ACE inhibitors may increase lithium levels, monitor for toxicity.
• Thiazide diuretics: may enhance hypotensive effect.
• Other antihypertensives: additive blood pressure lowering, adjust dose as needed.