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| __NOTOC__
| | #REDIRECT [[Moexipril#Adult Indications and Dosage]] |
| {{Moexipril}}
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| {{CMG}}; {{AE}} {{AM}}
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| ==Dosage and Administration==
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| Moexipril and [[hydrochlorothiazide]] are effective treatments for hypertension. The recommended dosage range of moexipril is 7.5 to 30 mg daily, administered in a single or two divided doses one hour before meals, while [[hydrochlorothiazide]] is effective in a dosage of 12.5 to 50 mg daily.
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| The side effects of moexipril are generally rare and apparently independent of dose; those of [[hydrochlorothiazide]] are a mixture of dose-dependent phenomena (primarily hypokalemia) and dose-independent phenomena (e.g., [[pancreatitis]]), the former much more common than the latter. Therapy with any combination of moexipril and hydrochlorothiazide will be associated with both sets of dose-independent side effects, but regimens in which moexipril is combined with low doses of hydrochlorothiazide produce minimal effects on serum potassium. In Moexipril HCl and [[Hydrochlorothiazide]] Tablets controlled clinical trials, the average change in serum potassium was near zero in subjects who received 3.75 mg / 6.25 mg or 7.5 mg / 12.5 mg, but subjects who received 15 mg / 12.5 mg or 15 mg / 25 mg experienced a mild decrease in serum potassium, similar to that experienced by subjects who received the same dose of [[hydrochlorothiazide]] monotherapy. To minimize dose-independent side effects, it is usually appropriate to begin combination therapy only after a patient has failed to achieve the desired effect with monotherapy.
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| ====Dose Titration Guided by Clinical Effect====
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| A patient whose blood pressure is not adequately controlled with either moexipril or [[hydrochlorothiazide]] monotherapy may be given Moexipril HCl and Hydrochlorothiazide Tablets 7.5 mg / 12.5 mg, Moexipril HCl and [[Hydrochlorothiazide]] Tablets 15 mg / 12.5 mg or Moexipril HCl and Hydrochlorothiazide Tablets 15 mg / 25 mg one hour before a meal. Further increases of moexipril, [[hydrochlorothiazide]] or both depend on clinical response. The hydrochlorothiazide dose should generally not be increased until 2-3 weeks have elapsed.
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| Total daily doses above 30 mg / 50 mg a day have not been studied in hypertensive patients. Patients whose blood pressures are adequately controlled with 25 mg of hydrochlorothiazide daily, but who experience significant potassium loss with this regimen, may achieve blood pressure control without electrolyte disturbance if they are switched to moexipril 3.75 mg/hydrochlorothiazide 6.25 mg (one-half of the Moexipril HCl and [[Hydrochlorothiazide]] Tablets 7.5 mg / 12.5 tablet). For patients who experience an excessive reduction in blood pressure with Moexipril HCl and [[Hydrochlorothiazide]] Tablets 7.5 mg / 12.5 mg, the physician may consider prescribing moexipril 3.75 mg/[[hydrochlorothiazide]] 6.25 mg.
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| ====Replacement Therapy====
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| The combination may be substituted for the titrated individual active ingredients.
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| ====Use in Renal Impairment====
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| The usual dosage regimen of Moexipril HCl and [[Hydrochlorothiazide]] Tablets does not need to be adjusted as long as the patient's creatinine clearance is > 40 mL/min/1.73 m2 ([[serum creatinine]] approximately < 3 mg/dL or 265 µmol/L). In patients with more severe renal impairment, loop diuretics are preferred to thiazides, so Moexipril HCl and Hydrochlorothiazide Tablets is not recommended.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = MOEXIPRIL HYDROCHLORIDE TABLET [APOTEX CORP.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=d18108f5-98ca-1220-d145-bcf4e71ceaee | publisher = | date = | accessdate = }}</ref>
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| ==References==
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| {{Reflist}}
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| {{FDA}}
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| [[Category:Cardiovascular Drugs]]
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| [[Category:Drugs]]
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