Moexipril use in specific populations: Difference between revisions

Revision as of 21:35, 14 February 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Zaghw, M.D. [2], Amr Marawan, M.D. [3]

Moexipril

Moexipril tablet

Moexipril and Hydrochlorothiazide tablet

Moexipril and Hydrochlorothiazide tablet

Overview

Moexipril tablet is an angiontensin converting enzyme inhibitor drug that is FDA approved for the treatment of hypertension, heart failure, left ventricular dysfunction after myocardial infarction, diabetic nephropathy. Adverse reactions include hypotension, rash, hyperkalemia, disorder of taste, cough. hypotension, rash, hyperkalemia, disorder of taste, cough.

Category

Antihypertensive Agents, Angiotensin Converting Enzyme Inhibitors. Editor-In-Chief: C. Michael Gibson, M.S., M.D. [4]; Associate Editor(s)-in-Chief: Amr Marawan, M.D. [5]

Nursing Mothers

It is not known whether moexipril hydrochloride is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when moexipril hydrochloride is given to a nursing mother.

Pediatric Use

Neonates with a history of in utero exposure to moexipril hydrochloride:

If oliguria or hypotension occurs, direct attention toward support of blood pressure and renal perfusion. Exchange transfusions or dialysis may be required as a means of reversing hypotension and/or substituting for disordered renal function.

Safety and effectiveness of moexipril hydrochloride in pediatric patients have not been established.

Geriatric Use

Clinical studies of moexipril hydrochloride did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.^[1]

References

↑ "MOEXIPRIL HYDROCHLORIDE TABLET [APOTEX CORP.]".

Adapted from the FDA Package Insert.

[dailymed.nlm.nih.gov-1] "MOEXIPRIL HYDROCHLORIDE TABLET [APOTEX CORP.]".

[1]

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 ====Nursing Mothers====
-It is not known whether moexipril or moexiprilat is excreted in human milk. [[Thiazides]] are excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from hydrochlorothiazide and the unknown effects of moexipril or moexiprilat in infants, a decision should be made whether to discontinue nursing or to discontinue Moexipril HCl and [[Hydrochlorothiazide]] Tablets, taking into account the importance of the drug to the mother.
+It is not known whether moexipril hydrochloride is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when moexipril hydrochloride is given to a nursing mother.
 ====Pediatric Use====
-Safety and effectiveness of Moexipril HCl and Hydrochlorothiazide Tablets in pediatric patients have not been established.
+Neonates with a history of in utero exposure to moexipril hydrochloride:
+If [[oliguria]] or [[hypotension]] occurs, direct attention toward support of blood pressure and renal perfusion. Exchange transfusions or [[dialysis]] may be required as a means of reversing [[hypotension]] and/or substituting for disordered renal function.
+Safety and effectiveness of moexipril hydrochloride in pediatric patients have not been established.
 ====Geriatric Use====
-Of the patients who received Moexipril HCl and Hydrochlorothiazide Tablets in controlled clinical studies, 24% were 65 years of age or older. No overall differences in effectiveness or safety were observed between these patients and younger patients. In elderly patients receiving moexipril, plasma levels of drug are slightly higher and renal clearance is reduced when compared to younger patients, but these effects did not have detectable consequences. Hydrochlorothiazide is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.<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>
+Clinical studies of moexipril hydrochloride did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.<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>