moexipril hydrochloride

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moexipril hydrochloride

Perdix (UK), Univasc

Pharmacologic class: Angiotensin-converting enzyme (ACE) inhibitor

Therapeutic class: Antihypertensive

Pregnancy risk category C (first trimester), D (second and third trimesters)

Pregnancy risk category C (first trimester), D (second and third trimesters)

FDA Box Warning

• When used during second or third trimester of pregnancy, drug may cause fetal harm or death. Discontinue drug as soon as possible when pregnancy is detected.


Inhibits conversion of angiotensin I to the vasoconstrictor angiotensin II, inactivates bradykinin and other vasodilatory prostaglandins, increases plasma renin levels, and reduces aldosterone levels. Net effect is systemic vasodilation.


Tablets: 7.5 mg, 15 mg

Indications and dosages


Adults: 7.5 mg P.O. daily 1 hour before a meal; may increase if blood pressure control is inadequate. Range is 7.5 mg to 30 mg/day in one or two divided doses given 1 hour before a meal.

Dosage adjustment

• Renal impairment
• Concurrent diuretic therapy


• Hypersensitivity to drug
• Angioedema secondary to ACE inhibitor use


Use cautiously in:
• renal or hepatic impairment, hypovolemia, hyponatremia, aortic stenosis or hypertrophic cardiomyopathy, cardiac or cerebrovascular insufficiency
• family history of angioedema
• concurrent diuretic therapy
• black patients
• elderly patients
• pregnant or breastfeeding patients
• children (safety not established).


• Give 1 hour before meals (food reduces drug absorption).
• Adjust dosage, as ordered, according to blood pressure response.

Adverse reactions

CNS: dizziness, fatigue

CV: chest pain, peripheral edema

EENT: pharyngitis, sinusitis

GI: nausea, diarrhea

GU: urinary frequency

Metabolic: hyperkalemia

Musculoskeletal: myalgia

Respiratory: upper respiratory infection, increased cough

Skin: rash, flushing, angioedema

Other: fever, flulike symptoms, hypersensitivity reaction


Drug-drug.Allopurinol: increased risk of hypersensitivity reaction

Antacids: decreased moexipril absorption

Antihypertensives, general anesthetics, nitrates, phenothiazines: additive hypotension

Cyclosporine, indomethacin, potassium-sparing diuretics, potassium supplements, salt substitutes: hyperkalemia

Digoxin, lithium: increased blood levels of these drugs

Diuretics: excessive hypotension

Nonsteroidal anti-inflammatory drugs: blunted antihypertensive response

Drug-diagnostic tests.Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, potassium: increased levels

Antinuclear antibody: positive titer

Sodium: decreased level

Drug-food.Salt substitutes containing potassium: hyperkalemia

Drug-behaviors.Acute alcohol ingestion: additive hypotension

Patient monitoring

• Monitor vital signs and neurologic and cardiovascular status.
• Assess respiratory status, staying alert for persistent dry cough.
• Evaluate for allergic reactions and angioedema.
• Know that moexipril monotherapy is less effective in black patients, who may need additional concurrent antihypertensives.

Patient teaching

• Instruct patient to take 1 hour before a meal.
• Tell patient to report persistent dry cough and signs or symptoms of infection (especially upper respiratory infection).
• Advise patient to change position slowly (especially during first few days of therapy), to minimize hypotension and dizziness.
• Instruct patient to limit foods high in potassium and avoid salt substitutes containing potassium.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, and behaviors mentioned above.

moexipril hydrochloride

(mōek´sipril´ hī´drōklor´īd),
n brand name: Univasc;
drug class: angiotensin-converting enzyme (ACE) inhibitor;
action: selectively suppresses renin-angiotensin-aldosterone system; inhibits ACE; prevents conversion of angiotensin I to angiotensin II; results in dilation of arterial, venous vessels;
use: hypertension as a single drug or in combination with a thiazide diuretic.
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