Moexipril/Hydrochlorothiazide Uses/Indications Dosage Side effects- DrugsAce

Classes

DEA Class; Rx

Common Brand Names; Uniretic

ACEI/Diuretic Combos;
ACEI/HCTZ Combos

Description

Moexipril/hydrochlorothiazide is a fixed-combination tablet that combines an angiotensin-converting enzyme (ACE) inhibitor, moexipril, and a thiazide diuretic, hydrochlorothiazide

Moexipril prevents the conversion of angiotensin I to angiotensin II (a potent vasoconstrictor) through inhibition of ACE by competing with physiologic substrate (angiotensin I) for active site of ACE; inhibition of ACE initially results in decreased plasma angiotensin II concentrations & consequently, blood pressure may be reduced in part through decreased vasoconstriction, increased renin activity, and decreased aldosterone secretion

Hydrochlorothiazide is a thiazide diuretic that inhibits Na reabsorption in distal renal tubules resulting in increased excretion of Na+ and water, also K+ and H+ ions

Indications

Indicated for the treatment of hypertension.

Contraindications

Anuria

Hypersensitivity to either component or sulfonamides

History of angioedema

Hereditary or idiopathic angioedema

Coadministration of neprilysin inhibitors (eg, sacubitril) with ACE inhibitors may increase angioedema risk; do not administer ACE inhibitors within 36 hr of switching to or from sacubitril/valsartan

Bilateral renal artery stenosis

Adverse Effects

Moexipril

Dizziness
Hypotension
Peripheral edema
Cough
Headache
Myalgia
Hyponatremia
Pharyngitis
Sinusitis
Rash
Nausea/vomiting
Hyperkalemia
Hyponatremia
Polyuria
Angioedema
Arrhythmia
Chest pain
Pneumonitis
Syncope
Proteinuria
Agranulocytosis (especially if patient has CVD with or without renal impairment)
Hepatic failure (rare)
Renal failure

Hydrochlorothiazide

Anorexia
Epigastric distress
Hypotension
Orthostatic hypotension
Photosensitivity
Anaphylaxis, anemia, confusion, erythema multiforme skin reactions including Stevens-Johnson syndrome, exfoliative dermatitis including toxic epidermal necrolysis, hypomagnesemia, hyponatremia, hypochloremia, dizziness, fatigue, headache, hypercalcemia, hyperuricemia, hyperglycemia, hyperlipidemia, hypercholesterolemia, muscle weakness or cramps, nausea, purpura, rash, vertigo, vomiting

Warnings

Excessive hypotension if concomitant diuretics, hypovolemia, hyponatremia

Risk of hyperkalemia, especially in patients with renal impairment, DM or those taking concomitant K+-elevating drugs

Dual blockade of the renin angiotensin system with ARBs, ACE inhibitors, or aliskiren associated with increased risk for hypotension, hyperkalemia, and renal function changes (including acute renal failure) compared to monotherapy

DM, fluid or electrolyte imbalance, hyperuricemia or gout, SLE, liver disease, renal disease

May aggravate digitalis toxicity

Sensitivity reactions may occur with or without history of allergy or asthma

Biliary cirrhosis or biliary obstruction

Apheresis (LDL) with dextran sulfate, hypertrophic cardiomyopathy, collagen vascular disease, hemodialysis with high flux membrane, aortic stenosis

Myelosuppression

Renal impairment may occur

Neutropenia/agranulocytosis reported

Cough may occur within the first few months

Cholestatic jaundice may occur

Risk of male sexual dysfunction

Acute transient myopia and acute angle-closure glaucoma has been reported, particularly with history of sulfonamide or penicillin allergy (hydrochlorothiazide is a sulfonamide)

Avoid concomitant use with lithium