Fosinopril is indicated for the treatment of heart failure in combination with a non-potassium sparing diuretic and where appropriate, digitalis. In these patients, fosinopril improve symptoms and exercise tolerance, reduce severity of heart failure and decrease the frequency of hospitalisation for heart failure.
For this indication, competent medicine agencies globally authorize below treatments:
10 - 40 mg
From 10 To 40 mg once every day
The recommended initial dose is 10mg once daily, initiated under close medical supervision. If the initial dose is well tolerated patients should then be titrated to a dose of up to 40mg once daily. The appearance of hypotension after the initial dose should not preclude careful dose titration of fosinopril, following effective management of the hypotension. Fosinopril should be used in addition to diuretics and digitalis where appropriate.
It is recommended that treatment is initiated in hospital for patients with severe cardiac failure (NYHA IV) and those at particular risk of first dose hypotension, i.e. patients on multiple or high dose diuretics (e.g. >80mg furosemide), patients with hypovolaemia, hyponatraemia (serum sodium <130 meq/l), pre-existing hypotension (systolic blood pressure <90 mmHg), patients with unstable cardiac failure and those on high-dose vasodilator therapy. Renal function and serum potassium should be monitored.