Heart failure

Active Ingredient: Fosinopril

Indication for Fosinopril

Population group: only adults (18 years old or older)

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 once a day

Route of admnistration


Defined daily dose

10 - 40 mg

Dosage regimen

From 10 To 40 mg once every day

Loading dose

10 mg

Detailed description

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.

Heart Failure – High Risk Patients

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.

Active ingredient


Fosinopril is the pro-drug (ester) of the long acting active ACE inhibitor fosinoprilat. After oral administration fosinopril is quickly and fully metabolised to the active fosinoprilat. Fosinopril contains a phosphinic group capable of a specific binding to the active site of the angiotensin converting enzyme, preventing the conversion of angiotensin I in angiotensin II.

Read more about Fosinopril

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