Usual Adult Dose for Hypertension

Initial dose:

• Patients not receiving diuretic therapy: 7.5 mg orally once a day 1 hour before meals
• Patients receiving diuretic therapy: 3.75 mg orally once a day 1 hour before meals

• Diuretic therapy should be discontinued, if possible, 2 to 3 days before starting this drug. If blood pressure remains uncontrolled with this drug alone, diuretic therapy may be restarted. If diuretic therapy cannot be discontinued, initiate this drug at a lower dose.
• Total daily doses above 60 mg have not been studied in hypertensive patients.
• The antihypertensive effect of this drug may diminish toward the end of the dosing interval. Therefore, measure blood pressure just prior to dosing.

Renal Dose Adjustments

CrCl 40 mL/min/1.73 m2 or less: Initial dose: 3.75 mg orally once a day 1 hour before meals; Maximum dose: 15 mg/day

Liver Dose Adjustments

Data not available

Dose Adjustments

The antihypertensive effect of moexipril may diminish towards the end of the dosing interval. Blood pressure should, therefore, be measured just prior to dosing to determine whether satisfactory blood pressure control is obtained. If control is not adequate, increased dose or divided dosing can be tried.

Precautions

US BOXED WARNING:

• FETAL TOXICITY: If pregnancy is detected, discontinue this drug as soon as possible. Drugs that act directly on the renin-angiotensin system (RAS) can cause injury and death to the developing fetus.

Dialysis

Data not available

Other Comments

Administration advice: Should be taken 1 hour before meals.

Monitoring:

• Monitor serum electrolytes periodically.
• Monitor renal function during the first few weeks of therapy.
• Consider monitoring white blood cell counts in patients with collagen vascular disease, especially if the disease is associated with impaired renal function.

• Advise patients to immediately report any signs or symptoms of angioedema (breathing difficulty or swelling of face, extremities, eyes, lips, or tongue) and to stop taking this drug until consulting a physician.
• Encourage patients to report any lightheadedness that may occur during treatment initiation and to stop taking this drug until consulting a physician.
• Caution patients to consult their physician if excessive perspiration, dehydration, vomiting, or diarrhea occurs as it may lead to excessive blood pressure reduction due to reduced fluid volume.
• Advise patients against using potassium-sparing diuretics, potassium supplements or potassium-containing salt substitutes without consulting their physician.
• Tell patients to promptly report any sign of infection (e.g., sore throat, fever), which may be a sign of neutropenia.
• Females of childbearing age should be informed of the consequences of exposure to this drug during pregnancy; ask these patients to report pregnancies as soon as possible.