Hypertension:

Indications for: Moexipril/Hydrochlorothiazide

Hypertension (not for initial therapy).

Adult Dosage:

Take 1 hour before a meal. Switching from monotherapy with either component: 1 tab once daily, then adjust; usual max 30mg/50mg per day. Allow 2–3 weeks for titration of HCTZ component. Or, substitute for individually-titrated components.

Children Dosage:

Not established.

Moexipril/Hydrochlorothiazide Contraindications:

History of ACEI-associated angioedema. Anuria. Sulfonamide allergy. Concomitant aliskiren in patients with diabetes.

Boxed Warning:

Fetal toxicity.

Moexipril/Hydrochlorothiazide Warnings/Precautions:

Fetal toxicity may develop; discontinue if pregnancy is detected. Renal impairment (CrCl ≤40mL/min): not recommended. Discontinue if angioedema, laryngeal edema, jaundice, or marked elevation of hepatic enzymes occurs. Renal or hepatic dysfunction. Salt/volume depletion. CHF. Ischemic heart disease. Aortic or renal artery stenosis. Cerebrovascular disease. Dialysis (esp. high-flux membrane). Surgery. Diabetes. Gout. Asthma. Postsympathectomy. Monitor WBC counts in renal or collagen vascular disease. SLE. Acute myopia and secondary angle-closure glaucoma. Monitor electrolytes and renal function. Elderly. Neonates. Pregnancy (Cat.D); monitor. Nursing mothers: not recommended.

Moexipril/Hydrochlorothiazide Classification:

ACE inhibitor + diuretic.

Moexipril/Hydrochlorothiazide Interactions:

See Contraindications. Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Concomitant aliskiren in renal impairment (CrCl <60mL/min): not recommended. May cause hyperkalemia with K+ sparing diuretics, K+ supplements, or K+ containing salt substitutes. Hypokalemia with corticosteroids, ACTH, amphotericin B. May increase lithium, digitalis, diazoxide toxicity. Alcohol, CNS depressants may increase orthostatic hypotension. Adjust antidiabetic, antigout medications. Potentiates nondepolarizing muscle relaxants. Antagonizes norepinephrine. May be antagonized by, and renal toxicity potentiated by NSAIDs (including COX-2 inhibitors): monitor renal function in elderly and/or volume-depleted. May interfere with parathyroid tests. Reduced absorption with cholestyramine and colestipol resins. Nitritoid reactions with concomitant injectable gold (eg, sodium aurothiomalate); rare.

Adverse Reactions:

Cough, dizziness, fatigue, headache, hyperuricemia, electrolyte disturbances, hyperglycemia, rash, facial flushing, GI upset, angioedema (eg, intestinal), orthostatic hypotension, neutropenia; rare: hepatic failure.

Note:

Formerly known under the brand name Uniretic.

Metabolism:

Hepatic.

Drug Elimination:

Fecal, renal.

How Supplied:

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