How does this medication work? What will it do for me?

Fosinopril belongs to the class of medications called angiotensin converting enzyme inhibitors (ACE inhibitors). It is used to treat high blood pressure. It works by relaxing blood vessels and by helping the heart to pump blood that carries oxygen to the different parts of the body more efficiently.

Fosinopril may also be used in addition to digoxin or a thiazide diuretic or both to treat congestive heart failure.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

10 mg
Each white-to-off-white, diamond-shaped tablet with "R" scoreline "R" on one side and "FS" scoreline "10" on the other contains 10 mg of fosinopril sodium. Nonmedicinal ingredients: crospovidone, glycerol behenate, hydroxypropyl cellulose, microcrystalline cellulose, pregelatinized starch, and sodium starch glycolate.

20 mg
Each white-to-off-white capsule-shaped tablet with "R" on one side and "FS 20" on the other side contains 20 mg of fosinopril sodium. Nonmedicinal ingredients: crospovidone, glycerol behenate, hydroxypropyl cellulose, microcrystalline cellulose, pregelatinized starch, and sodium starch glycolate.

How should I use this medication?

The recommended adult dose of fosinopril ranges from 10 mg to 40 mg daily in a single daily dose, with or without meals. The dose of the medication usually begins at 10 mg daily, with dosing increases as directed by your doctor occurring approximately every 2 weeks as needed. It may take up to 2 weeks to see the full effects of the medication.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take fosinopril if you:

  • are allergic to fosinopril or any ingredients of the medication
  • have diabetes or kidney disease and are taking the medication aliskiren
  • have a history of angioedema (a serious allergic reaction that causes the area around the throat and tongue to swell) after taking any ACE inhibitors (e.g., captopril, enalapril, lisinopril, ramipril)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • cough (dry, persistent)
  • diarrhea
  • difficulty achieving or maintaining an erection
  • dizziness when rising from a standing or sitting position
  • headache
  • muscle cramps
  • nausea
  • rash
  • unusual tiredness
  • vomiting

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention. Check with your doctor as soon as possible if any of the following side effects occur:

  • chest pain
  • fast, pounding heart beat
  • signs of fluid and electrolyte imbalance (e.g., drowsiness, muscle pain or cramps, weakness, irregular heartbeat)
  • signs of reduced liver function (e.g., abdominal pain, itching of skin, yellow eyes or skin, loss of appetite, nausea or vomiting)
  • signs of low blood pressure (e.g., dizziness, lightheadedness, or fainting)
  • signs of too much potassium in the body (e.g., confusion, irregular heartbeat, nervousness, shortness of breath or difficulty breathing, weakness or heaviness of legs, numbness or tingling in hands, feet, or lips)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • chest pain
  • signs of angioedema (e.g., swelling of face, mouth, hands, or feet)
  • signs of a serious allergic reaction (abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
  • trouble swallowing or breathing (sudden)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

HEALTH CANADA ADVISORY

February 4, 2014

Health Canada has issued new restrictions concerning the use of fosinopril. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Angioedema: Angioedema, a serious allergic reaction that causes the area around the throat and tongue to swell, that may occur with use of fosinopril. If you experience swelling of the face, tongue, or throat, stop taking fosinopril at once and get immediate medical attention. Other medications in the class of medications known as ACE inhibitors should not be taken in the future. People who have had angioedema caused by other substances may be at increased risk of angioedema while receiving an ACE inhibitor.

Blood counts: This medication can decrease the number of neutrophils (a type of white blood cell that helps fight infection), red blood cells (which carry oxygen), and platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. If you notice any signs of infection (e.g., fever, chills, or sore throat) or unusual bleeding or bruising, contact your doctor immediately.

Cough: People taking fosinopril may develop a dry, persistent cough that usually disappears only after stopping or lowering the fosinopril dose. Be sure to tell your doctor of any cough that does not seem to be related to a usual cause.

Fluid and electrolyte balance: In rare cases, people who take fosinopril experience an increase in blood levels of potassium. This rarely causes problems, but potassium levels should be monitored by your doctor.

Kidney function: Changes in kidney function have been seen for certain people who take this medication (e.g., people with narrowed blood vessels in their kidneys, or those with severe congestive heart failure). The use of diuretics (water pills), aliskiren or nonsteroidal anti-inflammatory drugs (NSAIDs) may further increase risk of kidney problems for people already at risk for this problem. If you have kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: This medication may worsen liver function. If you have liver disease or poor liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you notice any signs of liver problems (e.g., abdominal pain, itching of skin, yellow eyes or skin, loss of appetite, vomiting), contact your doctor immediately.

Surgery: Anaesthetics and pain relievers used during can cause decreased blood pressure. Fosinopril may make the decrease in blood pressure worse. Make sure that your health care team knows you are taking this medication.

Low blood pressure: Occasionally, blood pressure drops too low after taking fosinopril. This usually happens after the first or second dose or when the dose is increased. It is more likely to occur for those who take aliskiren or water pills, have a salt restricted diet, are on dialysis, are suffering from diarrhea or vomiting, or have been sweating excessively and not drinking enough liquids. If low blood pressure causes you to faint or feel lightheaded, contact your doctor.

Pregnancy: ACE inhibitors such as fosinopril may cause severe harm or death to the developing baby if taken by the mother during pregnancy. This medication should not be used during pregnancy. If you discover you are pregnant, stop taking fosinopril at once and contact your doctor.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking fosinopril, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of fosinopril for children have not been established. Its use by this age group is not recommended.

What other drugs could interact with this medication?

There may be an interaction between fosinopril and any of the following:

  • alcohol
  • aldesleukin
  • aliskiren
  • allopurinol
  • alpha blockers (e.g., alfuzosin, doxazosin, tamsulosin)
  • alpha agonists (e.g., clonidine, methyldopa)
  • amifostine
  • amphetamines (e.g., dextroamphetamine, lisdexamphetamine)
  • other angiotensin converting enzyme inhibitors (ACEIs; captopril, enalapril, ramipril)
  • angiotensin receptor blockers (ARBs; e.g., candasartan, irbesartan, losartan)
  • antacids (e.g., calcium carbonate, magnesium hydroxide)
  • aripiprazole
  • azathioprine
  • barbiturates (e.g., butalbital, pentobarbital, phenobarbital)
  • beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)
  • brimonidine
  • calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
  • ciprofloxacin
  • cyclosporine
  • diabetes medications (e.g., chlorpropamide, glipizide, glyburide, insulin, metformin, nateglinide, rosiglitazone)
  • dipyridamole
  • diuretics (water pills; e.g., furosemide, amiloride, spironolactone, triamterene)
  • drosperinone
  • duloxetine
  • eplerenone
  • everolimus
  • grass pollen allergen extract
  • guanfacine
  • heparin
  • iron dextran
  • iron gluconate
  • levodopa
  • lithium
  • low-molecular-weight heparins (e.g., dalteparin, enoxaparin, tinzaparin)
  • medications that increase potassium levels (e.g., potassium supplements, salt substitutes containing potassium)
  • methylphenidate
  • monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
  • nitrates (e.g., isosorbide dinitrate, isosorbide mononitrate)
  • nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, indomethacin, naproxen)
  • obinutuzumab
  • pentoxifylline
  • phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)
  • pregabalin
  • risperidone
  • rituximab
  • sirolimus
  • sodium phosphates
  • temsirolimus
  • tizanidine
  • tolvaptan
  • trimethoprim
  • yohimbine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2017. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Riva-Fosinopril