General Toxicity Notes
Blood pressure is the best guide to dose and interval. Hypotensive effects magnified by natriuretic agents or sodium depletion. May cause hyperkalemia, metabolic acidosis. Acute renal dysfunction with bilateral or transplant renal artery stenosis, low renal perfusion pressure. Dry cough in 5-10% of patients.
Half-Life (Normalesrd) Hours
9.8/30-40
Plasma Protein Binding %
50
Volume Of Distribution L/Kg
2.6
Dose For Normal Renal Function
7.5 mg q24h
Second Dose
Second Dose: 7.5-30 mg q24h
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
50% [B]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
50% [B]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: Dose after dialysis,[D]
Supplement For Dialysis [Recommendation Level]: Pd
PD: Dose for GFR <10,[D]
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50,[D]
References
Cawello W, Boekens H, Waitzinger J, Miller U. Moexipril shows a long duration of action related to an extended pharmacokinetic half-life and prolonged ACE inhibition. Int J Clin Pharmacol Ther. 2002; 40: 9-17. [PMID: 11837383] / Song JC, White CM. Clinical pharmacokinetics and selective pharmacodynamics of new angiotensin converting enzyme inhibitors: an update. Clin Pharmacokinet. 2002; 41: 207-24. [PMID: 11929321]
Toxicity Notes
There is insufficient information available to characterize the relationship between moexipril and renal function, but at creatinine clearances in the range of 10 to 40 mL/min, the T1/2 of moexipril increased by a factor of 3 to 4. No data on extracorporeal removal. Avoid in renal failure until more information available.