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Fosinopril: an overview.

Abstract

Angiotensin-converting enzyme (ACE) inhibitors are an effective, well-tolerated option for management of mild-to-moderate hypertension. An increase of nearly 250% in prescriptions between 1986 and 1990 testifies to the growing importance of this drug class. With the development of newer ACE inhibitors, the debate on pharmacokinetic and pharmacodynamic differences and the clinical relevance of such differences has also been growing in importance. It is in this context that the clinical data on fosinopril will be reviewed. Fosinopril has several intriguing features, among them a unique chemical structure and elimination profile. In addition, preliminary data on cardiac effects and on risk for cough are provocative and support further study. The antihypertensive efficacy of fosinopril is comparable to other ACE inhibitors. Thus, fosinopril represents an interesting and useful addition to this antihypertensive class.

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BibTeXRIS

R Guthrie. 1993-12-30. Fosinopril: an overview.. https://doi.org/10.1016/0002-9149(93)91051-i

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Aggregation behavior of fosinopril sodium--a new angiotensin-converting enzyme inhibitor.

Fosinopril sodium is an effective new angiotensin-converting enzyme (ACE) inhibitor that is very useful for the clinical treatment of hypertension. After oral administration, fosinopril sodium is only partially absorbed (about one third of the drug). We studied the solution behavior of fosinopril sodium in aqueous media by a combination of high-resolution nuclear magnetic resonance (NMR) spectroscopy and laser light scattering (LLS). LLS characterizes the self-association properties of fosinopril sodium in solution, and NMR chemical shifts provide information on molecular conformation and interactions. The results revealed that fosinopril sodium has a micelle-like self-association behavior with a critical micelle concentration (cmc) approximately 1.5 mg/mL. Hydrophobic interactions could induce formation of micellar aggregates, which had a narrow hydrodynamic size distribution, with an average diameter of approximately 150 nm at concentrations above the cmc. The surface activity and self-association of fosinopril sodium may be responsible for its early observed concentration-dependent stability in aqueous solution, unexpected decrease in solubility in the presence of metal ions, as well as the limited absorption in clinical studies.

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[Evaluation of the total hepatic function after treatment with fosinopril in hypertensive patients with liver cirrhosis].

Fosinopril is distinguished from other ACE inhibitors by a pharmacokinetic pecularity in the sense that is can be metabolized either by liver or kidney. This was the rationale of the present research the aim of which was to verify if administered to patients with liver cirrhosis the drug was liable to alter global liver function and ability to metabolize drugs. Eight cirrhotic males, mean age 56 years, also suffering from high blood pressure, were studied. In these patients, liver and kidney function tests (BUN, creatinine blood level, serum and urinary electrolytes, creatinine clearance, calcium and phosphor blood level, transaminases, alkaline phosphatase prothrombin time, cholinesterase, gamma-glutamyl-transpeptidase) were carried out at baseline and after 30 days' fosinopril treatment (1 capsule every morning in the fasting state); in addition total functioning liver mass was assessed by the galactose test, and drug-metabolizing capacity by the antipyrine test. Treatment resulted in a significant improvement of pressure values in all patients (p < 0.01) and did not alter liver and kidney function parameters. Besides, no side effects were registered, especially no case of orthostatic hypotension. The antipyrine test was not influenced by fosinopril treatment. Therefore, short-term treatment with this ACE-inhibitor can be concluded to be effective and not to cause additional alterations of liver function in patients with liver cirrhosis.

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