Moexipril is an angiotensin-converting enzyme (ACE) inhibitor prescribed to manage cardiovascular conditions. It is available as a tablet and is typically taken orally.
How Moexipril Works
Moexipril inhibits the angiotensin-converting enzyme (ACE). This enzyme converts angiotensin I into angiotensin II, a potent vasoconstrictor. By blocking ACE, moexipril reduces angiotensin II production.
Angiotensin II normally causes blood vessels to narrow, which increases blood pressure. When moexipril inhibits its formation, blood vessels relax and widen, a process called vasodilation. This vasodilation allows blood to flow more easily, which in turn lowers blood pressure.
ACE inhibition also decreases aldosterone secretion, a hormone promoting sodium and water retention. Reduced aldosterone levels lead to less fluid retention and a small increase in serum potassium. These actions, combined with blood vessel relaxation, help lower blood pressure and ease the heart’s workload.
Conditions Moexipril Treats
Moexipril primarily treats essential hypertension, or high blood pressure. It lowers elevated blood pressure, reducing the risk of cardiovascular events like strokes and heart attacks. It is often used alone or in combination with other antihypertensive medications or diuretics.
Moexipril also manages congestive heart failure. In heart failure, the heart struggles to pump blood effectively. Moexipril reduces strain on the heart, making it easier to pump blood and improving overall heart function.
Taking Moexipril Safely
Moexipril is typically taken orally once or twice daily, usually one hour before meals. Adhere strictly to dosage instructions from a healthcare provider. For hypertension, the initial adult dose is often 7.5 milligrams (mg) once daily, adjustable up to 30 mg per day. If on diuretic therapy, a lower initial dose of 3.75 mg once daily may be prescribed.
Common side effects include a dry cough, dizziness, fatigue, diarrhea, headache, muscle aches, mild skin itching or rash, flu-like symptoms, pharyngitis, or flushing.
More serious, less common side effects require immediate medical attention. Angioedema, a rare but severe allergic reaction, involves swelling of the face, lips, tongue, or throat and can lead to difficulty breathing. If swelling occurs, stop the medication and seek emergency medical help immediately.
Moexipril can also cause low blood pressure, especially when standing up quickly, or if there is excessive sweating, vomiting, or diarrhea.
Kidney problems, including acute renal failure, can develop, particularly in individuals with pre-existing kidney conditions. Regular blood tests are often needed to monitor kidney function.
An increase in potassium levels in the blood, known as hyperkalemia, is another potential serious side effect. Symptoms of high potassium can include muscle weakness or an irregular heartbeat, and these should be reported to a doctor promptly.
Liver damage, characterized by symptoms like dark urine, yellow skin or eyes, or persistent nausea and vomiting, also warrants immediate medical consultation.
Moexipril should not be used during pregnancy, as it can harm or cause death to an unborn baby, particularly in the second and third trimesters. Pregnant women on moexipril should stop the medication and inform their doctor immediately. It is not known if moexipril passes into breast milk.
Moexipril should be used with caution in patients with kidney or liver disease, and those with a history of angioedema related to previous ACE inhibitor treatment should avoid it. Patients with diabetes or certain kidney conditions should not use moexipril concurrently with medications containing aliskiren, such as Tekturna. Additionally, individuals on dialysis or with low sodium levels may be at increased risk of very low blood pressure.
Drug interactions are important. Co-administration with potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride) or potassium supplements can increase hyperkalemia risk, requiring cautious use and close monitoring. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may reduce the blood pressure-lowering effect of moexipril and can potentially worsen kidney function. Use of lithium alongside moexipril can increase lithium levels in the blood, potentially leading to toxicity, necessitating careful monitoring of lithium levels. Medications containing sacubitril (e.g., Entresto) should not be taken within 36 hours of moexipril due to an increased risk of angioedema.