Monograph

C09AA09 - Fosinopril

Propably not porphyrinogenic

Rationale

No evidence of significant CYP-dependent metabolism. Two references stating (probable) non- porphyrinogenicity. Risk for gastrointestinal adverse events in the form of nausea, vomiting, diarrhoea, abdominal pain and dyspepsia motivates vigilance against insufficient intake of food, especially of carbohydrate.

Chemical description

Hydrolyzed by esterases in the liver to fosinoprilate, an ACE-inhibitor. Of this is 75% excreted in unchanged form by the kidneys, 20-30% as glucuriode conjugate and 1-5% as p-hydroxy metabolite. South African list:use with care. French list: authorized.

Therapeutic characteristics

Common side effects that can be potentially porphyrinogenic through reduction in carbohydrate intake and that also can be confused with an acute porphyria attack are nausea, vomiting, diarrhoea, abdominal pain and dyspepsia. Other common side effects are musculoskeletal pain, myalgia, fatigue, chest pain and asthenia.

IPNet drug reports

Uneventful use reported in 1 patient with acute porphyria.

Similar drugs

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