PMID- 9211084
OWN - NLM
STAT- MEDLINE
DCOM- 19970902
LR  - 20181113
IS  - 0012-6667 (Print)
IS  - 0012-6667 (Linking)
VI  - 54
IP  - 1
DP  - 1997 Jul
TI  - Fosinopril. A review of its pharmacology and clinical efficacy in the management 
      of heart failure.
PG  - 103-16
AB  - Fosinopril is the prodrug of the active diacid ACE inhibitor fosinoprilat. In 
      patients with heart failure, fosinopril reduces pulmonary capillary wedge 
      pressure, mean arterial blood pressure, mean right atrial pressure and heart 
      rate, and increases stroke volume index and cardiac index. The drug has 
      compensatory dual elimination routes via renal and hepatic systems and 
      accumulates to a lesser extent than enalapril and lisinopril in patients with 
      chronic renal insufficiency with or without heart failure. Comparative studies of 
      3 or 6 months' duration with fosinopril 10 to 40 mg/day have demonstrated 
      clinical efficacy significantly superior to that of placebo in patients with 
      heart failure [mostly New York Heart Association (NYHA) functional class II or 
      III]. Fosinopril treatment consistently increased exercise duration and improved 
      heart failure symptoms in these patients. Significantly fewer fosinopril than 
      placebo recipients withdrew or were hospitalised because of worsening heart 
      failure. Additionally, significantly more fosinopril than placebo recipients 
      showed improvement, and fewer patients had deteriorated, in terms of NYHA 
      functional class. Fosinopril and enalapril showed similar clinical efficacy over 
      6 and 12 months' treatment in patients with NYHA functional class II to IV heart 
      failure. As yet, there are no data showing a mortality benefit with fosinopril. 
      Fosinopril was well tolerated in clinical trials in patients with heart failure. 
      Dizziness (11.9 vs 5.4% for placebo), cough (9.7 vs 5.1%) and hypotension (4.4 vs 
      0.8%) were the most commonly reported adverse events. In 6- or 12-month 
      comparative studies, fosinopril therapy was associated with a lower incidence of 
      dizziness and hypotension, but a higher incidence of vertigo, than enalapril 
      therapy. 0.8% of patients discontinued the drug because of cough, which occurred 
      to a similar extent with fosinopril and enalapril. Thus, based on available 
      clinical evidence, fosinopril is an effective and well tolerated option for the 
      management of patients with heart failure. Although clinical data are limited, 
      fosinopril may be especially useful in patients with renal or hepatic impairment.
FAU - Davis, R
AU  - Davis R
AD  - Adis International Limited, Auckland, New Zealand.
FAU - Coukell, A
AU  - Coukell A
FAU - McTavish, D
AU  - McTavish D
LA  - eng
PT  - Journal Article
PT  - Review
PL  - New Zealand
TA  - Drugs
JT  - Drugs
JID - 7600076
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - R43D2573WO (Fosinopril)
SB  - IM
MH  - Angiotensin-Converting Enzyme Inhibitors/adverse 
      effects/pharmacokinetics/*pharmacology/*therapeutic use
MH  - Animals
MH  - Fosinopril/adverse effects/pharmacokinetics/*pharmacology/*therapeutic use
MH  - Heart Failure/*drug therapy/physiopathology
MH  - Hemodynamics/drug effects
MH  - Humans
RF  - 53
EDAT- 1997/07/01 00:00
MHDA- 1997/07/01 00:01
CRDT- 1997/07/01 00:00
PHST- 1997/07/01 00:00 [pubmed]
PHST- 1997/07/01 00:01 [medline]
PHST- 1997/07/01 00:00 [entrez]
AID - 10.2165/00003495-199754010-00012 [doi]
PST - ppublish
SO  - Drugs. 1997 Jul;54(1):103-16. doi: 10.2165/00003495-199754010-00012.