What are the generic names for fosinopril (Angiotensin-Converting Enzyme Inhibitor)-HCTZ (Hydrochlorothiazide)?

Generic Names for Fosinopril-HCTZ

The generic names for the combination medication are fosinopril sodium and hydrochlorothiazide.

Components and Classification

• Fosinopril sodium: An angiotensin-converting enzyme (ACE) inhibitor
• Hydrochlorothiazide (HCTZ): A thiazide diuretic

Clinical Uses

This combination medication is commonly used for:

• Treatment of hypertension (high blood pressure)
• Management of heart failure
• Reduction of cardiovascular events in high-risk patients

Mechanism of Action

The combination works synergistically through complementary mechanisms:

• Fosinopril: Inhibits the angiotensin-converting enzyme, which:

  • Prevents conversion of angiotensin I to angiotensin II
  • Reduces vasoconstriction
  • Decreases aldosterone secretion
  • Lowers blood pressure through vasodilation

• Hydrochlorothiazide: Acts as a thiazide diuretic, which:

  • Inhibits sodium and chloride reabsorption in the distal convoluted tubule
  • Increases water excretion
  • Reduces blood volume
  • Lowers blood pressure through decreased cardiac output and peripheral resistance

Dosing Information

According to clinical guidelines, typical dosing includes:

• Fosinopril: 10-40 mg once daily 1
• HCTZ: 12.5-25 mg once daily 1

The combination is typically available in several fixed-dose formulations, such as:

• Fosinopril 10 mg/HCTZ 12.5 mg
• Fosinopril 20 mg/HCTZ 12.5 mg

Pharmacokinetic Properties

Fosinopril has unique pharmacokinetic properties compared to other ACE inhibitors:

• It is a prodrug that is hydrolyzed to the active form fosinoprilat 2
• Unlike other ACE inhibitors, fosinoprilat has dual elimination routes (hepatic and renal) 2
• This dual elimination pathway makes it suitable for patients with moderate to severe renal dysfunction without requiring significant dosage adjustments 2, 3

Clinical Considerations

• The combination of fosinopril and HCTZ provides synergistic antihypertensive effects 4
• This combination has been shown to reduce oxidative stress and improve endothelial function in hypertensive patients with obesity 4
• In patients with renal impairment, fosinopril can be safely coadministered with HCTZ without significant increases in fosinoprilat concentrations 3

Important Note

When prescribing this combination, be aware that:

• If eGFR is <30 mL/min/m², a loop diuretic rather than HCTZ should be prescribed 1
• The combination of an ACE inhibitor and a diuretic has been shown to reduce cardiovascular and total mortality in certain patient populations 1