Marked reduction of blood pressure, shock, stupor, bradycardia, disturbance of water and electrolyte balance, renal failure, temporary hyperventilation, tachycardia, palpitations, dizziness, anxiety and cough. Treatment: The patient should be placed in intensive care, with careful monitoring serum electrolytes and creatinine. To reduce the absorption of the drug must gastric lavage purpose adsorbents and sodium sulfate for 30 minutes after administration of fosinopril. In the case of significant decrease of blood pressure put a patient with raised feet on the bed and make a rapid intravenous mix lidocaine with testosterone administration of 0.9% sodium chloride solution in / in the introduction of catecholamines. In severe bradycardia – atropine sulfate, in some cases, it may require the use of an artificial pacemaker.
The interaction with other drugs
Diuretics, ethanol, nitroglycerin, other nitrates and vasodilators fosinopril enhance the antihypertensive effect of the drug.
With simultaneous use of drugs with potassium fosinopril, heparin, potassium-sparing diuretics (including with amiloride, spironolactone, triamterene), with additives to foods containing potassium, increases the risk of hyperkalemia, especially in patients with heart failure and diabetes.
Concomitant use of antacids (including aluminum hydroxide, magnesium hydroxide, simethicone), may reduce the absorption inhibitor.
in the application inhibitors of the enzyme with drugs lithium may reversible increase in the concentration of lithium in blood plasma and, accordingly, increase the risk of its toxic effects.
reduce the antihypertensive effect inhibitors, rendering thus a synergistic effect on the increase of potassium in the blood plasma, but also can cause renal dysfunction.
Simultaneous use inhibitors and drugs that reduce the concentration of glucose in the blood (insulin, hypoglycemic agents for oral administration) may cause a further decrease in the concentration of glucose in blood and the risk of hypoglycemia, particularly in the first weeks of treatment and in patients with renal insufficiency.
Simultaneous use of certain tricyclic antidepressants, antipsychotics agents, anesthetics (including opioid analgesics and drugs for general anesthesia) inhibitors may result in further reduction of blood pressure and the development of orthostatic hypotension,
Sympathomimetics reduce the antihypertensive effect inhibitors. While the use of immunosuppressants, cytotoxic drugs: corticosteroids for systemic use, allopurinol and procainamide, there is a risk of leucopenia.
Fosinopril may understate the rates of serum digoxin concentrations.
Before using the and during the reception should be carefully monitored blood pressure, renal function, the number of blood cells, the potassium content, the concentration of creatinine and glucose in the blood serum.
In just a few days before the start of therapy spent earlier antihypertensive treatment should be discontinued.
patients with severe chronic heart failure III and IV functional class mix lidocaine with testosterone classification, as well as patients of other risk groups, treatment should be started under medical supervision.
patients with impaired water and electrolyte balance recommended the correction of water and electrolyte abnormalities prior to treatment , patients treated with insulin or hypoglycemic agents for oral administration, while taking inhibitors need to monitor the concentration of glucose in the blood, especially during the first month of use.
if conditions accompanied by a decrease in the bcc (diuretics, salt-free diet, vomiting, diarrhea, hemodialysis), reninzavisimoy hyponatremia, cerebrovascular disease, ischemic heart disease increases the risk of a sharp decline in blood pressure, If renovascular hypertension, bilateral renal artery stenosis or stenosis of the artery only functioning kidney is increased risk of severe hypotension and pitting failure.Also, during treatment with mix lidocaine with testosterone inhibitors may increase the concentration of urea nitrogen and serum creatinine. These effects usually occur in patients with renal insufficiency, they are reversible and disappear after cessation of treatment.
At the systemic connective tissue diseases (systemic lupus erythematosus, scleroderma) and therapy of immunosuppressants (including after kidney transplantation) increases the risk of neutropenia, agranulocytosis.
When hyperkalemia. stenosis of the aortic valve, hypertrophic obstructive cardiomyopathy, heart failure III and IV functional class classification, for the treatment of hypoglycemic agents in patients at risk of hypoglycaemia increases with diabetes.
In patients receiving mix lidocaine with testosterone inhibitors may increase potassium in the blood serum, in patients at risk hyperkalemia, namely in patients with renal insufficiency, uncontrolled diabetes mellitus, host kaliysberegayushie diuretics, potassium supplements or other drugs, the reception of which can lead to an increase of serum potassium (eg heparin), may cause hyperkalemia.
in hemodialysis using vysokoprotochnyh poliakrilnitrilozyh membrane plasmapheresis with the use of dextran sulfate in patients with elevated low-density lipoprotein, as well as the specific desensitisation to bee venom increases the risk of allergic reactions.