Moexipril is an ACE inhibitor used primarily for hypertension.

It is less commonly prescribed compared to lisinopril or enalapril.

Class: → ACE Inhibitors

• Inhibits Angiotensin-Converting Enzyme (ACE) • ↓ Angiotensin II • ↓ Aldosterone • ↑ Bradykinin

Net Effects: • ↓ Systemic vascular resistance • ↓ Blood pressure • ↓ Sodium retention

Mechanism identical to other ACE inhibitors.

• Prodrug (converted to active moexiprilat) • Shorter duration compared to lisinopril • Absorption reduced by food (take 1 hour before meals)

Because of food effect and less convenient dosing, rarely first-line in modern practice.

• Approved for treatment of hypertension • Not commonly used for heart failure compared to other ACE inhibitors

→ Hypertension Module

Hypertension: • Start: 7.5 mg once daily (1 hour before meals) • Typical range: 7.5–30 mg daily (once or divided)

May require twice-daily dosing.

• Prodrug → activated in liver • Renally cleared • Reduced bioavailability with food • Half-life ~2–9 hours (active metabolite)

Dose adjustment required in renal impairment.

Class Effects: • Dry cough • Hyperkalemia • Hypotension • Angioedema (rare)

No major differences from other ACE inhibitors.

Monitor: • Serum creatinine • Potassium

Check labs within 1–2 weeks of initiation or dose changes.

• Pregnancy • History of ACE inhibitor–induced angioedema • Bilateral renal artery stenosis

✔ Less commonly used ACE inhibitor ✔ Must be taken before meals ✔ Similar efficacy to other ACE inhibitors ✔ No clear advantage over more commonly used agents

Related:

→ ACE Inhibitors → Lisinopril → Enalapril → Return to CV Modules