Monopril vs. Mavik for Heart Failure and Hypertension: Important Differences and Potential Risks.

Key takeaways

Fosinopril (generic, brand name Monopril no longer available) and trandolapril (generic, brand name Mavik no longer available) are both ACE inhibitors used to treat high blood pressure and heart failure. Both medications also protect the kidneys in people with diabetes. Fosinopril is typically started at 10 mg and increased to 20 mg to 40 mg once daily, whereas trandolapril starts at 1 mg to 2 mg once daily, with a maximum dose of 8 mg. Both medications can cause a dry cough and dizziness, but trandolapril has a higher incidence of these side effects. Additionally, trandolapril is more likely to cause high uric acid levels. Both medications require regular blood tests to monitor kidney health and potassium levels. Neither should be taken during pregnancy due to the risk of birth defects.

Fosinopril

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Trandolapril

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Summary for Monopril

Prescription only

Fosinopril sodium (Monopril) is an angiotensin-converting enzyme (ACE) inhibitor. It's used to treat high blood pressure in adults and children. It can also treat heart failure. Fosinopril comes as a tablet that's taken by mouth once daily. Most people don't experience any side effects from fosinopril. But people who did reported cough and dizziness. Though rare, fosinopril and other ACEI inhibitors can cause angioedema, which can be serious. Brand name Monopril has been discontinued; fosinopril is only available as a generic medication.

Indications for Monopril

High blood pressure in people ages 6 years and older
Heart failure (in combination with other medications)

Pros and Cons for Monopril

Pros

Taken by mouth
Taken once a day
Available as a lower-cost generic

Cons

Can cause a cough that might not go away until you stop the medication
Not safe to use if you're pregnant
Might not work as well for lowering high blood pressure in Black adults

Common Side Effects for Monopril

For the treatment of high blood pressure

Cough (2%)
Dizziness (2%)
Nausea or vomiting (1%)

For the treatment of heart failure

Dizziness (12%)
Cough (10%)
Low blood pressure (4%)
Muscle pain (3%)
Nausea or vomiting (2%)
Diarrhea (2%)
Chest pain (2%)
Upper respiratory tract infection (2%)

Warnings for Monopril

Not safe during pregnancy
Angioedema (swelling) and serious allergic reactions
Risk of infection (lower white blood cell count)
Low blood pressure
Worsening kidney problems
High potassium levels
Risk of liver problems

Summary for Mavik

Prescription only

Trandolapril is a prescription medication that's used to treat high blood pressure (hypertension). It's also used to lower the risk of death and hospitalization in people with heart failure after a heart attack. Trandolapril is taken by mouth, typically once daily. Although the brand name for this medication (Mavik) has been discontinued, trandolapril is available as a lower-cost generic tablet. Common side effects include dry cough and dizziness.

Indications for Mavik

Treatment of high blood pressure
Lowering the risk of death and hospitalization in people with certain types of heart failure after a recent heart attack

Pros and Cons for Mavik

Pros

Available as a lower-cost generic medication
Only taken once a day
Can help protect the kidneys in people with diabetes and high blood pressure

Cons

More likely to cause dry cough compared to angiotensin II receptor blockers (ARBs)
Can’t take while pregnant
Requires regular blood work to make sure your kidneys are healthy

Common Side Effects for Mavik

Cough (35%)
Dizziness (23%)
Higher uric acid levels (15%)
Low blood pressure (11%)

Please note: The side effects above were reported by people taking this medication to lower the risk of death and hospitalization in certain heart failures after recent heart attack.