Hypertension. Initial: 10 mg once daily; then, adjust dose depending on BP response at peak (2—6 hr after dosing) and trough (24 hr after dosing) blood levels. Maintenance: Usually 20-40 mg/day, although some clients manifest beneficial effects at doses up to 80 mg.

In clients taking diuretics. Discontinue diuretic 2-3 days before starting fosinopril. If diuretic cannot be discontinued, use an initial dose of 10 mg fosinopril.

Congestive heart failure. Initial: 10 mg once daily; then, following initial dose, observe the client for at least 2 hr for the presence of hypotension or orthostasis (if either is present, monitor until BP stabilizes). An initial dose of 5 mg is recommended in heart failure with moderate to severe renal failure or in those who have had significant diuresis. The dose is increased over several weeks, not to exceed a maximum of 40 mg daily (usual effective range is 20-40 mg once daily).

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