Home Drug Guide Spirapril Hydrochloride

Drug Guide

Generic Name

Spirapril Hydrochloride

Brand Names Renormax

Classification

Therapeutic: Antihypertensive

Pharmacological: ACE inhibitor (Angiotensin-Converting Enzyme inhibitor)

FDA Approved Indications

  • Hypertension
  • Heart failure (off-label)

Mechanism of Action

Spirapril inhibits the angiotensin-converting enzyme, reducing the conversion of angiotensin I to angiotensin II, leading to vasodilation, decreased blood volume, and reduced blood pressure.

Dosage and Administration

Adult: Typically 2.5 to 5 mg once daily, titrated based on response. Maximum dose usually 20 mg daily.

Pediatric: Data limited; use in children not well established.

Geriatric: Start at lower doses due to increased sensitivity; monitor closely.

Renal Impairment: Dose adjustment may be necessary; start at lower doses and titrate gradually.

Hepatic Impairment: No specific adjustment recommended, but caution advised.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; crosses the placenta.

Metabolism: Hydrolyzed to active metabolite spiraprilat.

Excretion: Primarily via renal route.

Half Life: Approximately 2-4 hours for spirapril, active metabolite has a longer half-life.

Contraindications

  • History of angioedema related to previous ACE inhibitor use
  • Concurrent use with aliskiren in patients with diabetes or renal impairment
  • Pregnancy (especially second and third trimesters)

Precautions

  • Renal impairment
  • Hyperkalemia
  • Aortic stenosis
  • Caution in patients with bilateral renal artery stenosis

Adverse Reactions - Common

  • Cough (Common)
  • Hyperkalemia (Uncommon)
  • Dizziness (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Angioedema (Rare)
  • Neutropenia or agranulocytosis (Rare)
  • Renal impairment or failure (Rare)

Drug-Drug Interactions

  • Use with other antihypertensives or diuretics may enhance hypotensive effects.
  • Potassium-sparing diuretics or potassium supplements can increase hyperkalemia risk.
  • Use with NSAIDs may reduce antihypertensive efficacy and impair renal function.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, renal function (BUN, serum creatinine), and serum electrolytes regularly.

Diagnoses:

  • Risk for decreased cardiac output
  • Risk for electrolyte imbalance

Implementation: Administer as prescribed, typically once daily. Educate patients on symptoms of hypotension, cough, and angioedema.

Evaluation: Assess blood pressure response and renal function periodically.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report signs of swelling, difficulty breathing, or rash immediately.
  • Avoid potassium supplements and potassium-rich foods unless advised by healthcare provider.
  • Warn about possible dizziness or lightheadedness, especially when standing up quickly.

Special Considerations

Black Box Warnings:

  • Pregnancy: can cause injury or death to the fetus; discontinue as soon as pregnancy is detected.

Genetic Factors: Genetic predisposition to angioedema may increase risk.

Lab Test Interference: May alter serum potassium and renal function tests.

Overdose Management

Signs/Symptoms: Severe hypotension, dizziness, dehydration.

Treatment: Discontinue medication, provide supportive care, and administer IV fluids as needed. Use vasopressors if necessary.

Storage and Handling

Storage: Store at room temperature away from moisture, heat, and light.

Stability: Stable for 24 months when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.