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Combination of
Fosinopril Angiotensin converting enzyme inhibitor
Hydrochlorothiazide Thiazide diuretic
Clinical data
Trade names Monopril HCT
Pregnancy cat.
  • C (1st trimester); D (2nd & 3rd trimesters)
Legal status
  • Prescription only
Routes Oral
ATC code C09BA09

Fosinopril/hydrochlorothiazide (trade name Monopril HCT) is the combination preparation of fosinopril, an angiotensin converting enzyme (ACE) inhibitor, and hydrochlorothiazide, a thiazide diuretic. It is a combination drug to treat high blood pressure (hypertension)[1]

This drug has a boxed warning about its significant risk to cause fetal/neonatal morbidity and mortality when being used during pregnancy (2nd and 3rd trimesters).[2]

FDA modified its labeling on February, 2009 to include a precaution of drug interaction with gold. "Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and hypotension) have been reported rarely in patients on therapy with injectable gold (sodium aurothiomalate) and concomitant ACE inhibitor therapy including Monopril/Monopril HCT."[3]


The recommended initial dosage of Fosinopril/hydrochlorothiazide for adults with high blood pressure (hypertension) is losartan-hydrochlorothiazide 10 mg/12.5 mg per day. The dosage range could be 10-80 mg/12.5-50 mg once a day. When CrCl < 30 mL/min or serum creatinine ≥ 3 mg/dL, patient should not use this drug. Since metabolism of active metabolite fosinoprilat will be reduced in progressive liver disease, patient with hepatic impairment should use this drug with caution. [4]

Adverse effects[edit]

Combination of adverse responses caused by fosinopril and hydrochlorothiazide.