Moxonidine

Registered South African indications:

• Hypertension

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Severe renal impairment
• Sick sinus syndrome
• Sino-atrial block
• 2nd or 3rd degree atrioventricular block
• Bradycardia
• Severe cardiac failure

Cautions

• Pregnancy
• Breastfeeding
• Moderate renal impairment
• Mild to moderate hepatic impairment
• Elderly
• Abrupt withdrawal
• 1st degree atrioventricular block
• Severe coronary artery disease
• Unstable angina pectoris
• Moderate cardiac failure
• Galactose intolerance
• Lapp lactase deficiency
• Glucose malabsoprtion

Forms avail. in SA and covered in this monograph: tab

Essential hypertension - mild to moderate

• Oral (tab): Initial: 0.2mg, dly; Titrate after 3 weeks; Maintenance: 0.2-0.4mg/day in 1-2 divided doses; Max: 0.6mg/24hrs; Max single dose: 0.4mg  

Not established for use in children below 18 years

Pregnancy

• Caution
• There are no adequate data from use of moxonidine in pregnant woman. Studies in animals have shown embryo-toxicological effects. The potential risk for humans is unknown. Moxonidine should not be used during pregnancy unless clearly necessary

Breastfeeding

• Caution; not recommended
• Moxonidine is secreted in breast milk and should therefore not be used during breastfeeding
• If therapy with moxonidine is considered absolutely necessary, breastfeeding should be stopped

Renal Impairment

• Mild (GFR>60ml/min): No dose adjustment recommended
• Moderate (GFR 30-60ml/min): Caution; dose adjustment recommended
  Max single dose: 0.2mg; Max: 0.4mg/24hrs 
• Severe (GFR<30ml/min): Contraindicated

Hepatic Impairment

• Caution; no information available

Elderly

• Caution; no dose adjustment recommended
  Start with the lowest dose and dose increments should be introduced

Porphyria Information

• Not porphyrinogenic (NP)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Headache
• Dizziness
• Vertigo
• Somnolence
• Insomnia
• Nervousness
• Syncope
• Orthostatic hypotension
• Aesthenia

Cardiovascular Disorders

• Bradycardia
• Oedema

Gastrointestinal Disorders

• Dry mouth
• Diarrhoea
• Nausea and vomiting
• Dyspepsia

Musculoskeletal Disorders

• Neck pain
• Back pain

Skin and Subcutaneous Tissue Disorders

• Rash
• Pruritus
• Angioedema

Sensory Disorders

• Tinnitus

• Beta blockers
• Antihypertensive agents
• Central nervous system depressants
• Tricyclic antidepressants
• Agents excreted through tubular excretion

None routine

Moxonidine is a centrally acting antiadrenergic agent that selectively interact with I1-imidazoline receptors in the rostral ventrolateral medulla, an area critical to the central control of the peripheral sympathetic nervous system. The net effect of this interaction with the I1-imidazoline receptors is reduced activity of sympathetic nerves.

Tablet 0.2mg

• Cynt (Abbott)
• Moxotens (Sandoz)
• Physiotens (Abbott) originator

Tablet 0.3mg

• Moxotens (Sandoz)
• Physiotens (Abbott) originator

Tablet 0.4mg

• Cynt (Abbott)
• Physiotens (Abbott) originator