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Warnings & Precautions
WARNINGS Anaphylactoid and Possibly Related Reactions
Presumably because angiotensin-converting enzyme inhibitors affect the metabolism of eicosanoids and polypeptides, including endogenous bradykinin, patients receiving ACE inhibitors (including MONOPRIL) may be subject to a variety of adverse reactions, some of them serious. Head and Neck Angioedema: Text Continues Below
Angioedema involving the extremities, face, lips, mucous membranes, tongue, glottis or larynx has been reported in patients treat-ed with ACE inhibitors. If angioedema involves the tongue, glottis or larynx, airway obstruction may occur and be fatal. If laryngeal stridor or angioedema of the face, lips, mucous membranes, tongue, glottis or extremities occurs, treatment with MONOPRIL should be discontinued and appropriate therapy instituted immediate-ly. Where there is involvement of the tongue, glottis, or larynx, likely to cause airway obstruction, appropriate therapy, e. g., subcutaneous epinephrine solu-tion 1: 1000 (0.3 mL to 0.5 mL) should be promptly administered (see PRECAU-TIONS: Information for Patients and ADVERSE REACTIONS). Intestinal Angioedema: Intestinal angioedema has been reported in patients treated with ACE inhibitors. These patients presented with abdominal pain (with or without nausea or vomiting); in some cases there was no prior history of facial angioedema and C-1 esterase levels were normal. The angioedema was diag-nosed by procedures including abdominal CT scan or ultrasound, or at surgery, and symptoms resolved after stopping the ACE inhibitor. Intestinal angioedema should be included in the differential diagnosis of patients on ACE inhibitors pre-senting with abdominal pain. Anaphylactoid reactions during desensitization: Two patients undergoing desensitizing treatment with hymenoptera venom while receiving ACE inhibitors sustained life-threatening anaphylactoid reactions. In the same patients, these reactions were avoided when ACE inhibitors were temporarily withheld, but they reappeared upon inadvertent rechallenge. Page: 1 | 2 | 3 | 4 | 5 | Next >>
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