WAMPOCAP
Clinical safety rating: caution
Comprehensive clinical and safety monograph for WAMPOCAP (WAMPOCAP).
WAMPOCAP is an angiotensin II receptor blocker (ARB) that selectively inhibits the binding of angiotensin II to the AT1 receptor, resulting in vasodilation, reduced aldosterone secretion, and decreased blood pressure.
| Metabolism | Metabolized primarily by CYP2C9 and CYP3A4 to an active metabolite. |
| Excretion | Primarily renal excretion as unchanged drug (60-70%) and metabolites (20-30%). Biliary/fecal excretion accounts for 5-10%. |
| Half-life | Terminal elimination half-life is 12-15 hours in adults with normal renal function; prolonged to 24-40 hours in moderate renal impairment (CrCl 30-50 mL/min). |
| Protein binding | Approximately 95% bound to albumin and alpha-1-acid glycoprotein. |
| Volume of Distribution | Volume of distribution is 0.8-1.2 L/kg, indicating extensive tissue distribution. |
| Bioavailability | Oral: 75-85% (due to first-pass metabolism); IM: 90-100%; rectal: 60-70%. |
| Onset of Action | Oral: 30-60 minutes; IV: immediate (within minutes); IM: 15-30 minutes. |
| Duration of Action | Oral: 8-12 hours; IV: 4-6 hours (dose-dependent); IM: 6-8 hours. Duration may be extended in hepatic impairment. |
50 mg orally twice daily with or without food.
| Dosage form | CAPSULE |
| Renal impairment | For GFR 30-59 mL/min: 25 mg twice daily; GFR 15-29 mL/min: 25 mg once daily; GFR <15 mL/min: not recommended. |
| Liver impairment | Child-Pugh A: no adjustment; Child-Pugh B: 25 mg once daily; Child-Pugh C: not recommended. |
| Pediatric use | 1 mg/kg/dose twice daily (max 50 mg/dose) for children ≥2 years. |
| Geriatric use | For patients ≥65 years, start at 25 mg twice daily; may increase based on tolerability. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for WAMPOCAP (WAMPOCAP).
| Breastfeeding | No data on presence in breast milk; molecular weight <500 Da suggests excretion. M/P ratio unknown. Use caution; consider alternative therapy due to potential for infant CNS effects. |
| Teratogenic Risk | No human data; animal studies show fetal growth restriction and skeletal variants at 3x MRHD. First trimester: potential for neural tube defects (based on animal data). Second/third trimester: risk of low birth weight and developmental delay. Avoid in pregnancy unless benefit outweighs risk. |
| Fetal Monitoring |
■ FDA Black Box Warning
Fetal toxicity: Drugs acting directly on the renin-angiotensin system can cause injury and death to the developing fetus. Discontinue as soon as possible when pregnancy is detected.
| Serious Effects |
["Concomitant use with aliskiren in patients with diabetes","History of hypersensitivity to WAMPOCAP or any component","Pregnancy (second and third trimesters)"]
| Precautions | ["Monitor renal function and serum potassium during therapy","Hypotension in volume-depleted patients","Avoid use with aliskiren in patients with diabetes","Angioedema risk","Hepatic impairment"] |
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| Maternal: blood pressure, liver function tests, renal function, and serum electrolytes monthly. Fetal: ultrasound growth assessment every 4 weeks from 24 weeks; nonstress test weekly from 32 weeks. |
| Fertility Effects | Animal studies: reduced fertility and implantation rates at high doses. Human data limited; may impair spermatogenesis and menstrual regularity. Reversible upon discontinuation. |