Quinapril
ACE Inhibitor · ACE inhibitor
Indications
Hypertension, adjunct to diuretics and, where appropriate, digitalis in congestive heart failure.
Dosage
Adults: Essential hypertension: 10 mg once daily, maintenance 20-40 mg daily in up to 2 divided doses. Max 80 mg/day. Elderly: 2.5 mg once daily. Maintenance and max dose, same as adults. Essential hypertension if used in addition to diuretic: Initially 2.5 mg. Usual maintenance 10-20 mg daily in divided doses. Initiate therapy in hospital; reduce dose of diuretic before initiating therapy. Max 80 mg/day. Heart failure: 2.5 mg daily, increased gradually to 10-20 mg daily in 1-2 divided doses if tolerated, max 40 mg/day. Children: Not recommended.
Adverse Effects
Headache, dizziness, rhinitis, cough, upper respiratory tract infection, fatigue, nausea. Dyspepsia, myalgia, chest pain, abdominal pain. Angioedema (discontinue immediately). Hypotension, hyperkalaemia, paraesthesia, rhinitis, GI upset, insomnia, dyspnoea, back pain, asthaenia, pharyngitis, raised blood creatinine and urea. Reports of hepatic failure (discontinue), neutropenia, agranulocytosis.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: History of angioedema associated with previous ACE inhibitor therapy, hereditary/idiopathic angioedema. Outflow obstruction. Severe renal impairment (CrCl<10mL/min). Precautions: Mild to moderate renal impairment (CrCl<60mL/min), severe CHF, salt or volume depletion, aortic stenosis, renovascular hypertension, renal artery stenosis, ischaemic heart or cerebrovascular disease, haemodialysis, hepatic impairment. Monitor renal function, electrolytes, white cell count, BUN and urinary protein before and during therapy. Collagen vascular disease, surgery/anaesthesia, LDL apheresis.
Interactions
Potassium sparing diuretics or potassium supplement, NSAIDs, tetracyclines, other antihypertensives, sacubitril/valsartan, lithium, antacids, allopurinol, immunosuppressants, temsirolimus, corticosteroids, procainamide, antidiabetic agents, alcohol, barbiturates, hyposensitising agents, trimethoprim, heparin, vasodilators, anaesthetics, sodium aurothiomalate (gold), high-flux dialysis memebranes.
Advice to Patient
Take before meals at the same time of day. Take first dose at bedtime. Contact prescriber if there is swelling of face/mouth/lips/tongue or throat, chest pain or difficulty in breathing, constant cough, muscle pain, joint pain, back pain or skin rash occurs. Take in sitting position to prevent hypotension. Do not take potassium supplements or salt substitutes without consulting prescriber. Change position slowly when climbing stairs and from lying or sitting to standing position.
Pharmacokinetics
Onset of action: 1 hr. Peak effect: Antihypertensive: 2-4 hrs postdose. Duration: 24 hrs (chronic dosing). Absorption: Quinapril: =60%. Metabolism: Rapidly hydrolyzed to quinaprilat, the active metabolite. Half-life elimination: Infants and children <7 yrs: Quinaprilat: 2.3 hrs. Adults: Quinapril: 0.8 hrs. Quinaprilat: 3 hrs. Time to peak, serum: Infants and children <7 yrs: 1.7 hrs. Adults: Quinapril: 1 hr. Quinaprilat: Approx. 2 hrs. Excretion: Urine.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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