Accupril

Quinapril HCl

HTN as monotherapy or concomitantly w/ thiazide diuretics & β-blockers. CHF concomitantly w/ a diuretic &/or cardiac glycoside.

HTN Patient not on diuretic Initially 10 or 20 mg once daily. Maintenance: May be titrated to 20-40 mg daily as a single or in 2 divided doses depending upon response. Dose adjustment should be made at interval of 4 wk. Patient w/ concomitant use of diuretic Initially 5 mg, subsequently titrated to attain optimal response. CHF Initially 5 mg once daily or bid. If tolerated, may be titrated up to 10-40 mg daily in 2 equally divided doses w/ concomitant therapy w/ diuretic &/or cardiac glycoside. Renal impairment CrCl >60 mL/min 10 mg, 30-60 mL/min 5 mg, 10-30 mL/min 2.5 mg. Elderly Initially 10 mg once daily, followed by titration to optimal response.

Should be taken on an empty stomach.

Hypersensitivity. History of angioedema related to previous treatment w/ ACE inhibitor. Increased risk of angioedema when combined w/ sacubitril/valsartan. Do not co-administer w/ aliskiren in patients w/ diabetes, moderate to severe kidney insufficiency (GFR <60 mL/min/1.73 m²), hyperkalemia (>5 mmol/L), CHF patients who are hypotensive. Do not co-administer w/ ARB or other ACE inhibitors. Women of childbearing potential not using adequate contraceptive measures. Pregnancy.

Discontinue immediately if laryngeal stridor or angioedema of the face, tongue, or glottis occurs. Include intestinal angioedema in the differential diagnosis of patients presenting w/ abdominal pain. History of angioedema unrelated to ACE inhibitor therapy. Anaphylactoid reactions in patients during treatment w/ Hymenoptera venom, those undergoing LDL apheresis w/ dextran-sulfate absorption, & those hemodialyzed using certain high-flux membranes (eg, polyacrylonitrile membranes). Dual blockade of the renin-angiotensin system. Hypotension. Agranulocytosis & bone marrow depression in patients w/ uncomplicated HTN but more frequently in those w/ renal impairment, especially if w/ collagen vascular disease. Hyperkalemia. Combination w/ K-sparing diuretics or other drugs known to raise serum K levels. Hyponatremia & SIADH. Diabetes. Non-productive, persistent cough that resolves after discontinuation of therapy. Surgery/anesth. Concomitant use w/ mTOR inhibitor (eg, temsirolimus), DPP-IV inhibitor (eg, vildagliptin) or a neutral endopeptidase inhibitor; insulin or oral hypoglycemic agents. Black patients. May impair to drive or operate machinery. Renal impairment. Hepatic impairment or progressive liver disease. Lactation. Ped patients.

Headache, dizziness, cough, fatigue, rhinitis, nausea &/or vomiting, myalgia.

Reduced absorption of tetracycline & other drugs that interact w/ Mg. Increased serum levels & symptoms of lithium toxicity. May deteriorate renal function including possible acute renal failure w/ NSAIDs including selective COX-2 inhibitors. Anti-hypertensive effect may be attenuated w/ NSAIDs. Occasional excessive reduction of BP w/ diuretics. Severe hyperkalemia w/ trimethoprim-containing products. Dual blockade of the renin-angiotensin system associated w/ increased risk of hypotension, hyperkalemia & changes in renal function including acute renal failure w/ ARB, ACE inhibitors or aliskiren. Concomitant therapy w/ K-sparing diuretics (eg, spironolactone, triamterene, or amiloride), K supplements, K-containing salt substitutes or other drugs known to raise serum K levels.

ACE Inhibitors/Direct Renin Inhibitors

C09AA06 - quinapril ; Belongs to the class of ACE inhibitors. Used in the treatment of cardiovascular disease.

Rx