Quinapril

Hypertension Quinapril tablets are indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including the class to which this drug principally belongs. There are no controlled trials demonstrating risk reduction with quinapril tablets. …

• Hypertension Monotherapy: The recommended initial dosage of quinapril in patients not on diuretics is 10 or 20 mg once daily
• Dosage should be adjusted according to blood pressure response measured at peak (2–6 hours after dosing) and trough (predosing)
• Generally, dosage adjustments should be made at intervals of at least 2 weeks
• Most patients have required dosages of 20, 40, or 80 mg/day, given as a single dose or in two equally divided doses
• In some patients treated once daily, the antihypertensive effect may diminish toward the end of the dosing interval
• In such patients an increase in dosage or twice daily administration may be warranted
• In general, doses of 40–80 mg and divided doses give a somewhat greater effect at the end of the dosing interval
• Concomitant Diuretics: If blood pressure is not adequately controlled with quinapril monotherapy, a diuretic may be added
• In patients who are currently being treated with a diuretic, symptomatic hypotension occasionally can occur following the initial dose of quinapril
• To reduce the likelihood of hypotension, the diuretic should, if possible, be discontinued 2 to 3 days prior to beginning therapy with quinapril (see WARNINGS )
• Then, if blood pressure is not controlled with quinapril alone, diuretic therapy should be resumed
• If the diuretic cannot be discontinued, an initial dose of 5 mg quinapril should be used with careful medical supervision for several hours and until blood pressure has stabilized. …

• Quinapril tablets are contraindicated in patients who are hypersensitive to this product and in patients with a history of angioedema related to previous treatment with an ACE inhibitor
• Quinapril tablets are contraindicated in combination with a neprilysin inhibitor (e.g., sacubitril). …

FETAL TOXICITY • When pregnancy is detected, discontinue quinapril as soon as possible. • Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus. See Warnings: Fetal Toxicity WARNINGS Anaphylactoid and Possibly Related Reactions Presumably because ACE inhibitors affect the metabolism of eicosanoids and polypeptides, including endogenous bradykinin, patients receiving ACE inhibitors (including quinapril) may be subject to a variety of adverse reactions, some of them serious. …

Hypertension Quinapril has been evaluated for safety in 4960 subjects and patients. Of these, 3203 patients, including 655 elderly patients, participated in controlled clinical trials. Quinapril has been evaluated for long-term safety in over 1400 patients treated for 1 year or more. Adverse experiences were usually mild and transient. In placebo-controlled trials, discontinuation of therapy because of adverse events was required in 4.7% of patients with hypertension. …

Doses of 1440 to 4280 mg/kg of quinapril cause significant lethality in mice and rats. No specific information is available on the treatment of overdosage with quinapril. The most likely clinical manifestation would be symptoms attributable to severe hypotension. Laboratory determinations of serum levels of quinapril and its metabolites are not widely available, and such determinations have, in any event, no established role in the management of quinapril overdose. …

Take it when you remember, unless it is nearly time for the next dose. Then skip the missed one. Never take two doses at once to make up for it. Check your leaflet, as some medicines are different.