Quinapril Hydrochloride(kwin’ ah pril)
Accupril
PREGNANCY CATEGORY D
Drug Classes
ACE inhibitor
Antihypertensive
Therapeutic Actions
Quinapril blocks ACE from converting angiotensin I to angiotensin II, a powerful vasoconstrictor, leading to decreased BP, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synthesis also may be involved in the antihypertensive action.
Indications
Treatment of hypertension alone or in combination with thiazide-type diuretics
Adjunctive therapy in the management of HF with cardiac glycosides, diuretics, and beta-adrenergic blockers
Unlabeled use: Pediatric hypertension
Contraindications and Cautions
Contraindicated with allergy to quinapril or other ACE inhibitors, pregnancy, angioedema.
Use cautiously with impaired renal function, unilateral or bilateral renal artery stenosis, salt or volume depletion, lactation.
Available Forms
Tablets—5, 10, 20, 40 mg
Dosages
Adults
Hypertension: Initial dose, 10 or 20 mg PO daily. Maintenance dose, 20–80 mg/day PO as a single dose or two divided doses. Patients on diuretics should discontinue
the diuretic 2–3 days before beginning quinapril therapy. If BP is not controlled, add diuretic slowly. If diuretic cannot be discontinued, begin quinapril therapy with 5 mg and monitor carefully for hypotension.
HF: Initial dose, 5 mg PO bid. Dose may be increased as needed to relieve symptoms; usual range, 10–20 mg PO bid; increase doses at weekly intervals until effective dose is reached.
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