Quinapril

What is Quinapril

Quinapril is an oral angiotensin-converting enzyme (ACE) inhibitor used in the treatment of hypertension and heart failure.

Similar to ramipril, quinapril is a prodrug that requires deesterification to the active metabolite quinaprilat. Quinaprilat is threefold more potent than the parent compound.

Quinapril may be dosed once or twice daily when used for hypertension, and is given twice daily for the treatment of heart failure. Quinapril does not contain a sulfhydryl group, which has implications regarding the drug’s adverse reaction profile.

Quinapril has been investigated in patients with angina, and found to have neutral effects.

During a 27 month study in 1,750 patients with ischemic heart disease and preserved left ventricular function, quinapril was well-tolerated, but had no benefit in reducing the occurrence of ischemic events or progression of coronary atherosclerosis.

Quinapril was initially approved by the FDA in November 1991.

Brand Name

Accupril

Indications

  • heart failure
  • hypertension

Side Effects

  1. abdominal pain
  2. agranulocytosis
  3. alopecia
  4. amblyopia
  5. anaphylactoid reactions
  6. angina
  7. angioedema
  8. anxiety
  9. arthralgia
  10. azotemia
  11. back pain
  12. chest pain (unspecified)
  13. cholestasis
  14. constipation
  15. cough
  16. depression
  17. diaphoresis
  18. diarrhea
  19. dizziness
  20. drowsiness
  21. dyspepsia
  22. dyspnea
  23. edema
  24. elevated hepatic enzymes
  25. exfoliative dermatitis
  26. fatigue
  27. flatulence
  28. flushing
  29. GI bleeding
  30. headache
  31. heart failure
  32. hemolytic anemia
  33. hepatic failure
  34. hepatic necrosis
  35. hepatitis
  36. hyperkalemia
  37. hypertensive crisis
  38. hyponatremia
  39. hypotension
  40. impotence (erectile dysfunction)
  41. infection
  42. insomnia
  43. jaundice
  44. malaise
  45. myalgia
  46. myocardial infarction
  47. nausea
  48. neutropenia
  49. oliguria
  50. orthostatic hypotension
  51. palpitations
  52. pancreatitis
  53. paresthesias
  54. pemphigus
  55. pharyngitis
  56. photosensitivity
  57. pneumonitis
  58. pruritus
  59. rash
  60. renal failure (unspecified)
  61. sinus tachycardia
  62. stroke
  63. syncope
  64. teratogenesis
  65. thrombocytopenia
  66. vertigo
  67. vomiting
  68. xerostomia

Monitoring Parameters

  • blood pressure
  • serum creatinine/BUN
  • serum potassium
  • serum sodium

Contraindications

  • ACE-inhibitor induced angioedema
  • angioedema
  • Angiotensin-converting enzyme inhibitors (ACE inhibitors) hypersensitivity
  • aortic stenosis
  • autoimmune disease
  • Black patients
  • bone marrow suppression
  • breast-feeding
  • cardiomyopathy
  • cerebrovascular disease
  • children
  • collagen-vascular disease
  • coronary artery disease
  • dialysis
  • geriatric
  • heart failure
  • hepatic disease
  • hereditary angioedema
  • hymenoptera venom (insect sting) allergy desensitization
  • hyperkalemia
  • hyponatremia
  • hypotension
  • hypovolemia
  • immunosuppression
  • low-density lipoprotein apheresis
  • pregnancy
  • renal artery stenosis
  • renal disease
  • renal failure
  • renal impairment
  • scleroderma
  • systemic lupus erythematosus (SLE)

Interactions

  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Pseudoephedrine
  • Acrivastine; Pseudoephedrine
  • Aldesleukin, IL-2
  • Alemtuzumab
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Alogliptin; Metformin
  • Alpha-glucosidase Inhibitors
  • Alprostadil
  • Amifostine
  • Amiloride
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amobarbital
  • Amphetamine; Dextroamphetamine Salts
  • Amyl Nitrite
  • Angiotensin II
  • Angiotensin II receptor antagonists
  • Apomorphine
  • Apraclonidine
  • Aprotinin
  • Aripiprazole
  • Asenapine
  • Azathioprine
  • Azilsartan
  • Azilsartan; Chlorthalidone
  • Baclofen
  • Benzphetamine
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bosentan
  • Brexpiprazole
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Cabergoline
  • Calcium Phosphate, Supersaturated
  • Canagliflozin; Metformin
  • Candesartan
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
  • Carvedilol
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chloroprocaine
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Ciprofloxacin
  • Clozapine
  • Co-Enzyme Q10, Ubiquinone
  • Cocaine
  • Codeine; Phenylephrine; Promethazine
  • Conivaptan
  • Cyclophosphamide
  • Cyclosporine
  • Dapagliflozin; Metformin
  • Delafloxacin
  • Demeclocycline
  • Desloratadine; Pseudoephedrine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmethylphenidate
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Quinidine
  • Diazoxide
  • Diethylpropion
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Phenylephrine
  • Doxycycline
  • Drospirenone
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Duloxetine
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enflurane
  • Entecavir
  • Ephedrine
  • Eplerenone
  • Eprosartan
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Ertugliflozin; Metformin
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Etomidate
  • Everolimus
  • Fexofenadine; Pseudoephedrine
  • Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
  • Fluorescein
  • Fluoxetine; Olanzapine
  • Fospropofol
  • Gemifloxacin
  • General anesthetics
  • Glipizide; Metformin
  • Glyburide; Metformin
  • Gold
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guaifenesin; Pseudoephedrine
  • Haloperidol
  • Halothane
  • Heparin
  • Hydralazine; Isosorbide Dinitrate, ISDN
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Ibuprofen; Pseudoephedrine
  • Icatibant
  • Iloperidone
  • Iloprost
  • Incretin Mimetics
  • Indapamide
  • Insulins
  • Intravenous Lipid Emulsions
  • Iohexol
  • Iopamidol
  • Iopromide
  • Ioversol
  • Irbesartan
  • Iron Dextran
  • Isocarboxazid
  • Isoflurane
  • Isoproterenol
  • Isosorbide Dinitrate, ISDN
  • Isosorbide Mononitrate
  • Isosulfan Blue
  • Kanamycin
  • Ketamine
  • Lanthanum Carbonate
  • Levodopa
  • Levofloxacin
  • Linagliptin; Metformin
  • Lisdexamfetamine
  • Lithium
  • Loop diuretics
  • Loratadine; Pseudoephedrine
  • Losartan
  • Lovastatin; Niacin
  • Lurasidone
  • Magnesium Salts
  • Magnesium Sulfate; Potassium Sulfate; Sodium Sulfate
  • Meglitinides
  • Mestranol; Norethindrone
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methamphetamine
  • Methohexital
  • Methylphenidate
  • Milrinone
  • Minocycline
  • Moxifloxacin
  • Naproxen; Pseudoephedrine
  • Nateglinide
  • Nebivolol; Valsartan
  • Nefazodone
  • Nesiritide, BNP
  • Niacin, Niacinamide
  • Niacin; Simvastatin
  • Nitrates
  • Nitroglycerin
  • Nitroprusside
  • Non-Ionic Contrast Media
  • Nonsteroidal antiinflammatory drugs
  • Norfloxacin
  • Ofloxacin
  • Olanzapine
  • Olmesartan
  • Omadacycline
  • Oxymetazoline
  • Paliperidone
  • Pentoxifylline
  • Phenelzine
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Polyethylene Glycol; Electrolytes
  • Polyethylene Glycol; Electrolytes; Ascorbic Acid
  • Potassium
  • Pramlintide
  • Prazosin
  • Pregabalin
  • Procainamide
  • Procaine
  • Propofol
  • Pseudoephedrine
  • Quinidine
  • Rasagiline
  • Repaglinide
  • Risperidone
  • Sacubitril; Valsartan
  • Salicylates
  • Sarecycline
  • Selegiline
  • Sevoflurane
  • SGLT2 Inhibitors
  • Silodosin
  • Sirolimus
  • Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Spironolactone
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfonylureas
  • Tacrolimus
  • Telavancin
  • Telbivudine
  • Telmisartan
  • Temsirolimus
  • Tetrabenazine
  • Tetracaine
  • Tetracycline
  • Tetracyclines
  • Thiazide diuretics
  • Thiazolidinediones
  • Thiopental
  • Thiothixene
  • Tizanidine
  • Tolvaptan
  • Tranylcypromine
  • Trazodone
  • Triamterene
  • Trimethoprim
  • Valsartan
  • Yohimbine
  • Ziprasidone
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