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ACCUPRIL
CHF and arrhythmias
Hypertension
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Drug Name:

ACCUPRIL Rx

Generic Name and Formulations:
Quinapril (as HCl) 5mg+, 10mg, 20mg, 40mg; tabs; +scored.

Company:
Pfizer Inc.

Therapeutic Use:

Indications for ACCUPRIL:

Heart failure inadequately controlled by diuretics and/or digitalis.

Adult:

Initially 5mg twice daily, if needed increase weekly to 20–40mg daily in 2 equally divided doses. In CHF with hyponatremia or renal impairment: initially 2.5–5mg once daily based on CrCl (see full labeling), if needed titrate dose under supervision.

Children:

Not established.

Pharmacological Class:

ACE inhibitor.

Contraindications:

History of ACEI-associated or other angioedema. Concomitant aliskiren in patients with diabetes, hyperkalemia, or CHF who are hypotensive. Concomitant ARBs or other ACE inhibitors in diabetics with end organ damage, patients with moderate-to-severe renal impairment (GFR <60mL/min/1.73m2), hyperkalemia, or CHF who are hypotensive.

Warnings/Precautions:

Fetal toxicity may develop; discontinue if pregnancy is detected. Salt/volume depletion. Renal or hepatic impairment. Severe CHF. Dialysis (esp. high-flux membrane). Monitor renal function in severe CHF, hypertension, or renal artery stenosis. Monitor WBCs in renal or collagen vascular disease. Monitor for hyperkalemia in diabetes or renal insufficiency. Surgery. Discontinue if angioedema, laryngeal edema, jaundice or marked elevation in liver enzymes occurs. Give SC epinephrine for airway obstruction if indicated. Reduce dose or discontinue quinapril or concomitant diuretic if symptomatic hypotension develops. Black patients: increased risk of angioedema, possibly less effective. Neonates. Pregnancy (Cat.D); monitor. Nursing mothers.

Interactions:

See Contraindications. K+ supplements, K+ sparing diuretics, K+ containing salt substitutes may cause hyperkalemia. May increase lithium levels; monitor frequently. Antagonizes tetracycline. Potentiated by diuretics. May be antagonized by NSAIDs including COX-2 inhibitors. Nitritoid reactions with concomitant injectable gold (eg, sodium aurothiomalate); rare. Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Concomitant aliskiren in renal impairment (CrCl <60mL/min): not recommended. Increased risk of angioedema with concomitant mTOR inhibitor (eg, temsirolimus).

Adverse Reactions:

Headache, dizziness, fatigue, cough, nausea, vomiting, abdominal pain, hypotension, hyperkalemia, back pain, tachycardia, dry mouth, somnolence, sweating; rare: angioedema, anaphylactoid reactions, excessive hypotension, hepatic failure, neutropenia, agranulocytosis.

Metabolism:

Hepatic. 97% protein bound.

Elimination:

Renal.

How Supplied:

Tabs—90

ACCUPRIL

  • 40mg tablets (Qty:30)
  • appx. price $90.00
GoodRx

Indications for ACCUPRIL:

Hypertension.

Adult:

Monotherapy: initially 10–20mg once daily. Usual maintenance: 20–80mg daily in 1–2 divided doses. Elderly: initially 10mg once daily. Patients on diuretic: suspend diuretic for 2–3 days before starting; resume diuretic if BP not controlled by quinapril alone. If diuretic cannot be discontinued, or if creatinine clearance (CrCl) 30–60mL/min: initially 5mg daily. CrCl 10–30mL/min: initially 2.5mg daily.

Children:

Not established.

Pharmacological Class:

ACE inhibitor.

Contraindications:

History of ACEI-associated or other angioedema. Concomitant aliskiren in patients with diabetes, hyperkalemia, or CHF who are hypotensive. Concomitant ARBs or other ACE inhibitors in diabetics with end organ damage, patients with moderate-to-severe renal impairment (GFR <60mL/min/1.73m2), hyperkalemia, or CHF who are hypotensive.

Warnings/Precautions:

Fetal toxicity may develop; discontinue if pregnancy is detected. Salt/volume depletion. Renal or hepatic impairment. Severe CHF. Dialysis (esp. high-flux membrane). Monitor renal function in severe CHF, hypertension, or renal artery stenosis. Monitor WBCs in renal or collagen vascular disease. Monitor for hyperkalemia in diabetes or renal insufficiency. Surgery. Discontinue if angioedema, laryngeal edema, jaundice or marked elevation in liver enzymes occurs. Give SC epinephrine for airway obstruction if indicated. Reduce dose or discontinue quinapril or concomitant diuretic if symptomatic hypotension develops. Black patients: increased risk of angioedema, possibly less effective. Neonates. Pregnancy (Cat.D); monitor. Nursing mothers.

Interactions:

See Contraindications. K+ supplements, K+ sparing diuretics, K+ containing salt substitutes may cause hyperkalemia. May increase lithium levels; monitor frequently. Antagonizes tetracycline. Potentiated by diuretics. May be antagonized by NSAIDs including COX-2 inhibitors. Nitritoid reactions with concomitant injectable gold (eg, sodium aurothiomalate); rare. Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Concomitant aliskiren in renal impairment (CrCl <60mL/min): not recommended. Increased risk of angioedema with concomitant mTOR inhibitor (eg, temsirolimus).

Adverse Reactions:

Headache, dizziness, fatigue, cough, nausea, vomiting, abdominal pain, hypotension, hyperkalemia, back pain, tachycardia, dry mouth, somnolence, sweating; rare: angioedema, anaphylactoid reactions, excessive hypotension, hepatic failure, neutropenia, agranulocytosis.

Metabolism:

Hepatic. 97% protein bound.

Elimination:

Renal.

How Supplied:

Tabs—90

ACCUPRIL

  • 40mg tablets (Qty:30)
  • appx. price $90.00
GoodRx

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