Drug Index

Quinapril

 
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Mechanism :

Competitive inhibitor of angiotensin-converting enzyme (ACE).


Indication :

• Off-label: Pediatric hypertension


Contraindications :

Hypersensitivity to quinapril or any component of the formulation; angioedema related to previous treatment with an ACE inhibitor; concomitant use with aliskiren in patients with diabetes mellitus; concomitant use with neprilysin inhibitor (e.g., sacubitril) or within 36 hours of switching to or from neprilysin inhibitor.


Dosing :

Off-label: 5-10 mg PO daily.


Adverse Effect :

Dizziness, coughing, fatigue, nausea, vomiting, hypotension, dyspnea, diarrhea, headache, rash, myalgia, angioedema, palpitation, vasodilation, tachycardia, heart failure, hyperkalemia, myocardial infarction, cerebrovascular accident, hypertensive crisis.


Interaction :

Angiotensin II Receptor Blockers: May enhance the adverse/toxic effect of Angiotensin-Converting Enzyme Inhibitors.
Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents.
Loop Diuretics: May enhance the hypotensive effect of Angiotensin-Converting Enzyme Inhibitors.
Nonsteroidal Anti-Inflammatory Agents: Angiotensin-Converting Enzyme Inhibitors may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents. Specifically, the combination may result in a significant decrease in renal function.
Potassium-Sparing Diuretics: May enhance the hyperkalemic effect of Angiotensin-Converting Enzyme Inhibitors. Risk C: Monitor therapy.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Start with low dose, adjust according to response
10-20Start with low dose, adjust according to response
<10Start with low dose, adjust according to response

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in GFR<10 mL/min
HD25% dialysed. Dose as in GFR<10 mL/min
HDF/High fluxDialysed. Dose as in GFR<10 mL/ min
CAV/VVHDUnknown dialysability. Dose as in GFR=10–20 mL/min

Hepatic Dose :

Quinaprilat serum concentrations are reduced in patients with alcoholic cirrhosis due to impaired de-esterification of quinapril. In hepatic impairment even though drug metabolism is impaired, the excretion of metabolite is unaltered and hence dose adjustment may not be required.
06/01/2020 01:07:34 Quinapril
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