Class: ACEI, Antihypertensive
Dosage Forms. Tablet: 5 mg, 10 mg, 20 mg, 40 mg
Common FDA Label Indication, Dosing, and Titration.
1. Heart failure: 5 mg po bid, may titrate to 20-40 mg po bid
2. Hypertension: 10-20 mg po daily, may titrate to 80 mg po daily
1. Diabetic nephropathy: 20-40 mg po daily
MOA. Quinapril is a competitive ACE inhibitor. It also reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein–kinin system, and can alter prostanoid metabolism, inhibit the sympathetic nervous system, and inhibit the tissue renin–angiotensin system.
Drug Characteristics: Quinapril
Medication Safety Issues: Quinapril
Drug Interactions: Quinapril
Adverse Reactions: Quinapril
Efficacy Monitoring Parameters. Decreased BP, signs/symptoms of CHF.
Toxicity Monitoring Parameters. Signs/symptoms of angioedema, severe persistent cough, hypotension; monitor baseline and periodic electrolytes, SCr, BUN, urine protein.
Key Patient Counseling Points. Avoid pregnancy. Avoid sudden discontinuation; rebound hypertension can occur. Use potassium supplements or salt substitutes only under medical supervision. May cause dizziness that may worsen if dehydrated.
Clinical Pearls. Safety and efficacy not established in children. Observe patients who are volume depleted for at least 2 h after taking the initial dose of quinapril. The full effect may not be observed for 2-4 wk.