Quinapril (Accupril)
Class and Catgeory
Before you buy Quinapril (Accupril) online, read common information about the medication.
Chemical class: Ethylester of quinaprilat
Therapeutic class: Antihypertensive
Pregnancy category: C (first trimester), D (later trimesters)
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Drug Indications and Dosages
Before purchase Quinapril (Accupril) online , you must read how it works.
To treat hypertension
Tablets
Adults. Initial: 10 or 20 mg daily, adjusted every 2 wk based on clinical response. Maintenance: 20 to 80 mg daily or in divided doses b.i.d.
Dosage Adjustment Initial dosage reduced to 5 mg daily for patients who are dehydrated from previous diuretic therapy, those who are still receiving diuretic therapy, and those with creatinine clearance of 30 to 60 ml/min/1.73 m2. Dosage reduced to 2.5 mg daily for patients with creatinine clearance of 10 to 30 ml/min/1.73 m2.
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Contraindications of Drug
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History of angioedema related to previous treatment with ACE inhibitor, hypersensitivity to quinapril or its components
Generic Drug Interactions
Drugs
allopurinol, bone marrow depressants, corticosteroids (systemic), procainamide: Increased risk of fatal neutropenia or agranulocytosis
CNS depressants, other hypotension-producing drugs: Additive hypotensive effects
cyclosporine, potassium preparations, potassium-sparing diuretics: Possibly hyperkalemia
lithium: Possibly increased blood lithium level and risk of toxicity nonsteroidal anti-inflammatory drugs (NSAIDs)
sympathomimetics: Decreased anti-hypertensive effect of quinapril
sodium aurothiomalate: Possibly nitritoid reactions such as facial flushing, nausea, vomiting, and hypotension
tetracyclines:Reduced tetracycline absorption light-headedness, especially for first few days of therapy. Advise patient to avoid hazardous activities until drug's CNS effects are known and to notify prescriber if he faints.
Inform woman of childbearing age of risks of taking quinapril during pregnancy, especially during the second and third trimesters. Caution her to use effective contraception and to notify prescriber immediately of known or suspected pregnancy.
Advise patient having surgery or anesthesia to tell specialist that he takes quinapril. Instruct patient to consult prescriber before using potassium supplements or salt substitutes that contain potassium.
Foods
low-salt milk, salt substitutes: Increased risk
of hyperkalemia
Activities
alcohol use: Additive hypotensive effects
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Drugs Adverse Reactions
Central Nervous System: Depression, dizziness, drowsiness, fatigue, fever, headache, insomnia, light-headedness, malaise, paresthesia, sleep disturbance, syncope, vertigo
Cardiovascular: Chest pain, hypotension, orthostatic hypotension, palpitations, tachycardia
Eyes, Ears, Nose, And Throat: Amblyopia, dry mouth, loss of taste, pharyngitis
Gastrointestinal: Abdominal pain, constipation, diarrhea, indigestion, nausea, vomiting
Genitourinary: Impotence
Musculoskeletal: Arthralgia, back pain, myalgia
Respiratory: Cough, dyspnea
Skin: Alopecia, diaphoresis, flushing, pho-tosensitivity, pruritus, rash, urticaria
Other: Anaphylaxis, angioedema
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Nursing Considerations for Generic Drugs
• Use quinapril cautiously in patients with renal impairment.
WARNING Patients with heart failure, hyponatremia, or severe volume or salt depletion; those who've recently received intensive diuresis or an increase in diuretic dosage; and those undergoing dialysis may be at risk for excessive hypotension. Monitor blood pressure often for first 2 weeks of therapy and whenever quinapril or diuretic dosage increases. If excessive hypotension occurs, notify prescriber immediately, place patient in a supine position, and, if prescribed, infuse normal saline solution.
WARNING Because of the risk of angioedema, be prepared to discontinue drug and administer emergency measures, including subcutaneous epinephrine 1:1,000 (0.3 to 0.5 ml), if swelling of tongue, glottis, or larynx causes airway obstruction.
• Monitor blood pressure often to assess drug's effectiveness.
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