Quinapril

Quinapril (HCl) is 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. The antihypertensive activity of quinapril is sufficiently long to allow for once-daily dosing. The antihypertensive effects of quinapril are due primarily to a decrease in circulating ACE; the drug does not appear to affect the pressor response to angiotensin II, epinephrine, or norepinephrine. Quinaprilat competes with angiotensin I for angiotensin-converting enzyme, thereby blocking the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor and negative-feedback mediator for renin activity; thus, when quinapril lowers angiotensin II plasma levels, blood pressure decreases and plasma renin activity increases.it inhibits Kininase II (identical to ACE), an enzyme that degrades bradykinin, a potent vasodilator, to inactive peptides, resulting in increased bradykinin levels. Bradykinin-induced vasodilation is thought to be of secondary importance in the blood-pressure lowering effect. A bradykinin mechanism may, however, contribute to ACE-inhibitor-induced angioneurotic edema.

Brands
ACCUPRIL ACCUPRIL ACCUPRIL MAKUPRIL MAKUPRIL MAKUPRIL MALEXIN MALEXIN MALEXIN MALEXIN
Adult Dose
Dose: 5 to 10 mg
Single Dose: 7.5 (7.5)
Frequency: 24 hourly
Route: PO
Instructions: Initial dose.
Neonatal
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Paedriatic
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Characteristics
Quinapril HCl is the derivative of Quinapril. It is of Synthetic origin and belongs to Isoquinoline. It belongs to Angiotensin converting enzyme inhibitor-ACEI pharmacological group on the basis of mechanism of action and also classified in Antihypertensive Agents pharmacological group.The Molecular Weight of Quinapril is 475.00.
Contraindications
Quinapril is contraindicated in conditions like Pregnancy.
Effects
The symptomatic adverse reactions produced by Quinapril are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Headache, Fatigue, Nausea, Diarrhea, Rashes, Pruritus, Hypotension, Edema, Rhinitis, Paresthesias, Increased intracranial pressure, Respiratory tract infections.
Indications
Quinapril is primarily indicated in conditions like Congestive heart failure, Congestive heart failure (adjunct), Essential hypertension, Gastric acid reduction during anaesthesia, Hypertension.
Interactions
Quinapril is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAlcoholAlprostadilEnhanced hypotensive effects when alprostadil given with ACE inhibitors (e.g Quinapril)Cyclosporin AQuinapril may enhance the nephrotoxic effect of Cyclosporin A. MajorDelayedMonitor for increased signs and symptoms of nephrotoxicity during concomitant therapy with Cyclosporine and Quinapril. Maintenance of adequate hydration (caution with diuretic use) may reduce risk of ill effects. IndomethacinIndomethacin may diminish the antihypertensive effect of Quinapril.ModerateRapidConsider alternative anti-inflammatory therapy, especially in CHF patients, to avoid the potential negative consequences of concomitant Indomethacin therapy (fluid accumulation/edema). Monitor for decreased therapeutic effects of Quinapril if Indomethacin is initiated/dose increased, or increased effects if Indomethacin is discontinued/dose decreased. Monitor blood pressure, in particular. This is probably of most concern with chronic dosing of Indomethacin; however, blood pressure increases have been noted following a single Indomethacin dose. In addition, concomitant therapy with Indomethacin and Quinapril increases the risk of renal dysfunction. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Increased level of Blood urea nitrogen (BUN) concentrationsIncreased in serum creatinin
Risks
Drug should not be given to Pregnant Mothers.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Tab Store Below 40°C. Protect from Sunlight and Moisture.
Warnings
Quinapril should be used with caution in patients with medical history especially a history of angioedema, high blood levels of potassium, kidney disease or kidney dialysis, salt restrictive diet, liver disease and of any allergies, especially of any drug allergy. Get up slowly, to avoid dizziness and lightheadedness when rising from a seated or lying position. Limit intake of alcohol and use caution when exercising or during hot weather as these can aggravate dizziness and lightheadedness. It should be used only when clearly needed during the first three months of pregnancy and not recommended for use during the last six months of the pregnancy. Caution is advised when this medication is used in children and elderly.
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