Quinapril 5mg Tablets

Quinapril is a prodrug that is hydrolyzed to quinaprilat, its active metabolite. Quinaprilat is an angiotensin-converting enzyme (ACE) inhibitor. It prevents the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor and stimulator of aldosterone secretion. This leads to decreased systemic vascular resistance, reduced aldosterone secretion (resulting in decreased sodium and water retention), and increased bradykinin levels (contributing to vasodilation). These effects result in a reduction in blood pressure.

Serious Side Effects: Seek Medical Attention Immediately

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of kidney problems, including:
+ Inability to pass urine
+ Changes in urine output
+ Blood in the urine
+ Sudden weight gain
Signs of high potassium levels, such as:
+ Abnormal heartbeat
+ Confusion
+ Weakness, lightheadedness, or dizziness
+ Feeling like passing out
+ Numbness or tingling
+ Shortness of breath
Severe dizziness or fainting
Persistent cough
Severe stomach pain
Severe nausea or vomiting
Liver problems, which may be indicated by:
+ Dark urine
+ Fatigue
+ Decreased appetite
+ Stomach pain or upset
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes (jaundice)
Signs of infection, such as:
+ Fever
+ Chills
+ Sore throat

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor or seek medical help:

Cough
* Dizziness

Reporting Side Effects

This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have a history of angioedema, a severe and potentially life-threatening reaction characterized by swelling of the hands, face, lips, eyes, tongue, or throat, difficulty breathing, swallowing problems, or unusual hoarseness.
If you are undergoing any of the following medical treatments: apheresis, dialysis, or hemofiltration.
If you are currently taking any of the following medications: Aliskiren, azilsartan, candesartan, eprosartan, irbesartan, losartan, olmesartan, telmisartan, or valsartan.
* If you have taken a medication containing sacubitril within the last 36 hours.

Please note that this is not an exhaustive list of all potential interactions. It is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any health problems, with your doctor and pharmacist. This will help ensure your safety while taking this medication. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.

Important Information to Share with Your Healthcare Team

Inform all of your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

Precautions to Ensure Your Safety

To avoid accidents, do not drive or perform tasks that require alertness until you know how this medication affects you. When getting up from a sitting or lying down position, rise slowly to minimize the risk of dizziness or fainting. Be cautious when climbing stairs.

Monitoring Your Health

Follow your doctor's instructions for checking your blood pressure regularly. Additionally, have your blood work checked as directed by your doctor and discuss the results with them.

Interactions with Other Substances

If you are taking a salt substitute containing potassium, a potassium-sparing diuretic, or a potassium product, consult with your doctor. Similarly, if you are on a low-salt or salt-free diet, discuss this with your doctor.

Special Considerations

If you have high blood pressure and are taking this medication, talk to your doctor before using over-the-counter (OTC) products that may increase blood pressure, such as cough or cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and certain natural products or aids. Also, consult with your doctor before consuming alcohol.

Staying Safe in Various Situations

In hot weather or during physical activity, be cautious and drink plenty of fluids to prevent dehydration. If you experience excessive sweating, fluid loss, vomiting, or diarrhea, inform your doctor, as these conditions may lead to low blood pressure.

Effectiveness and Potential Risks

It is essential to note that this medication may be less effective in lowering blood pressure in Black patients. In some cases, another medication may be prescribed in conjunction with this one. If you have any questions or concerns, discuss them with your doctor.

Rare but Serious Reaction

A severe and potentially life-threatening reaction called angioedema has been reported. The risk of angioedema may be higher in Black patients.

Breastfeeding

If you are breastfeeding, inform your doctor, as you will need to discuss any potential risks to your baby.

• Aliskiren (in patients with diabetes or renal impairment)
• Sacubitril/valsartan (Entresto) - concomitant use or within 36 hours of last dose of ACE inhibitor

• Potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride) - increased risk of hyperkalemia
• Potassium supplements - increased risk of hyperkalemia
• NSAIDs (Nonsteroidal Anti-inflammatory Drugs) - may reduce antihypertensive effect and increase risk of renal impairment
• Lithium - increased serum lithium levels and toxicity
• mTOR inhibitors (e.g., sirolimus, everolimus, temsirolimus) - increased risk of angioedema
• Neprilysin inhibitors (e.g., sacubitril) - increased risk of angioedema

• Diuretics (thiazide, loop) - increased risk of symptomatic hypotension (especially first-dose)
• Other antihypertensives - additive hypotensive effects
• Insulin and oral hypoglycemics - increased risk of hypoglycemia
• Gold (sodium aurothiomalate) - nitritoid reactions (facial flushing, nausea, vomiting, hypotension) reported rarely

• Antacids - may reduce bioavailability (separate administration by 2 hours)

• Angioedema (swelling of face, lips, tongue, throat, extremities)
• Persistent dry cough
• Dizziness or lightheadedness (especially with first dose or dose increase)
• Signs of hyperkalemia (muscle weakness, fatigue, irregular heartbeat)
• Signs of infection (fever, sore throat) due to rare neutropenia

Contraindicated during the second and third trimesters of pregnancy due to significant risk of fetal injury and death. Discontinue as soon as pregnancy is detected. Use in the first trimester is generally avoided due to potential risks.

Quinapril and its active metabolite quinaprilat are excreted in human milk in small amounts. Generally considered low risk for healthy, full-term infants, but caution is advised, especially for preterm or ill infants. Monitor infant for adverse effects.

Safety and effectiveness have not been established in pediatric patients. Use is generally not recommended.

No overall differences in effectiveness or safety have been observed between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Start with lower doses (e.g., 5 mg) and titrate slowly, especially in those with impaired renal function.

• Quinapril is a prodrug that is converted to its active form, quinaprilat, in the liver.
• A common side effect of ACE inhibitors, including quinapril, is a persistent dry cough, which typically resolves upon discontinuation.
• Angioedema (swelling of the face, lips, tongue, or throat) is a rare but potentially life-threatening side effect that can occur at any time during treatment.
• First-dose hypotension can occur, especially in patients who are volume-depleted (e.g., on diuretics, salt-restricted diet). Consider discontinuing diuretics 2-3 days prior to initiation if possible, or start with a lower dose (5 mg).
• Monitor serum potassium levels, especially in patients with renal impairment, diabetes, or those taking potassium-sparing diuretics or supplements, due to the risk of hyperkalemia.
• Avoid concomitant use with sacubitril/valsartan due to increased risk of angioedema; a 36-hour washout period is required between these drugs.

• Other ACE inhibitors (e.g., lisinopril, enalapril, ramipril)
• Angiotensin Receptor Blockers (ARBs) (e.g., losartan, valsartan, candesartan)
• Calcium Channel Blockers (CCBs) (e.g., amlodipine, nifedipine)
• Thiazide diuretics (e.g., hydrochlorothiazide, chlorthalidone)
• Beta-blockers (e.g., metoprolol, carvedilol)

If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further evaluation and guidance. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may have additional patient information leaflets, so it is a good idea to consult with your pharmacist for more information. If you have any questions or concerns about your medication, do not hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When reporting the overdose, be prepared to provide details about the medication taken, the amount, and the time it occurred.