Contraindicated in:
- Hypersensitivity
- History of angioedema with previous use of ACE inhibitors
- Concurrent use with aliskiren in patients with diabetes or moderate-to-severe renal impairment (CCr <60 mL/min)
- Concurrent use with sacubitril
- OB: Can cause injury or death of fetus – if pregnancy occurs, discontinue immediately
- Lactation: Discontinue or use formula.
Use Cautiously in:
- Patients with renal impairment, hypovolemia, hyponatremia, and concurrent diuretic therapy — initial dose reduction recommended
- Black patients (monotherapy for hypertension less effective, may require additional therapy; higher risk for angioedema)
- Surgery/anesthesia (hypotension may be exaggerated)
- Women of childbearing potential
- Pedi: Children <6 yr (safety not established)
- Geri: Initial dose ↓ recommended.
Exercise Extreme Caution in:
- Family history of angioedema.
CNS: dizziness, fatigue, headache.
Resp: cough.
CV: hypotension, chest pain.
GI: abdominal pain, diarrhea, nausea, vomiting.
GU: impaired renal function.
Derm: rash.
F and E: hyperkalemia.
MS: back pain, myalgia.
Resp: dyspnea.
Misc: ANGIOEDEMA.
Therapeutic Classification: antihypertensives
Pharmacologic Classification: ace inhibitors
Absorption: 60% absorbed following oral administration (high-fat meal may ↓ absorption).
Distribution: Crosses the placenta; enters breast milk.
Protein Binding: 97%.
Metabolism/Excretion: Converted by the liver, GI mucosa, and tissue to quinaprilat, the active metabolite: 96% eliminated by the kidneys.
Half-life: Quinapril — 0.8 hrQuinaprilat — 3 hr (↑ in renal impairment).
(effect on BP — single dose†)
†Full effects may not be noted for several weeks.
