Quinapril

ACCUPRIL

Open Quinapril in the interactive console ↗

Pronunciation: KWIN-a-pril

Quinapril ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Quinapril ballicule

Quinapril ACCUPRIL mascot mnemonic cartoon — Visual mnemonic: Quinapril mascot
**“Queen April’s Acumen”**
Easter/April theme → ACE inhibitor = -pril (aPril)
Bananas in bunches → ↑ serum potassium

What it isACE inhibitor; hypertension and heart failure.

Why this oneLong-acting once-daily prodrug with the class renal benefit.

What limits itCough, hyperkalemia and the hemodynamic creatinine rise. Contraindicated in pregnancy; tetracycline absorption is reduced by its magnesium content.

Quinapril molecular structure (skeletal formula) — Molecular structure: Quinapril

Quinapril prescription history

Animated chart of estimated U.S. prescriptions per year, RAAS inhibitors (1981–2026). Quinapril enters in 1991 (estimated).

FDA-approved for

hypertension (1991)

Principal riskAngioedema and hyperkalemia

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Overdose danger2 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk4 / 4

Legacy pregnancy categoryD

Defining liabilityHyperkalemia, kidney injury, angioedema, fetal toxicity and increased lithium exposure.

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Fetal toxicity — discontinue as soon as pregnancy is detected.

FDA dosing	Population	Start	Target	Max
Hypertension	Adults	10 or 20 mg QD (5 mg if on a diuretic)	20-80 mg/day QD or divided BID	80 mg/day
Hypertension	Elderly (>=65 y)	10 mg QD	titrate to response	80 mg/day
Heart failure (adjunct to diuretics/digitalis)	Adults	5 mg BID	20-40 mg/day divided BID

Titration Hypertension: adjust at intervals of at least 2 weeks. Heart failure: titrate at weekly intervals.

Renal Reduce initial dose by CrCl: >60 mL/min 10 mg; 30-60 mL/min 5 mg; 10-30 mL/min 2.5 mg; <10 mL/min insufficient data

Hepatic Undefined

Instructions

If on a diuretic, discontinue it 2-3 days before starting if possible; otherwise start 5 mg with close monitoring until BP stabilizes

Available strengths

tab 5, 10, 20, 40 mg

Contraindications

History of angioedema related to previous ACE inhibitor therapy
Combination with a neprilysin inhibitor (e.g., sacubitril); do not give within 36 h of switching to/from sacubitril/valsartan
Co-administration with aliskiren in patients with diabetes

Cautions

Fetal toxicity — discontinue when pregnancy detected
Angioedema
Symptomatic hypotension, especially with concomitant diuretics
Hyperkalemia
Impaired renal function

Adverse reactions

Headache, dizziness, fatigue, cough, nausea/vomiting, abdominal pain

Pregnancy Fetal toxicity — drugs acting on the renin-angiotensin system can cause injury/death to the developing fetus; discontinue as soon as pregnancy is detected (boxed warning).

Lactation Undefined

Cost

Quinapril (ACCUPRIL)

Strength		#/mo	CostPlus
5 mg	tab	30 qd	not offered
10 mg	tab	30 qd	not offered
20 mg	tab	30 qd	not offered
40 mg	tab	30 qd	not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Quinapril is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entry2004

Active metabolites

Quinaprilat

Open Quinapril in the interactive console ↗

Memory aids: interaction avatars

Box: minimal PK interactions

Open Quinapril in the interactive console ↗

Self-check

Quinapril: Why can tetracycline absorption fall?
The tablet's magnesium content.
Quinapril: Which physiologic state contraindicates it?
Pregnancy.