QuinaprilQuinapril Hydrochloride

About Quinapril

Quinapril blocks the enzyme that makes angiotensin II, a hormone that tightens blood vessels, so vessels relax and blood pressure falls. It is labeled for high blood pressure, alone or with thiazide diuretics, and for heart failure, added to diuretics, digitalis or both; safety and effectiveness in children have not been established. For blood pressure, adults not taking a diuretic start at 10 or 20 mg once a day, adjusted at intervals of at least two weeks, and most take 20, 40 or 80 mg a day in one or two doses; someone who must stay on a diuretic starts at 5 mg, older adults at 10 mg, and people with reduced kidney function at 5 or 2.5 mg. In heart failure it starts at 5 mg twice a day, raised weekly toward 20 to 40 mg a day in two doses, with observation for at least two hours after the first dose.

The boxed warning is fetal toxicity: drugs acting on the renin-angiotensin system can injure and kill a developing baby, so quinapril is stopped as soon as pregnancy is detected. Angioedema, swelling of the face, lips, tongue or throat that can block the airway, can occur, especially after the first dose; it has been reported more often in Black patients, and mTOR inhibitors or a neprilysin inhibitor raise the risk. Swelling of the intestine can show up as stomach pain. It must not be taken after angioedema with an ACE inhibitor, within 36 hours of sacubitril and valsartan (Entresto), or with aliskiren in diabetes. It can raise potassium, drop blood pressure too far at the start, especially with diuretics or dehydration, and change kidney function, so potassium and kidney function are checked. A persistent dry cough is a known ACE inhibitor effect, and jaundice or signs of infection such as fever and sore throat need prompt attention. Dizziness, tiredness, cough and an upset stomach are common.

Accupril has been discontinued, as has Accuretic, a separate combination with hydrochlorothiazide, and the FDA has recorded that neither was withdrawn for safety or effectiveness reasons. The FDA has listed quinapril tablets in shortage since January 2023, so before the prescription is sent it is worth asking the pharmacy whether it can get your strength. Quinapril tablets contain magnesium and reduce the absorption of tetracycline, and anyone who becomes pregnant should tell the prescriber as soon as possible.

Taking Quinapril

How to take it

Once or twice a day as prescribed, at about the same times each day; a high-fat meal moderately reduces how much is absorbed. Keep taking it even if you feel well, and call the prescriber about vomiting, diarrhea or heavy sweating, which can drop blood pressure too far.

If you miss a dose

Take it as soon as you remember, unless it is almost time for the next dose; then skip the missed dose and carry on as usual. Do not take a double dose.

Storage

At room temperature, protected from light, in a tightly closed container away from moisture, out of reach of children.

Interactions to know about

Potassium supplements, salt substitutes containing potassium and other medicines that raise potassium add to the risk of high potassium, and it raises lithium levels. NSAIDs such as ibuprofen and naproxen can blunt its effect and strain the kidneys. It is not combined with aliskiren in diabetes or taken within 36 hours of sacubitril and valsartan; mTOR inhibitors add to the risk of angioedema, and rare reactions have occurred with injectable gold.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Quinapril differs from pharmacy to pharmacy

Quinapril has been generic for years, but only a few companies make it and the FDA has listed the tablets in shortage since January 2023, so whether a pharmacy can get a given strength varies, and a quote is only useful if the pharmacy can actually fill it. Where it is in stock, quotes for the same tablet can still differ between pharmacies.

Ways to pay less for Quinapril without insurance

• Before the prescription is sent, ask the pharmacy whether it has your strength and quantity in stock.
• Compare more than one pharmacy, and confirm each can fill the full quantity.
• Once your dose is stable, ask for a ninety-day supply if the pharmacy has enough on hand.
• If quinapril is hard to find or quoted high, ask the prescriber whether another generic ACE inhibitor, such as lisinopril, enalapril or benazepril, would suit you.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Quinapril

1. 1.Do you have my strength in stock, and can you fill the full quantity?
2. 2.Which swelling or breathing symptoms mean I should stop it and get help?
3. 3.Should I avoid potassium supplements, salt substitutes or ibuprofen with it?
4. 4.What should I do if I become pregnant or plan to?

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