Quinapril (also known by its brand name, Accupril) is an angiotensin-converting enzyme (ACE) inhibitor. It's used to treat high blood pressure and heart failure in adults. This medication is available as a lower-cost generic tablet that's taken by mouth once or twice per day. Side effects include headache, dizziness, and cough.
High blood pressure
Heart failure
Quinapril (Accupril) is an angiotensin-converting enzyme (ACE) inhibitor. ACE is a protein in your body that works to squeeze your blood vessels and help your blood pressure go up. Quinapril (Accupril) blocks how ACE works, which causes your blood vessels to relax. This helps lower your blood pressure.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Blurred vision
confusion
difficult or labored breathing
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
stomach pain
sweating
tightness in the chest
unusual tiredness or weakness
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Headache
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
A first-choice medication for lowering blood pressure for many people
Available as a lower-cost generic
Can't take during pregnancy
Might not work as well for lowering high blood pressure in Black adults
Hasn't been studied in children
Take quinapril (Accupril) with or without food at any time of day. If it's hurting your stomach, try taking it with food to help.
You might feel dizzy when you first start taking quinapril (Accupril) and when your dose is raised. This should get better as your body gets used to your new blood pressure. Lower your risk of falls by standing up slowly and carefully from a sitting or lying down position.
Drink plenty of fluids while you're taking quinapril (Accupril), especially on hot days or after exercising. Your blood pressure might drop too much if you don't have enough fluids in your body. This can worsen dizziness and raise your risk of falls. Ask your provider about how to safely stay hydrated if you have heart failure or kidney problems.
Check your blood pressure on a regular basis and keep a log of your readings. Bring your log to your office visits so you can discuss with your provider about how well quinapril (Accupril) is working for you.
Make sure to get any blood work done as you take quinapril (Accupril). These blood tests help your provider check for side effects like changes in your potassium levels and kidney health. Your dose might need to be changed based on your lab results.
Make sure to tell your providers about all the medications you're taking or planning to take. Quinapril (Accupril) can interact with other medications. This can affect how well your medications work or raise your risk for side effects. Your providers and pharmacists can check that your medications are safe for you to take together.
Avoid using nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), with quinapril (Accupril) unless your provider says it's okay. Taking these medications with quinapril (Accupril) can raise your risk for kidney problems.
Continue to eat a variety of fruits and vegetables that you enjoy, follow a low-salt diet, and get regular exercise while you're taking quinapril (Accupril). This helps lower your blood pressure. You might be able to stop taking the medication if your blood pressure is well-controlled with these lifestyle changes.
Stop taking quinapril (Accupril) and tell your provider right away if you're pregnant. This medication isn't safe to take during pregnancy because it can harm your unborn baby. Your provider might prescribe a different medication that's safer during pregnancy and recommend lifestyle changes to make to help lower your blood pressure.
Quinapril (Accupril) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Quinapril (Accupril) can cause severe and sometimes life-threatening harm to unborn babies. For this reason, avoid using this medication during pregnancy. Before you start quinapril (Accupril), discuss with your provider about safer options to treat your blood pressure if you're pregnant or thinking of becoming pregnant. If you become pregnant while you're taking quinapril (Accupril), stop the medication and let your provider know right away.
Risk factors: Black people | Having angioedema in the past
People who take ACE inhibitors, like quinapril (Accupril), can experience a rare, but serious side effect called angioedema. This involves swelling in different parts of the body, including the face, throat, and tongue. Swelling of the tongue or throat area can be potentially life-threatening since it can make it difficult to breathe. Angioedema can happen at any time during treatment. You might be more likely to experience angioedema if you're Black, an older adult, or of female sex. Get medical attention immediately if you notice any unusual swelling, stomach pain, or difficulty breathing. You'll have to stop taking quinapril (Accupril) if this happens.
Risk factors: Not enough fluid in your body | Having diarrhea or vomiting for a long time | Low salt levels in your body | Taking higher doses of diuretic medications | Dialysis | Heart failure
Sometimes, taking quinapril (Accupril) can cause your blood pressure to drop too much. This can make you feel dizzy, tired, or lightheaded. This side effect is more common when you first start quinapril (Accupril) or when your provider raises your dose. Make sure to stay well-hydrated during treatment. Make sure to sit or lie down slowly while holding onto something if you feel dizzy, lightheaded, faint, or tired. And get medical help right away if you accidentally fall and hit your head.
Risk factors: Severe heart failure | Kidney problems or renal artery stenosis | Not enough fluid in your body | Taking other medications that can cause kidney damage
Quinapril (Accupril) is usually good for the kidneys. But in some cases, it can make kidney problems worse. The risk is higher for people who have certain types of kidney problems, such as renal artery stenosis or kidney damage from severe heart failure. Your provider might order lab tests every so often to make sure your kidneys are healthy and working properly. You'll typically need these lab tests before you start quinapril (Accupril) and periodically during treatment as needed. Let your provider know if you're urinating less often than usual, as this could be a sign that your kidneys aren't working as well.
Risk factors: Diabetes | Kidney problems | Taking other medications that also raise potassium
Quinapril (Accupril) can raise the amount of potassium in your body, which can sometimes be dangerous. Your risk of developing high potassium is greater if you have diabetes or kidney problems or if you're taking other medications that also raise potassium levels. For this reason, make sure your provider knows your full medical history and what medications you're taking before starting treatment. Tell your healthcare provider right away if you experience signs of high potassium levels, such as nausea, muscle weakness, or abnormal heartbeat.
Risk factors: History of liver problems | Drinking large amounts of alcohol
In some rare cases, people who took ACE inhibitors like quinapril (Accupril) developed a blocked bile duct. This condition can lead to liver problems or liver failure. Your provider might order blood tests to check your liver health from time to time. Let your provider know right away if you notice symptoms of liver problems, such as tiredness, stomach pain, or yellowing of your skin.
High blood pressure: The typical starting dose is 10 mg or 20 mg by mouth once daily. For people taking a diuretic (water pill), the typical starting dose is 5 mg by mouth once daily. The usual dose ranges from 20 mg to 80 mg per day (as a single dose or split into two equal doses during the day).
Heart failure: The typical starting dose is 5 mg by mouth twice daily. The usual dosage ranges from 10 mg to 20 mg by mouth twice daily.
Your provider will adjust your dose depending on your age, your kidney function, how well the medication is working to treat your condition, and whether you're having side effects.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
History of angioedema
Taking at the same time as aliskiren (Tekturna) for people with high blood sugar (diabetes)
Taking at the same time or within 36 hours of neprilysin inhibitors, such as Entresto (sacubitril / valsartan)
High blood pressure
Heart failure
Lower the risk for death after a heart attack
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Montford, J. R., et al. (2017). How dangerous is hyperkalemia? Journal of the American Society of Nephrology.
Parke-Davis Div of Pfizer Inc. (2023). Accupril- quinapril hydrochloride tablet, film coated [package insert]. DailyMed.
Rubenfire, M. (2018). 2017 guideline for high blood pressure in adults. American College of Cardiology.
Schoolwerth, A. C., et al. (2001). Renal considerations in angiotensin converting enzyme inhibitor therapy: A statement for healthcare professionals from the Council on the Kidney in Cardiovascular Disease and the Council for High Blood Pressure Research of the American Heart Association. Circulation.
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