II. Indications

III. Mechanism

  1. See ACE Inhibitor
  2. Non-sulfhydryl Angiotensin Converting Enzyme (ACE) inhibitor
  3. Quinapril is a prodrug, converted to its active form Quinaprilat via hydrolysis

IV. Dosing

  1. Adequate 24 hour Blood Pressure control may require twice daily dosing
  2. Hypertension
    1. Start 10 mg orally daily
      1. Start 2.5 to 5 mg orally daily in renal dysfunction or recurrent Diuretic use
    2. Target 20 to 40 mg/day
  3. Congestive Heart Failure (CHF)
    1. Start: 5 mg/day divided once to twice daily
    2. Titrate weekly to target 20 to 40 mg/day divided once to twice daily
    3. Low dose is especially important if concurrent Diuretic use
  4. Renal Dosing
    1. GFR 30-60
      1. Start 5 mg orally daily
    2. GFR 10-30
      1. Start 2.5 mg orally daily
  5. Maximum: 80 mg/day (no benefit above 40 mg/day)

V. Metabolism

  1. Excretion is 50-60% renal

VI. Supplied

  1. Available as generic scored tablets (5 mg) and unscored tablets (10,20 and 40 mg)

VII. Adverse Effects

VIII. Safety

  1. See ACE Inhibitor
  2. Pregnancy Category X
  3. Avoid in Lactation

X. References

  1. (2016) Presc Lett, Resource #321151, ACE Inhibitor Antihypertensive Dose Comparison
  2. (2020) Med Lett Drugs Ther 62(1598): 73-80
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 68-9
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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Related Studies

Cost: Medications

quinapril (on 2/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
QUINAPRIL 10 MG TABLET Generic $0.07 each
QUINAPRIL 20 MG TABLET Generic $0.09 each
QUINAPRIL 40 MG TABLET Generic $0.11 each
QUINAPRIL 5 MG TABLET Generic $0.08 each
QUINAPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB Generic $0.31 each
QUINAPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB Generic $0.36 each
QUINAPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB Generic $0.34 each

Ontology: quinapril (C0072857)

Definition (NCI) A prodrug and non-sulfhydryl angiotensin converting enzyme (ACE) inhibitor with antihypertensive activity. Quinapril is hydrolized into its active form quinaprilat, which binds to and inhibits ACE, thereby blocking the conversion of angiotensin I to angiotensin II. This abolishes the potent vasoconstrictive actions of angiotensin II and leads to vasodilatation. Quinapril also causes a decrease in angiotensin II-induced aldosterone secretion by the adrenal cortex, thereby promoting diuresis and natriuresis, and increases bradykinin levels.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C041125
SnomedCT 108578004, 386874003
LNC LP171631-7
English 2-(2-((1-(ethoxycarbonyl)-3-phenylpropyl)amino)-1-oxopropyl)-1,2,3,4-tetrahydro-3-isoquinolinecarboxylic acid, 3-Isoquinolinecarboxylic acid, 2-(2-((1-(ethoxycarbonyl)-3-phenylpropyl)amino)-1-oxopropyl)-1,2,3,4-tetrahydro-, monohydrochloride, (3S-(2(R*(R*)),3R*))-, quinapril, quinapril (medication), quinapril [Chemical/Ingredient], QUINAPRIL, Quinapril, Quinapril (product), Quinapril (substance)
Spanish quinaprilo, quinapril (producto), quinapril (sustancia), quinapril

Ontology: Accupril (C0244580)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C041125
English Accupril, accupril