Quinapril

Sounds like 'KWIN-a-pril'

Quinapril is used to treat high blood pressure and heart failure. Find out how to take it safely and possible side effects.

Quinapril is also called Accupril or Arrow-Quinapril.
Quinapril is available in combination with hydrochlorothiazide called Accuretic®.

Disrupted supply of Accuretic (quinapril and hydrochlorothiazide) tablets
From August 2022, supplies of Accuretic tablets will begin to be disrupted. 

✔ When you are next due a repeat supply of Accuretic, you need to talk to your healthcare provider to get a prescription for a new high blood pressure medicine.

✔ You should keep taking Accuretic as prescribed until you have your new treatment.

Note: Supplies of quinapril products, such as Arrow-Quinapril are not affected. There is ample stock.  

Read more: Supply issue: Accuretic (quinapril and hydrochlorothiazide) tablets


What is quinapril?

Quinapril has many different effects on the body and is used to treat a variety of conditions. It belongs to a group of medicines called ACE inhibitors. Quinapril may be used for:

  • high blood pressure by relaxing and widening your blood vessels and lowering your blood pressure
  • heart failure to help your heart pump blood more easily – this can help to relieve symptoms such as shortness of breath and swelling of your feet, legs and abdomen (tummy).

Dose

Quinapril tablets are available in different strengths: 5 mg, 10 mg and 20 mg. 

  • Your doctor or pharmacist will tell you the strength that is right for you. Your dose of quinapril will depend on what it is being used for.
  • Your doctor will usually start you on a low dose and increase the dose depending on how you respond. This allows your body to get used to the medicine and reduces side effects.
  • Quinapril may be taken once or twice a day.
  • Always take your quinapril exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much quinapril to take, how often to take it and any special instructions.
  • Check with your pharmacist if your tablets are different to what you expect.

My dose

Date Morning Evening
     
     
     
Notes:


How to take quinapril

  • Timing: Take quinapril at the same time each day. You can take quinapril with or without food.
  • Limit alcohol intake while you are taking quinapril. Alcohol can increase your chance of side effects such as dizziness and light-headedness. 
  • Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.

Precautions before taking quinapril

  • Are you pregnant or planning a pregnancy?
  • Are you breastfeeding?
  • Do you have problems with your kidneys or liver?
  • Have you ever had an allergic reaction with swelling of your lips, eyes or tongue (called angioedema)?
  • Are you are taking or using any other medicines? This includes any medicines you are using which are available to buy from a pharmacy, supermarket or natural health store without a prescription.

If so, it’s important that you tell your doctor or pharmacist before you start taking quinapril. Sometimes a medicine isn’t suitable for a person with certain conditions or it can only be used with extra care.

Cautions while you are taking quinapril

Have a sick day plan

If you have diarrhoea or are vomiting from a stomach bug, or have dehydration from other causes, it’s important to let your GP know, as they may advise you to stop taking your quinapril for a few days and start again when you feel better. 

Be careful when taking some pain relief medicines

ACE inhibitors can be used to protect your kidneys from damage if you have diabetes. However, if you are taking quinapril and diuretics (water pills), the combination of these with NSAIDs (anti-inflammatory pain relief medication) can be very harmful to your kidneys. It can cause acute kidney injury. This combination is called the 'dangerous trio' or 'triple whammy'. You have a higher risk of harm to your kidneys if you are also an older adult (over 65 years) or are dehydrated. 

If you are taking an ACE inhibitor with a diuretic, do not use NSAIDs for pain relief. Ask your doctor or pharmacist for a safer option. Read more about NSAIDs and protecting your kidneys.

Examples of diuretics Examples of NSAIDs
  • bendroflumetazide (Arrow-Bendrofluazide)
  • Chlortalidone (Hygroton)
  • Indapamide (Dapa-Tabs)
  • Metolazone (Zaroxolyn)
  • Furosemide (Lasix)
  • Bumetanide (Burinex)
  • Spironolactone (Spiractin)
  • Ibuprofen (Ibugesic, I-Profen, Nurofen)
  • Diclofenac (Voltaren)
  • Naproxen (Noflam, Naprosyn)
  • Mefenamic acid (Ponstan)
  • Celecoxib (Celebrex)
  • Tenoxicam (Tilcotil)

What are the side effects of quinapril?

Like all medicines, quinapril can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Dizziness
  • Feeling light headed 
  • Feeling faint or dizzy when you stand up
  • This is quite common when you first start taking quinapril and usually goes way with time.
  • Be careful when getting up from either lying down or sitting to avoid falls. These effects put you at risk of falls and injuries, especially if you are an older adult (over 65 years).
  • Stand up slowly. If you do feel dizzy sit or lie down for a few moments.
  • Tell your doctor if  this continues.
  • Tickle in the throat
  • Dry, irritating cough


  • This is quite common when you first start taking quinapril and usually goes away with time.
  • Tell your doctor if the cough is  troublesome and persistent.
  • Allergic reaction such as skin rash, itching, swelling of your lips, face and mouth or difficulty breathing, such as chest tightness or wheezing
  • Tell your doctor immediately or ring HealthLine 0800 611 116.
  • Signs of problems with your liver, such as yellowing of your skin or eyes, dark urine or pain in your abdomen (tummy)
  • Tell your doctor immediately or ring HealthLine 0800 611 116.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product

Interactions

  • Quinapril interacts with some medications and herbal supplements so check with your doctor or pharmacist before starting quinapril or before starting any new medicines.
  • Also, check with your pharmacist before taking over-the-counter medicines such as:
    • Anti-inflammatories such as diclofenac (eg, Voltaren Rapid)
    • Ibuprofen (eg, Nurofen), naproxen (eg, Naprogesic).

Learn more

The following links provide more information on quinapril.

Accuretic® Medsafe Consumer Information
New Zealand Formulary Patient Information: quinapril

References

  1. Quinapril New Zealand Formulary

Additional resources for healthcare professionals

Accuretic® Medsafe, NZ
Medicines and hyperkalaemia Medsafe, NZ, 2015
Hypertension in adults – the silent killer BPAC, NZ, 2013
Electrolyte disturbance with diuretics and ACE inhibitors can fam physician v.62(7) NCBI, US, 2016
How low can the potassium and sodium go with commonly prescribed blood pressure medications? Tools for Practice, Alberta College of Family Physicians (ACFP), US, 2016
Guide for initiation and up-titration of ACE inhibitors in patients with heart failure SafeRx Waitematā DHB, NZ, 2015

Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 30 Oct 2018