Quinapril Explained

Watchedfields:changed
Verifiedrevid:464378463
Width:222
Usan:Quinapril hydrochloride
Tradename:Accupril, others
Dailymedid:Quinapril
Routes Of Administration:By mouth
Atc Prefix:C09
Atc Suffix:AA06
Legal Us:Rx-only
Legal Us Comment:[1]
Legal Status:Rx-only
Protein Bound:97%
Elimination Half-Life:2 hours
Cas Number:85441-61-8
Pubchem:54892
Iuphar Ligand:6350
Drugbank:DB00881
Chemspiderid:49565
Unii:RJ84Y44811
Kegg:D03752
Chebi:8713
Chembl:1592
Iupac Name:(3S)-2-[(2''S'')-2-[[(2''S'')-1-ethoxy-1-oxo-4-phenylbutan-2-yl]amino]propanoyl]-3,4-dihydro-1H-isoquinoline-3-carboxylic acid
C:25
H:30
N:2
O:5
Smiles:O=C(OCC)[C@@H](N[C@H](C(=O)N2[C@H](C(=O)O)Cc1c(cccc1)C2)C)CCc3ccccc3
Stdinchi:1S/C25H30N2O5/c1-3-32-25(31)21(14-13-18-9-5-4-6-10-18)26-17(2)23(28)27-16-20-12-8-7-11-19(20)15-22(27)24(29)30/h4-12,17,21-22,26H,3,13-16H2,1-2H3,(H,29,30)/t17-,21-,22-/m0/s1
Stdinchikey:JSDRRTOADPPCHY-HSQYWUDLSA-N
Melting Point:120
Melting High:130

Quinapril, sold under the brand name Accupril[2] by the Pfizer corporation. It a medication used to treat high blood pressure (hypertension), heart failure, and diabetic kidney disease. It is a first line treatment for high blood pressure. It is taken by mouth.

Common side effects include headaches, dizziness, feeling tired, and cough. Serious side effects may include liver problems, low blood pressure, angioedema, kidney problems, and high blood potassium. Use in pregnancy and breastfeeding is not recommended.[3] It is among a class of drugs called ACE inhibitors and works by decreasing renin-angiotensin-aldosterone system activity.[4]

Quinapril was patented in 1980 and came into medical use in 1989.[5] It is available as a generic medication.[6] In 2020, it was the 253rd most commonly prescribed medication in the United States, with more than 1million prescriptions.[7] [8]

Medical uses

Quinapril is indicated for the treatment of high blood pressure (hypertension) and as adjunctive therapy in the management of heart failure. It may be used for the treatment of hypertension by itself or in combination with thiazide diuretics, and with diuretics and digoxin for heart failure.

Contraindications

Contraindications include:

Side effects

Side effects of Quinapril[9] include dizziness, cough, vomiting, upset stomach, angioedema, and fatigue.

Mechanism of action

Quinapril inhibits angiotensin converting enzyme, an enzyme which catalyses the formation of angiotensin II from its precursor, angiotensin I. Angiotensin II is a powerful vasoconstrictor and increases blood pressure through a variety of mechanisms. Due to reduced angiotensin production, plasma concentrations of aldosterone are also reduced, resulting in increased excretion of sodium in the urine and increased concentrations of potassium in the blood.

Partial Recall

In April of 2022, Pfizer voluntarily recalled five batches of the drug because of the presence of a nitrosamine, NNitroso-quinapril. Testing found that the amount of nitrosamines was above the acceptable daily intake level (all humans are exposed to nitrosamines up to a certain daily level by cured and grilled meats, water, dairy products, and vegetables) set by the U.S.'s Food and Drug Administration (FDA). Though long-term ingestion of NNitroso-quinapril potentially might cause cancer in some individuals, there is not believed to be an imminent risk of harm.[10] [11]

External links

Notes and References

  1. Web site: Accupril- quinapril hydrochloride tablet, film coated Accupril- quinapril tablet, film coated . DailyMed . 26 August 2021 . 25 March 2022.
  2. Web site: ACCUPRIL® Indications and Usage (quinapril HCl) Pfizer Medical Information - US . 2023-10-25 . www.pfizermedicalinformation.com.
  3. Web site: Quinapril Pregnancy and Breastfeeding Warnings . Drugs.com . 3 March 2019 . en.
  4. Web site: Quinapril Hydrochloride Monograph for Professionals . Drugs.com . American Society of Health-System Pharmacists . 3 March 2019 . en.
  5. Book: Fischer J, Ganellin CR . Analogue-based Drug Discovery . 2006 . John Wiley & Sons . 9783527607495 . 468 . en.
  6. Book: British national formulary : BNF 76. 2018. Pharmaceutical Press. 9780857113382. 172. 76.
  7. Web site: The Top 300 of 2020 . ClinCalc . 7 October 2022.
  8. Web site: Quinapril - Drug Usage Statistics . ClinCalc . 7 October 2022.
  9. Web site: Angiotensin-Converting Enzyme (ACE) Inhibitors . 2023-10-25 . Cleveland Clinic . en.
  10. Web site: Pfizer recalls blood pressure tablets due to increased cancer risk . .
  11. Web site: Pfizer Voluntary Nationwide Recall of Lots of ACCUPRIL® (Quinapril HCL) Due to N-Nitroso-Quinapril Content . . 22 April 2022 .