Quinapril is generally well tolerated but if you develop a troublesome cough, you must let your doctor know.
The first dose in particular can make you feel dizzy. It is best taken just before you go to sleep.Some painkillers and indigestion remedies could interfere with quinapril. Ask your pharmacist for advice before you buy any medicines 'over the counter'.
Clinical author's note: Michael Stewart 15/11/2018: Following an MHRA update, new advice has been added to this leaflet for people also taking the blood pressure medicine hydrochlorothiazide. Hydrochlorothiazide is only available in the UK in combination with other blood pressure medicines such as quinapril. It may be available on its own in other countries. For more information see 'Getting the most from your treatment' below or view the MHRA Alert.
|Type of medicine||An angiotensin-converting enzyme (ACE) inhibitor|
|Used for||High blood pressure (hypertension); heart failure|
|Also called||Accupro®; Accuretic® (quinapril in combination with hydrochlorothiazide)|
Quinapril belongs to a class of medicines called angiotensin-converting enzyme inhibitors, or ACE inhibitors. You may have been prescribed it to reduce high blood pressure (hypertension), or to treat heart failure. Your doctor will tell you why it has been prescribed for you.
ACE inhibitors like quinapril prevent your body from creating a hormone known as angiotensin II. They do this by blocking (inhibiting) a chemical called angiotensin-converting enzyme. They widen your blood vessels and help to reduce the amount of water put back into your blood by your kidneys.
These actions help to decrease blood pressure. Although people with high blood pressure often do not feel unwell, if left untreated, high blood pressure can harm the heart and damage blood vessels, leading to a heart attack or stroke.
Heart failure is a condition in which your heart does not work as well as it should. Because of this, there may be too much circulating fluid in your blood vessels. Quinapril helps to reduce this. It also appears to have a protective effect on the heart.
You may be prescribed quinapril on its own, or alongside other medicines to help your condition. The brand of quinapril called Accuretic® also contains a medicine called hydrochlorothiazide. This brand can be prescribed for people with high blood pressure. Combination brands like this help to reduce the total number of tablets you need to take each day.
Before taking quinapril
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking quinapril it is important that your doctor knows:
- If you are pregnant or breastfeeding.
- If you have problems with the way your kidneys work, or any problems with the way your liver works.
- If you are lacking in fluid in the body (dehydrated) - for example, if you have had diarrhoea or sickness very recently.
- If you have been told you have a build-up of fatty deposits on the walls of your arteries, a condition called atherosclerosis.
- If you have a particular type of poor circulation called peripheral arterial disease.
- If you have collagen vascular disease. This includes conditions such as systemic lupus erythematosus (SLE) and scleroderma.
- If you have been told you have a problem with the way your heart pumps blood
- If you have been told you have heart muscle disease (cardiomyopathy), problems with the way your heart pumps blood, or narrowing of the main blood vessel from your heart (aortic stenosis).
- If you have been told you have a low level of sodium in your blood.
- If you have ever had a reaction where your face, tongue or throat swells (angio-oedema).
- If you are having desensitisation treatment to protect against bee and wasp stings.
- If you are having dialysis treatment, or treatment to remove cholesterol from your blood by a machine (LDL apheresis).
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic or unusual reaction to any other ACE inhibitor (such as lisinopril, ramipril or enalapril), or to any other medicine.
How to take quinapril
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about quinapril and will provide you with a full list of side-effects which you may experience from taking it.
- Take the tablets exactly as your doctor tells you to. Quinapril is usually taken once daily, but it can also be prescribed as a twice-daily dose. Your dose will be printed on the label of the pack of tablets to remind you about what the doctor said to you.
- Your doctor is likely to advise you to take your very first dose at bedtime. This is because the first dose can make you feel dizzy.
- After the first dose, you can take quinapril at a time of day you find easy to remember, but try to take it at the same times of day each day. This will help you to remember to take your doses regularly. You can take quinapril tablets either with or without food. Swallow the tablet whole with a drink of water.
- If you forget to take a dose, take it as soon as you remember (unless it is nearly time for your next dose, in which case leave out the missed dose and take the next dose as normal). Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your progress can be monitored. Your doctor may want you to have some blood tests from time to time to check that your kidneys are working well.
- Each time you collect a prescription, check to make sure the tablets look the same as you have had before. This is because there are several strengths of tablet. If you have any questions about your tablets, please ask your pharmacist for advice.
- It is very important that you follow any dietary and lifestyle advice that you are given by your doctor. This may include advice about eating a healthy diet, not smoking, and taking regular exercise.
- If you buy any medicines, check with a pharmacist that they are suitable to take with quinapril. This is because some medicines (such as anti-inflammatory painkillers and indigestion remedies) could interfere with your treatment.
- It is likely that your doctor will advise that you do not use salt substitutes while you are taking quinapril. These products have a high content of potassium which could be harmful for you.
- If you drink alcohol, ask your doctor for advice about drinking alcohol while you are on quinapril. Alcoholic drinks can make you feel light-headed or dizzy, and they may not be advisable for you.
- If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking quinapril tablets. This is because some anaesthetics could cause your blood pressure to drop too low.
- Treatment with quinapril is usually long-term unless you experience an adverse effect. Continue to take the tablets unless you are advised otherwise.
If you are also taking hydrochlorothiazide in combination with this medicine
- Studies have suggested that taking higher doses of hydrochlorothiazide for long periods of time may increase the risk of certain skin cancers.
- Tell your doctor if you have ever been treated for skin cancer before.
- Tell your doctor about any new or changed moles or worrying marks on your skin.
- Use a sunscreen in strong sunlight. Do not use sunbeds.
Can quinapril cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with quinapril. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common quinapril side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Feeling light-headed or dizzy, especially when standing up||Getting up more slowly should help. If you begin to feel|
dizzy, lie down so that you do not faint, then sit for a few moments before standing. If this continues beyond the first few days, speak with your doctor. Do not drive and do not use tools or machines while you feel dizzy
|Dry irritating cough||If this continues, speak with your doctor, as an alternative medicine may be better for you|
|Headache, other aches and pains||Ask your pharmacist to recommend a suitable painkiller|
|Feeling sick (nausea) or being sick (vomiting), indigestion, tummy (abdominal) pain, diarrhoea||Stick to simple foods - avoid rich and spicy meals|
|Throat infections, runny nose, tingling feelings in your hands or toes, problems sleeping or feeling tired||Speak with your doctor if any of these become troublesome|
Important: if you experience any of the following rare but serious symptoms, stop taking quinapril and contact your doctor for advice straightaway:
- Any difficulty breathing, or swelling of your face, mouth, tongue or throat. These are signs of an allergic reaction.
- Any yellowing of your skin or whites of your eyes. These may be signs of jaundice which is a rare side-effect.
- A severe skin rash.
If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.
How to store quinapril
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Accupro® Tablets 5 mg, 10 mg, 20 mg and 40 mg; Pfizer Limited, The electronic Medicines Compendium. Dated March 2018.
British National Formulary, 77th Edition (Mar 2019); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.