Sacubitril Valsartan
Contraindicated
Textbook
Increased risk of angioedema.
Do not use in conjunction with ACEIs.
Source: G&G 14e · p602
Drug reference
Quinapril
ACE Inhibitor · Antihypertensive, Heart Failure Management
Also known as Quinapril hydrochloride
ACE InhibitorAntihypertensive, Heart Failure Management
CDSCO approvedSchedule H
EXCRETION
—
not curated
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
—
not curated
Top interactionssee all 12 →
- Sacubitril ValsartanContraindicatedTextbookG&G 14e · p602
- AminoglycosidesSevereTextbookG&G 14e
- Angiotensin Receptor BlockersSevereTextbookHarrison 22e · p2396
- AzilsartanSevereTextbookG&G 14e
Mechanism
Quinapril is an angiotensin-converting enzyme (ACE) inhibitor.
Indications
Essential hypertensionEssential hypertension if used in addition to diureticHeart failure (adjunct) (under close medical supervision)hypertensioncardiovascular diseaseheart failurediabetic nephropathyacute myocardial infarctionhigh risk of cardiovascular eventscoronary artery disease (without heart failure)Congestive heart failure (CHF)Myocardial infarction (MI)Prophylaxis in high cardiovascular risk subjectsNondiabetic nephropathyScleroderma crisis
Dosing
- Adult
- Essential hypertension: Initially 10 mg once daily; maintenance 20–40 mg daily in up to 2 divided doses. Essential hypertension if used in addition to diuretic: Initially 2.5 mg once daily; maintenance 20–40 mg daily in up to 2 divided doses.…
- Renal adjustment
- Max. initial dose 2.5 mg once daily if eGFR less than 40 mL/minute/1.73 m2.
- Hepatic adjustment
- Quinapril is a prodrug. Manufacturer advises caution when used in combination with a diuretic.
- Geriatric
- Essential hypertension: Initially 2.5 mg once daily; maintenance 20–40 mg daily in up to 2 divided doses.
- Max dose
- 80 mg per day (for hypertension); 40 mg per day (for heart failure)
Pharmacokinetics
Peak effect
quinaprilat in plasma are achieved in about 2 h
Half-life
initial t1/2 of quinaprilat is about 2 h; a prolonged terminal t1/2 (~25 h)
Bioavailability
rate, but not extent, of oral absorption (60%) may be reduced by food
Protein binding
Q/QT: 97%
Excretion
Quinaprilat and other metabolites of quinapril are excreted in the urine (61%) and feces (37%)
Contraindications
- Avoid in the first few weeks after delivery, particularly in preterm infants, due to the risk of profound neonatal hypotension.
Side effects
Common
Back painIncreased risk of infectionInsomniacoughhypotensionhyperkalemiaskin rashcough (5%-10%)
Serious
- Depression
- Generalised oedema
- Proteinuria
- Transient ischaemic attack
- Balance impaired
- Glossitis
- Arthritis
- Hypersensitivity
- Jaundice cholestatic
- Leucocytosis
- Pulmonary oedema
- Serositis
- Toxic epidermal necrolysis
- Vasculitis necrotising
- angioedema
- acute renal failure
- fetopathic syndrome
- neutropenia
- glycosuria
- anemia
- hepatotoxicity
- dysgeusia
- hepatic failure (rare)
- agranulocytosis (rare)
Pregnancy & lactation
Lactation
Avoid in the first few weeks after delivery, particularly in preterm infants, due to the risk of profound neonatal hypotension; if essential, may be used in mothers breast-feeding older infants—the infant’s blood pressure should be monitored.
Drug interactions
Aminoglycosides
Severe
Textbook
Increased risk and severity of renal impairment and nephrotoxicity.
Not explicitly stated, but implies careful monitoring of renal function and cautious co-administration.
Source: G&G 14e
Angiotensin Receptor Blockers
Severe
Textbook
Greater incidence of acute kidney injury (AKI) and adverse cardiac events.
The combination of these two classes should be avoided.
Source: Harrison 22e · p2396
Azilsartan
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Candesartan
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Dipeptidyl Peptidase Iv Inhibitor
Severe
Textbook
Increased risk of angioedema.
Avoid combination.
Source: G&G 14e · p600
Losartan + Hydrochlorothiazide
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Olmesartan + Amlodipine
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Olmesartan + Hydrochlorothiazide
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Olmesartan Medoxomil
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Sacubitril With Valsartan
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Telmisartan + Amlodipine
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Related guidelines
Other ACE Inhibitor drugs
Ask House about Quinapril
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-13 · House clinical team