Accupril: Effective Blood Pressure Control for Cardiovascular Health
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Accupril (quinapril hydrochloride) is an angiotensin-converting enzyme (ACE) inhibitor prescription medication clinically proven to manage hypertension and heart failure. This advanced therapeutic agent works by relaxing blood vessels, allowing blood to flow more smoothly and reducing the heart’s workload. Manufactured with pharmaceutical-grade precision, Accupril represents a cornerstone therapy in cardiovascular medicine, offering physicians a trusted option for long-term patient management. Its well-established efficacy profile makes it a frequently prescribed choice within evidence-based treatment protocols.
Features
- Contains quinapril hydrochloride as active pharmaceutical ingredient
- Available in 5mg, 10mg, 20mg, and 40mg tablet strengths
- Film-coated oral tablets for ease of administration
- Once or twice-daily dosing regimen options
- Manufactured under cGMP (current Good Manufacturing Practices) standards
- Demonstrated 24-hour blood pressure control with single daily dosing
- Bioavailability approximately 60% regardless of food intake
- Peak plasma concentrations achieved within 1 hour post-administration
Benefits
- Sustained Blood Pressure Reduction: Provides consistent 24-hour antihypertensive effect through potent ACE inhibition
- Cardiac Protection: Reduces afterload on the heart, decreasing myocardial oxygen demand
- Renal Function Preservation: Demonstrates nephroprotective effects in hypertensive patients with diabetes
- Improved Survival Rates: Shown to reduce mortality in heart failure patients when used as part of comprehensive therapy
- Flexible Dosing: Allows for individualized titration based on therapeutic response and tolerability
- Established Safety Profile: Decades of clinical use with well-characterized adverse effect patterns
Common use
Accupril is primarily indicated for the treatment of hypertension, either as monotherapy or in combination with thiazide diuretics. It is also approved for the management of heart failure as adjunctive therapy when standard treatments prove insufficient. Clinicians may prescribe Accupril for diabetic nephropathy due to its demonstrated renal protective properties. Off-label uses include secondary stroke prevention and management of left ventricular dysfunction following myocardial infarction. The medication is typically incorporated into long-term treatment plans rather than acute intervention protocols.
Dosage and direction
Initial dosing for hypertension typically begins with 10-20mg once daily, with adjustments based on blood pressure response. Most patients maintain on 20-80mg daily, administered as single or divided doses. For heart failure, starting dose is usually 5mg twice daily, with gradual titration to 20-40mg daily in divided doses. Dosage must be adjusted for patients with renal impairment: for creatinine clearance >60 mL/min, standard dosing applies; 30-60 mL/min, begin with 5mg daily; 10-30 mL/min, initial dose 2.5mg daily. Tablets should be swallowed whole with water, with or without food, at approximately the same time each day.
Precautions
Patients should be monitored for hypotension, especially during initial dosing and titration periods. Renal function and serum potassium should be assessed prior to initiation and periodically during therapy. Angioedema may occur at any time during treatment, requiring immediate discontinuation. Neutropenia/agranulocytosis has been reported with ACE inhibitors, particularly in patients with collagen vascular disease or renal impairment. Use with caution in patients with aortic stenosis or hypertrophic cardiomyopathy. Surgery or anesthesia may potentiate hypotension effects. Patients should maintain adequate hydration and avoid rapid position changes to minimize orthostatic effects.
Contraindications
Accupril is contraindicated in patients with known hypersensitivity to quinapril or any other ACE inhibitor. History of angioedema related to previous ACE inhibitor therapy represents an absolute contraindication. Concomitant use with aliskiren-containing products in patients with diabetes is contraindicated. Do not administer to patients with hereditary or idiopathic angioedema. Contraindicated during the second and third trimesters of pregnancy due to potential fetal injury and death. Avoid use in patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidney.
Possible side effect
Common adverse reactions (>5%) include headache, dizziness, fatigue, and cough. Less frequent effects (1-5%) comprise nausea, vomiting, abdominal pain, diarrhea, and orthostatic hypotension. Rare but serious side effects (<1%) include angioedema, hyperkalemia, neutropenia/agranulocytosis, hepatic failure, and pancreatitis. The characteristic dry, persistent cough occurs in approximately 5-15% of patients and may necessitate discontinuation. Hypotension may be symptomatic, particularly in volume-depleted patients. Rash and taste disturbance have been reported in some patient populations.
Drug interaction
Potassium supplements or potassium-sparing diuretics may increase risk of hyperkalemia. Nonsteroidal anti-inflammatory drugs may reduce antihypertensive effects and increase renal impairment risk. Dual blockade of the renin-angiotensin system with ARBs or aliskiren increases adverse event risk. Lithium levels may increase with concomitant use. Diuretics may potentiate hypotensive effects, particularly with initial dosing. Gold injections may cause nitritoid reactions. Tetracycline absorption may be reduced. Insulin and oral hypoglycemics may require dosage adjustment due to improved glucose tolerance.
Missed dose
If a dose is missed, it should be taken as soon as possible on the same day. However, if it is nearly time for the next scheduled dose, the missed dose should be skipped. Patients should never double the dose to make up for a missed administration. Consistent daily dosing is important for maintaining stable blood pressure control, but occasional missed doses are unlikely to cause significant therapeutic regression. Patients should establish routine administration habits and consider using pill organizers or reminder systems to maintain adherence.
Overdose
Symptoms of overdose may include severe hypotension, bradycardia, circulatory shock, electrolyte disturbances, and renal failure. Management involves supportive care with volume expansion with normal saline to maintain blood pressure. Hemodialysis may be effective in removing quinapril and its metabolites. Bradycardia may require atropine administration. Vasopressors such as dopamine or norepinephrine may be necessary for profound hypotension. Patients should be monitored in an intensive care setting with continuous hemodynamic monitoring until stable.
Storage
Store at controlled room temperature 20°-25°C (68°-77°F) with excursions permitted between 15°-30°C (59°-86°F). Keep container tightly closed and protect from moisture and light. Dispense in original container with child-resistant closure. Do not store in bathroom medicine cabinets due to humidity fluctuations. Keep out of reach of children and pets. Do not use if tablets show signs of discoloration, cracking, or other physical deterioration. Properly dispose of expired medication through medication take-back programs.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Accupril is available by prescription only and should be used under appropriate medical supervision. Individual patient responses may vary, and treatment decisions should be made by qualified healthcare professionals based on comprehensive patient assessment. Full prescribing information including boxed warnings should be reviewed before initiation of therapy. Patients should report any adverse reactions to their healthcare provider promptly.
Reviews
Clinical studies demonstrate Accupril’s efficacy with 70-80% of hypertensive patients achieving blood pressure control at recommended doses. The Quinapril Ischemic Event Trial (QUIET) showed significant cardiovascular risk reduction. Meta-analyses of ACE inhibitors consistently show mortality benefit in heart failure populations. Real-world evidence supports maintained efficacy over long-term use with appropriate monitoring. Some patients report cough as a limiting factor, while others appreciate the once-daily convenience. Physician surveys indicate high satisfaction with predictable pharmacokinetics and reliable antihypertensive effects across diverse patient populations.