Chemistry:Quinapril
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| Trade names | Accupril, others |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a692026 |
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| Routes of administration | By mouth |
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| Pharmacokinetic data | |
| Protein binding | 97% |
| Elimination half-life | 2 hours |
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| Chemical and physical data | |
| Formula | C25H30N2O5 |
| Molar mass | 438.524 g·mol−1 |
| 3D model (JSmol) | |
| Melting point | 120 to 130 °C (248 to 266 °F) |
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Quinapril, sold under the brand name Accupril among others, is a medication used to treat high blood pressure, heart failure, and diabetic kidney disease.[1] It is a reasonable initial treatment for high blood pressure.[1] It is taken by mouth.[1] Quinapril is a pro-drug, activated by esterases within the plasma to turn the ester group in the molecule to a carboxylate group which can then bind to the ACE enzyme and inhibit action. It becomes Quinaprilate and ultimately exerts its activity that way.
Common side effects include headaches, dizziness, feeling tired, and cough.[1] Serious side effects may include liver problems, low blood pressure, angioedema, kidney problems, and high blood potassium.[1] Use in pregnancy and breastfeeding is not recommended.[2] It is an ACE inhibitor and works by decreasing renin-angiotensin-aldosterone system activity.[1]
Quinapril was patented in 1980 and came into medical use in 1989.[3] It is available as a generic medication.[4] In 2017, it was the 269th most commonly prescribed medication in the United States, with more than one million prescriptions.[5][6]
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
- Pregnancy
- Impaired renal and liver function
- Patients with a history of angioedema related to previous treatment with an ACE inhibitor
- Hypersensitivity to quinapril
Side effects
Side effects of quinapril 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.
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 "Quinapril Hydrochloride Monograph for Professionals" (in en). American Society of Health-System Pharmacists. https://www.drugs.com/monograph/quinapril-hydrochloride.html.
- ↑ "Quinapril Pregnancy and Breastfeeding Warnings" (in en). https://www.drugs.com/pregnancy/quinapril.html.
- ↑ (in en) Analogue-based Drug Discovery. John Wiley & Sons. 2006. p. 468. ISBN 9783527607495. https://books.google.com/books?id=FjKfqkaKkAAC&pg=PA468.
- ↑ British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. pp. 172. ISBN 9780857113382.
- ↑ "The Top 300 of 2020". https://clincalc.com/DrugStats/Top300Drugs.aspx.
- ↑ "Quinapril - Drug Usage Statistics". https://clincalc.com/DrugStats/Drugs/Quinapril.
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