Accupril (quinapril) is used in adults alone or in combination with other medications to treat high blood pressure (hypertension). Lowering blood pressure may lower your risk of a stroke or heart attack.

Accupril is also used in adults together with other medications to treat heart failure.

Accupril belongs to a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly and the heart can pump blood more efficiently.

Do not use Accupril if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away.

You should not use Accuprilif you have ever had angioedema. Do not take Accupril within 36 hours before or after taking medicine that contains sacubitril(such as Entresto).

If you have diabetes, do not use Accupril together with any medication that contains aliskiren, a blood pressure medicine (brand names include Tekturna and Tekamlo).

Before taking this medicine

You should not use Accupril if you are allergic to quinapril, or if:

• have a history of angioedema; or

• you are allergic to any other ACE inhibitor, such as benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, ramipril, or trandolapril.

Do not take Accupril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use Accupril together with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking Accupril with aliskiren if you have kidney disease.

To make sure Accupril is safe for you, tell your doctor if you have ever had:

• a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis;

• heart problems;

• low blood pressure;

• high blood levels of potassium (hyperkalemia);

• if you are on a low-salt diet;

• low white blood cell counts;

• diabetes;

• kidney disease (or if you are on dialysis); or

• liver disease.

Do not use Accupril if you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant. Quinapril can cause injury or death to the unborn baby if you take Accupril during your second or third trimester.

Ask a doctor if it is safe to breastfeed while using this medicine.

Take Accupril exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Your blood pressure will need to be checked often. Your kidney or liver function may also need to be tested.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking Accupril. This can lead to very low blood pressure, electrolyte disorders, or kidney failure.

Tell your doctor if you have a planned surgery.

If you have high blood pressure, keep using Accupril even if you feel well. High blood pressure often has no symptoms.

Store tightly closed at room temperature, away from moisture and heat.

Usual Adult Dose for Hypertension:

Initial dose: 10 or 20 mg orally once a day in patients not on diuretics
Maintenance dose: 20 to 80 mg orally per day, administered as a single dose or in two equally divided doses

Use:
-Treatment of hypertension

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 5 mg orally twice a day
Maintenance dose: 20 to 40 mg orally per day administered in two equally divided doses

Comments:
-This dose may improve symptoms of heart failure, but increases in exercise duration have generally required higher doses.
-If the initial dosage is well tolerated, patients should then be titrated at weekly intervals until an effective dose.

Use:
-Management of heart failure as adjunctive therapy when added to conventional therapy including diuretics and/or digitalis

Usual Geriatric Dose for Congestive Heart Failure:

10 mg orally once a day

Comments: Dose should be titrated the same way as for other adult patients.

Uses:
-Treatment of hypertension
-Management of heart failure as adjunctive therapy when added to conventional therapy including diuretics and/or digitalis

Usual Geriatric Dose for Hypertension:

10 mg orally once a day

Comments: Dose should be titrated the same way as for other adult patients.

Uses:
-Treatment of hypertension
-Management of heart failure as adjunctive therapy when added to conventional therapy including diuretics and/or digitalis

You should not use Accupril if you are allergic to quinapril, or if:

• have a history of angioedema; or

• you are allergic to any other ACE inhibitor, such as benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, ramipril, or trandolapril.

Do not take Accupril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use Accupril together with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking Accupril with aliskiren if you have kidney disease.

To make sure Accupril is safe for you, tell your doctor if you have ever had:

• a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis;

• heart problems;

• low blood pressure;

• high blood levels of potassium (hyperkalemia);

• if you are on a low-salt diet;

• low white blood cell counts;

• diabetes;

• kidney disease (or if you are on dialysis); or

• liver disease.

Do not use Accupril if you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant. Quinapril can cause injury or death to the unborn baby if you take Accupril during your second or third trimester.

Ask a doctor if it is safe to breastfeed while using this medicine.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Do not take potassium supplements or use salt substitutes, unless your doctor has told you to.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Avoid strenuous exercise if you are being treated for heart failure. Ask your doctor about your risk.

Get emergency medical help if you have signs of an allergic reaction to Accupril: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Accupril may cause serious side effects. Call your doctor at once if you have:

• chest pain, fast, slow, or uneven heart rate;

• a light-headed feeling, like you might pass out;

• heart problems - swelling, rapid weight gain, feeling short of breath;

• kidney problems - swelling, urinating less, feeling tired or short of breath;

• liver problems - loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes), abnormal liver function tests;

• signs of infection - fever, chills, sore throat, body aches, unusual tiredness, loss of appetite, bruising or bleeding; or

• high blood potassium - nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement.

Common Accupril side effects may include:

• headache;

• nausea, vomiting, stomach pain;

• cough; or

• dizziness, tiredness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your other medicines, especially:

• lithium;

• a diuretic or "water pill";

• gold injections to treat arthritis;

• temsirolimus, sirolimus, or everolimus; or

• NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with quinapril, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.