Accupril

Accupril Information

Accupril

Accupril is indicated for the treatment of mild to moderate hypertension. Accupril is effective as monotherapy or concomitantly with diuretics in patients with hypertension. Accupril is indicated for the treatment of unresponsive systolic left ventricular failure of various aetiologies in which afterload reduction is advocated. Hypertension:

Monotherapy: The recommended initial dosage of Accupril in patients not on diuretics is 10 mg once daily. Depending upon clinical response, patient's dosage may be titrated (by doubling the dose) to a maintenance dosage of 20 to 40 mg/day given as a single dose or divided into two doses. Generally, dosage adjustments should be made at intervals of four weeks or according to patient's response. Long-term control is maintained in most patients with a single daily dosage regimen. Antihypertensive activity commences within one hour with peak effects usually achieved by two to four hours after dosing. Achievement of maximum blood pressure lowering effects may require two weeks of therapy in some patients.

Concomitant Diuretics: In patients who are also being treated with a diuretic, the initial dosage of Accupril is 5 mg in order to determine if excess hypotension will occur. The dosage should subsequently be titrated (as described above) to the optimal response (see SIDE EFFECTS AND SPECIAL PRECAUTIONS).

Congestive Heart Failure:The recommended initial dosage in patients with congestive heart failure due to unresponsive systolic left ventricular failure of various aetiologies in which afterload reduction is advocated, is a single 5 mg dose, following which the patient should be monitored closely for symptomatic hypotension. Patients may be titrated up to 40 mg per day given in two doses with concomitant diuretic and/or cardiac glycoside therapy. Patients can, however, normally be maintained effectively on doses of 10 to 20 mg per day given in one or two doses with concomitant therapy.

Hypertension Medication Accupril Side Effects:

The most frequent clinical adverse reactions in controlled trials with accupril were (in descending order of frequency) headache, dizziness, rhinitis, coughing, upper respiratory tract infection, fatigue, dyspepsia, nausea and vomiting, myalgia, abdominal pain, diarrhoea, insomnia, paresthesia, nervousness, asthenia, hypotension and leucopenia. Less frequent adverse events that have been reported include: palpitations, vasodilatation, dry mouth or throat, pancreatitis, vertigo, nervousness, depression, somnolence, pruritus, rash, exfoliative dermatitis, pemphigus, increased perspiration, alopecia, urinary tract infection, impotence, edema, arthralgia, hemolytic anaemia, and angioedema. Creatinine and Blood Urea Nitrogen: Increases (>1,25 times the upper limit of normal) in serum creatinine and blood urea nitrogen may occur especially with concomitant diuretic therapy.

Precautions on using Accupril Hypertension Medication:

Angioedema: Angioedema, including laryngeal edema, may occur, especially following the first dose of Accupril. Patients should be so advised and told to report immediately any signs or symptoms suggesting angioedema (swelling of face, eyes, lips, tongue, difficulty in breathing) and to discontinue medication until they have consulted with their physician. If laryngeal stridor or angioedema of the face, tongue, or glottis occur, treatment with Accupril should be discontinued immediately, the patient treated appropriately in accordance with accepted medical care, and carefully observed until the swelling disappears. Angioedema associated with laryngeal involvement may be fatal. Where there is involvement of the tongue, glottis, or larynx likely to cause airway obstruction, appropriate therapy e.g., subcutaneous adrenalin solution 1:1000 (0,3 to 0,5 mL) should be promptly administered.

Hypertension Medication Accupril Drug Interaction:

Tetracycline: Concomitant administration of tetracycline with Accupril reduced the absorption of tetracycline in healthy volunteers because of the presence of magnesium carbonate in the formulation. It is recommended that concomitant administration of Accupril and tetracycline be avoided.

Lithium: Increased serum lithium levels and symptoms of lithium toxicity have been reported in patients receiving concomitant lithium and ACE-inhibitor therapy due to the sodium-losing effect of these agents. These drugs should be administered with caution and frequent monitoring of serum lithium levels is recommended. If a diuretic is also used, it may increase the risk of lithium toxicity.

Other Agents: No important pharmacokinetic interactions occurred when Accupril was used concomitantly with propranolol, hydrochlorothiazide, digoxin, or cimetidine. No change in prothrombin time occurred when Accupril and warfarin were given together.

Concomitant Diuretic Therapy: Patients on diuretics, especially those on recently instituted diuretic therapy, may experience an excessive reduction of blood pressure after initiation of therapy with Accupril. Hypotensive effects after the first dose of Accupril may be minimized by discontinuing the diuretic a few days prior to initiation of therapy. In patients in whom a diuretic is continued, medical supervision should be provided up to two hours after the initial dosage of Accupril Hypertension Medication Accupril Overdose:

No data are available with respect to overdosage in humans. The oral LD50 of quinapril in mice and rats ranges from 1440 to 4280 mg/kg. The most likely clinical manifestation would be symptoms attributable to severe hypotension, which should normally be treated by intravenous volume expansion. Haemodialysis and peritoneal dialysis have little effect on the elimination of quinapril and quinaprilat.

Accupril Missed Dose:

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

Accupril Storage:

Store in a cool (below 25°C), dry place. Protect from light and moisture. Keep out of reach of children.