The Safety and Tolerability of Quinapril

Knapp, Lloyd; Frank, Graham J.; McLain, Richard; Rieger, Maira M.; Posvar, Edward L.; Singer, Robert M.

doi:10.1097/00005344-199000152-00009

Cited by 19 publications

(3 citation statements)

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“…Clinically significant adverse effects of Quinapril occur at low rates (Materson, 1992;Knapp et al, 1990;Canter et al, 1990).…”

Section: Risk Of Quinapril Therapymentioning

confidence: 99%

Risk-Benefit Analysis and Risk Minimization of Quinapril: A Review

Sunny¹

2014

American Journal of Pharmacology and Toxicology

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The purpose of this review is to give the readers an insight about the risks and benefits of 'quinapril', a potent Angiotensin Converting Enzyme Inhibitor (ACEI). Quinapril is a highly effective novel drug indicated for treatment of congestive heart failure and hypertension. Despite of the fact that safety profile is quite well with low incidence of adverse effects, an attempt has been made to minimize the risks and subsequently minimizing the adverse consequences of this competitive inhibitor, thereby increasing the benefits of this enzyme inhibitor in day to day clinical practice.

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“…Clinically significant adverse effects of Quinapril occur at low rates (Materson, 1992;Knapp et al, 1990;Canter et al, 1990).…”

Section: Risk Of Quinapril Therapymentioning

confidence: 99%

Risk-Benefit Analysis and Risk Minimization of Quinapril: A Review

Sunny¹

2014

American Journal of Pharmacology and Toxicology

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“…The present study was designed to find rare and possibly unknown adverse events [1] and to determine whether potential differences in data exist between information obtained unsolicited by interview (i.e. spontaneously reported) or, more formally, by a stan dardized questionnaire in two groups of hypertensive patients receiving either an angiotensin-converting en zyme (ACE) inhibitor, quinapril [2][3][4][5][6], or a preferred ini tially prescribed p-adrenergic receptor blocker, metoprolol [7][8][9],…”

Section: Introductionmentioning

confidence: 99%

Analysis of Adverse Effects among Patients with Essential Hypertension Receiving an ACE Inhibitor or a Beta-Blocker

Bahrmann²,

Benkert³

et al. 1996

Cardiology

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Evaluation of safety and efficacy of new drugs is based largely on data from clinical trials involving a limited number of patients. This approach does not necessarily detect the rare adverse events that may only be observed when very large numbers of patients are studied. Consequently, we designed a double-blind 12-week trial comparing the new angiotensin-converting enzyme (ACE) inhibitor, quinapril (n = 5,053), with a well-established β-adrenergic receptor blocker, metoprolol (n = 506). Essentially hypertensive patients (diastolic blood pressure 95-114 mm Hg) received either 10 mg quinapril or 50 mg metoprolol once daily, and the doses were doubled at 4-week intervals to a maximum of 40 and 200 mg, respectively, in nonresponders. Responder rates were similar under both regimens. Adverse events were assessed by interview as well as by a standard questionnaire. The overall prevalence of adverse events reported by standard questionnaire was higher than that reported spontaneously during interviews. With respect to typical ACE inhibitor adverse reactions (e.g. cough and taste disturbances), there was no difference between quinapril and metoprolol independent of the mode of reporting. In summary, both drugs showed comparable overall tolerance and safety. The discrepancy between spontaneously reported and questionnaire-reported adverse events was noteworthy, and this finding prevailed in a volunteer group of 327 patients who were treated with quinapril for 52 weeks. Thus, a questionnaire is of great significance in addition to the patient history/interview in a large-scale, double-blind study designed to learn about details of drug safety.

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“…Quinapril has an intermediate duration of action and in animal experiments is suggested to have a relatively high affinity for tissue ACE [10]. While the incidence of first dose hypotension following quinapril is increased with concomitant diuretic therapy, the overall incidence of this side effect with monotherapy is suggested to be low in comparison with captopril or enalapril in patients with hypertension [11]. In essential hypertension, the suggested maintenance dose of 20 mg quinapril was well tolerated and was not associated with excessive falls in blood pressure [12].…”

Section: Introductionmentioning

confidence: 99%

Haemodynamic response and pharmacokinetics after the first dose of quinapril in patients with congestive heart failure.

Squire

Lees

et al. 1994

Brit J Clinical Pharma

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1. Twenty‐four elderly patients with stable, chronic congestive heart failure, NYHA II‐IV, requiring addition of an ACE inhibitor to their existing therapy were randomised to receive double‐blind a single dose of quinapril 2.5 mg p.o. or matching placebo after 24‐48 h supervised diuretic withdrawal. 2. The effect of treatment on resting supine blood pressure, heart rate, plasma angiotensin converting enzyme (ACE) and circulating plasma renin activity was compared between groups over the first 24 h after dosing. The pharmacokinetic profiles of quinapril and the active metabolite quinaprilat were determined. 3. Compared with placebo, quinapril caused a statistically significant but modest fall in blood pressure from 3 to 10 h post dose. The maximum fall of 12 mm Hg (95% C.I. 5.4‐18.5) was seen at approximately 5 h. Circulating ACE activity was 40% inhibited within 1 h. Maximum ACE inhibition (83.6%, 95% C.I. 76.7‐90.5) was observed at 3 h. ACE remained 60% inhibited at 24 h post dose. tmax for quinapril was seen at 2.6 +/‐ 1.2 h. while tmax for quinaprilat was at 3.6, +/‐ 0.8 h. 4. Treatment with quinapril was associated with a significant rise in plasma renin activity (PRA) of 8.83 ng AI ml‐1 h‐1 (95% C.I. 0.30‐17.96) compared with placebo. 5. Compared with placebo, quinapril 2.5 mg inhibits plasma ACE by over 60% for 24 h and reduces blood pressure for at least 10 h in patients with stable, chronic congestive heart failure. The blood pressure fall, although moderate and well tolerated, is more sustained than previously described for quinapril in heart failure.

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The Safety and Tolerability of Quinapril

Cited by 19 publications

References 0 publications

Risk-Benefit Analysis and Risk Minimization of Quinapril: A Review

Risk-Benefit Analysis and Risk Minimization of Quinapril: A Review

Analysis of Adverse Effects among Patients with Essential Hypertension Receiving an ACE Inhibitor or a Beta-Blocker

Haemodynamic response and pharmacokinetics after the first dose of quinapril in patients with congestive heart failure.

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