Generic Name: quinapril hydrochloride
Product Name: Accupril
Indication: What Accupril is used for
Your doctor may have prescribed Accupril for another reason. Ask your doctor if you have any questions about why Accupril has been prescribed for you.
Accupril is not addictive.
This medicine is available only with a doctor’s prescription.
Action: How Accupril works
Accupril works by widening your blood vessels, which reduces pressure in the vessels, making it easier for your heart to pump blood around your body. This helps increase the supply of oxygen to your heart, so that when you place extra demands on your heart, such as during exercise, your heart may cope better and you may not get short of breath as easily.
Accupril belongs to a group of medicines called angiotensin-converting enzyme (ACE) inhibitors.
Each Accupril 5 mg – 5 mg contains the active ingredient quinapril (as the hydrochloride). Each Accupril 10 mg – 10 mg contains the active ingredient quinapril (as the hydrochloride). Each Accupril 20 mg – 20 mg contains the active ingredient quinapril (as the hydrochloride).
Accupril also contains the other ingredients such as magnesium carbonate hydrate, lactose monohydrate, gelatin, crospovidone, magnesium stearate, candelilla wax, iron oxide red, titanium dioxide.
Accupril does not contain sucrose, gluten, tartrazine or any other azo dyes.
Dose advice: How to use Accupril
Before you take Accupril
When you must not take it
Do not take Accupril if:
- You have an allergy to Accupril or any other medicine containing quinapril, or any of the ingredients listed here;
- You have taken any other ‘ACE inhibitor’ medicine before, which caused your face, lips, tongue, throat, hands or feet to swell up, or made it hard for you to breathe;
- You or your family have a history of swelling of the face, lips, tongue, throat, hands or feet for no apparent reason.
- Symptoms of an allergic reaction may include skin rash, itchiness, shortness of breath, swelling of the face, lips or tongue, muscle pain or tenderness or joint pain;
- If you have had an allergic reaction to an ACE inhibitor before, you may be allergic to Accupril;
- Use of ACE inhibitors have been associated with Syndrome of Inappropriate Anti-diuretic Hormone (SIADH) and subsequent low blood sodium levels;
- Your doctor may also wish to do a blood test to monitor your sodium levels to ensure they are within normal limits. In the elderly and other at-risk patients sodium levels may be monitored more frequently;
- You have kidney problems or a condition called ‘renal artery stenosis‘;
- You have regular dialysis for blood filtration.
- You may experience an allergic reaction;
- Do not take Accupril if you are currently taking a blood pressure lowering medicine containing aliskiren or with medicines known as angiotensin receptor blockers (ARB) or other ACE inhibitors and you have the following conditions:
- Do not take Accupril if you are pregnant or breastfeeding.
- Accupril may enter your womb or it may pass into the breast milk and there is the possibility that your baby may be affected;
- Do not take Accupril after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering;
If you are not sure whether you should start taking Accupril, talk to your doctor.
Use in children
The safety and effectiveness of Accupril in children have not been established.
Before you start to take it
Tell your doctor if you have allergies to:
- Any other medicines;
- Any other substances, such as foods, preservatives or dyes.
Tell your doctor if you have or have had any medical conditions, especially the following:
- Kidney problems, or are having dialysis;
- Liver problems;
- Heart problems;
- Low blood pressure, which you may notice as dizziness or lightheadedness;
- High levels of potassium in your blood.
You must also tell your doctor if you:
- Are following a very low salt diet;
- Are about to receive desensitisation therapy for an allergy;
- Are about to undergo dialysis or lipoprotein apheresis;
- Are about to have surgery or a general anaesthetic;
- Plan to become pregnant or breastfeed.
If you have not told your doctor about any of the above, tell them before you start taking Accupril.
Taking other medicines
Tell your doctor or pharmacist if you are taking any other medicines, including:
- All prescription medicines;
- All medicines, vitamins, herbal supplements or natural therapies you buy without a prescription from a pharmacy, supermarket, naturopath or health food shop.
Some medicines may be affected by Accupril or may affect how well it works. You may need different amounts of your medicines, or you may need to take different medicines. Your doctor will advise you.
Tell your doctor or pharmacist if you are taking any of the following:
- Other medicines used to treat high blood pressure;
- Other medicines that work in a similar fashion to ACE Inhibitors, such as Angiotensin Receptor Blockers (these are used to treat high blood pressure and/or heart failure);
- Diuretics, also known as fluid or water tablets;
- Non-steroidal anti-inflammatory drugs (NSAIDs) or Cox 2 inhibiting medicines used to relieve pain, swelling and other symptoms of inflammation, including arthritis;
- Potassium supplements or potassium-containing salt substitutes;
- Lithium, a medicine used to treat mood swings and some types of depression;
- Tetracycline antibiotics;
- Trimethoprim or trimethoprim/ sulfamethoxazole, medicines used to treat bacterial infections.
Tell your doctor if you are taking any of the following blood pressure lowering medicines:
- Angiotensin II receptor blocker (ARB);
For some patients, Accupril should not be taken in combination with these medicines.
Your doctor may check your kidney function, blood pressure and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.
Tell your doctor if you are taking any of the following medicines:
- mTOR inhibitors (e.g. temsirolimus), used in the treatment of kidney cancer;
- DPP-IV inhibitors (e.g. vildagliptin), used in the treatment of diabetes;
- NEP inhibitors (e.g. sacubitril/ valsartan), used in the treatment of congestive heart failure.
Taking Accupril in combination with these medicines may increase your risk of having an allergic reaction.
If you are not sure if you are taking any of the medicines mentioned here, check with your doctor or pharmacist.
Your doctor and pharmacist may have more information on medicines to be careful with or avoid while taking Accupril.
How to take Accupril
Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained here.
If you do not understand the instructions on the box, ask your doctor or pharmacist for help.
How much to take
Your doctor or pharmacist will tell you how many tablets you will need to take each day. This depends on your condition and whether or not you are taking any other medicines.
For high blood pressure
For most patients, not on diuretics, the usual starting dose is 5 mg to 10 mg taken once a day. The dose may need to be increased depending on your blood pressure at an interval of 4 weeks. Most patients take between 10 mg and 40 mg each day.
This dose may be taken once a day or divided into two equal doses per day (one in the morning and one at night).
For heart failure
The usual starting dose is 5 mg taken once a day. In most patients, effective doses are between 10 mg and 20 mg a day. Your doctor will advise whether the dose is to be taken as a single dose or as two separate doses (one in the morning and one at night).
How to take it
Swallow Accupril whole with a full glass of water.
Do not chew the tablets.
When to take it
Take Accupril at about the same time each day. Taking your tablets at the same time each day will have the best effect. It will also help you remember when to take the tablets.
Take Accupril before meals. Food with a high fat content may interfere with the absorption of Accupril.
How long to take it
Continue taking your medicine for as long as your doctor tells you. Accupril helps control your condition, but does not cure it. It is important to keep taking your medicine every day even if you feel well.
If you forget to take it
If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to. Otherwise, take it as soon as you remember and then go back to taking your medicine as you would normally.
Do not take a double dose to make up for the dose that you missed. This may increase the chance of you getting an unwanted side effect.
If you are not sure what to do, ask your doctor or pharmacist. If you have trouble remembering to take your medicine, ask your pharmacist for some hints.
If you take too much (overdose)
Immediately telephone your doctor or the Australian Poisons Information Centre (telephone 13 11 26), or the New Zealand National Poisons Information Centre (telephone 0800 POISON or 0800 764 766), or go to Accident and Emergency at the nearest hospital, if you think that you or anyone else may have taken too much Accupril. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.
If you take too much Accupril, you may feel light-headed, dizzy or you may faint.
While you are taking Accupril
Things you must do
If you are about to be started on any new medicine, remind your doctor, dentist or pharmacist that you are taking Accupril.
Make sure you drink enough water during exercise and hot weather when you are taking Accupril, especially if you sweat a lot. If you do not drink enough water while taking Accupril, you may feel faint, light-headed or sick. This is because your blood pressure is dropping suddenly. If you continue to feel unwell, tell your doctor.
Tell your doctor if you have excess vomiting or diarrhoea while taking Accupril. You may lose too much water and salt and your blood pressure may drop too much.
Tell your doctor immediately if you feel light-headed or dizzy after taking your first dose of Accupril, or when your dose is increased. This is especially important if you are taking Accupril for heart failure.
If you are going to have surgery that needs a general anaesthetic, tell your doctor or dentist that you are taking Accupril. Your blood pressure may drop suddenly.
If you become pregnant while taking Accupril, tell your doctor immediately.
If you are about to have any blood tests, tell your doctor that you are taking Accupril. Accupril may interfere with the results of some tests as it can result in sodium blood levels that are lower than the normal limits.
Have your blood pressure checked when your doctor says, to make sure Accupril is working.
Go to your doctor regularly for a check-up.
Your doctor may occasionally do a blood test to check your potassium levels and see how your kidneys are working.
Things you must not do
Do not give Accupril to anyone else, even if they have the same condition as you.
Do not take Accupril to treat any other complaints unless your doctor or pharmacist tells you to.
Do not stop taking Accupril, or change the dosage, without checking with your doctor.
Things to be careful of
If you feel light-headed, dizzy or faint when getting out of bed or standing up, get up slowly. Standing up slowly, especially when you get up from bed or chairs, will help your body get used to the change in position and blood pressure. If this problem continues or gets worse, talk to your doctor.
Be careful driving or operating machinery until you know how Accupril affects you. As with other ACE inhibitor medicines, Accupril may cause dizziness, light-headedness or tiredness in some people. Make sure you know how you react to Accupril before you drive a car, operate machinery, or do anything else that could be dangerous if you are dizzy or light-headed. If this occurs do not drive. If you drink alcohol, dizziness or light-headedness may be worse.
Things that would be helpful for your blood pressure or heart failure
Some self help measures suggested below may help your condition. Talk to your doctor or pharmacist about these measures and for more information.
Your doctor may advise you to limit your alcohol intake.
Your doctor may suggest losing some weight to help lower your blood pressure and help lessen the amount of work your heart has to do. Some people may need a dietician’s help to lose weight.
Eat a healthy diet which includes plenty of fresh vegetables, fruit, bread (preferably wholegrain), cereals and fish. Also eat less sugar and fat (especially saturated fat) which includes sausages, fatty meats, full cream dairy products, biscuits, cakes, pastries, chocolates, chips and coconut. Monounsaturated and polyunsaturated fats from olive oil, canola oil, avocado and nuts are beneficial in small quantities.
Your doctor may advise you to watch the amount of salt in your diet. To reduce your salt intake you should avoid using salt in cooking or at the table and avoid cooked or processed foods containing high sodium (salt) levels.
Regular exercise, maintained over the long term, helps to reduce blood pressure and helps get the heart fitter. Regular exercise also improves your blood cholesterol levels, helps reduce your weight and stress levels, and improves your sleep, mood and ability to concentrate. However, it is important not to overdo it. Before starting any exercise, ask your doctor about the best kind of programme for you.
Your doctor may advise you to stop smoking or at least cut down. Ask your doctor or pharmacist for further information and advice.
After taking Accupril
Keep your tablets in the box until it is time to take them. If you take the tablets out of the box they may not keep well.
Keep your tablets in a cool dry place where the temperature stays below 25 °C. Do not store Accupril or any other medicine in the bathroom or near a sink. Do not leave it on a windowsill or in the car on hot days. Heat and dampness can destroy some medicines.
Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
If your doctor or pharmacist tells you to stop taking Accupril or the tablets have passed their expiry date, ask your pharmacist what to do with any that are left over.
Schedule of Accupril
Accupril is a Prescription Only Medicine (Schedule 4).
Side effects of Accupril
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Accupril. Accupril helps most people with high blood pressure and heart failure, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.
It can be difficult to tell whether side effects are the result of taking Accupril, effects of your condition or side effects of other medicines you may be taking. For this reason it is important to tell your doctor of any change in your condition.
If you are over 65 years of age you may have an increased chance of getting side effects.
Do not be alarmed by the list of side effects. You may not experience any of them.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor if
Ask your doctor or pharmacist for advice if you notice any of the following and they worry you:
- Feeling light-headed, dizzy or faint;
- Dry cough;
- Feeling sick (nausea) or vomiting;
- Stomach pain;
- Unusual tiredness or weakness, fatigue;
- Feeling drowsy or sleepy during the day;
- Hair loss or thinning;
- Dry mouth or throat;
- Taste disturbances or loss of taste;
- Confusion or nervousness;
- Back pain;
- Difficulty in getting or maintaining an erection.
These side effects are usually mild. All side effects should be reported to a health professional.
Tell your doctor as soon as possible if
Tell your doctor as soon as possible if you notice any of the following:
- Disturbed vision;
- Symptoms of sunburn (such as redness, itching, swelling, blistering) which may occur more quickly than normal;
- Itchy, raised or red skin rash;
- Signs of worrying or frequent infections such as fever, severe chills, sore throat or mouth ulcers;
- Aching, tender or weak joints or muscles not caused by exercise;
- Feelings of deep sadness and unworthiness (depression);
- Severe upper stomach pain, often with nausea and vomiting;
- Passing little or no urine;
- Bleeding or bruising more easily than normal.
The above list includes serious side effects that may require medical attention. Serious side effects are rare.
Go to hospital if
Tell your doctor immediately or go to Accident and Emergency at your nearest hospital, if you notice any of the following:
- Fainting within a few hours of taking a dose;
- Fast or irregular heart beat;
- Shortness of breath or tightness in the chest;
- Sudden onset of stomach pains or cramps with or without nausea or vomiting;
- Severe flaking or peeling of the skin;
- Severe blisters and bleeding in the lips, eyes, mouth, nose and genitals;
- Chest pain.
These are very serious side effects. You may need urgent medical attention or hospitalisation. These side effects are very rare.
Stop taking Accupril and tell your doctor immediately or go to Accident and Emergency at your nearest hospital if you notice the following:
- Swelling of the face, lips, mouth, tongue or throat which may cause difficulty in swallowing or breathing.
Tell your doctor or pharmacist if you notice anything that is making you feel unwell.
Other side effects not listed above may also occur in some people.
For further information talk to your doctor.