ACE inhibitors
Quinapril
An ACE inhibitor that relaxes blood vessels to lower blood pressure; a dry cough is the most common nuisance side effect.
What is Quinapril?
Quinapril is an ACE inhibitor used to treat high blood pressure and heart failure. It relaxes blood vessels by blocking a hormone system that narrows them, which lowers blood pressure and eases the work of the heart. A persistent dry cough is the most common reason people switch from it, and kidney function and potassium are checked with blood tests.
Education and reference only. This is a plain-language guide to Quinapril — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Quinapril is an ACE inhibitor used in the UK to treat high blood pressure and, in some people, heart failure. It works on a hormone system that the body uses to narrow blood vessels and hold on to salt and water. By blocking this system, quinapril relaxes blood vessels and lowers blood pressure. It is taken regularly as a long-term medicine, with blood tests to check the kidneys and potassium, and the benefit is in lower cardiovascular risk over time.
How it works
Quinapril blocks an enzyme (angiotensin-converting enzyme, or ACE) that the body uses to make angiotensin II, a hormone that narrows blood vessels. With less of this hormone, the blood vessels relax and widen and the body holds on to less salt and water, so blood pressure falls. This same action can occasionally affect the kidneys and raise potassium, which is why blood tests are done, and the build-up of certain natural substances explains the dry cough some people get.
Company & origin
Originated / developed by: Developed by Parke-Davis (now part of Pfizer)..
Quinapril is an ACE inhibitor introduced in the late 1980s and marketed in the UK as Accupro for high blood pressure and heart failure.
What it treats
Conditions Quinapril is used for
Practical use
How to take Quinapril
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it regularly as prescribed, at about the same time each day.
- When you first start, take it at a time you can rest afterwards, as the first dose can lower blood pressure.
- Tell your prescriber if you develop a persistent dry cough, as a switch may help.
- Avoid salt substitutes that are high in potassium unless advised, as they can raise potassium too much.
- If you miss a dose, take it as soon as you remember unless it is nearly time for the next one — do not double up.
- Stop and seek urgent medical help if your face, lips, tongue or throat swell.
Weighing it up
Advantages & disadvantages of Quinapril
Advantages
- It is effective at lowering blood pressure and also helps protect the heart in heart failure.
- It is particularly useful in people with diabetes or kidney disease, where it can help protect the kidneys.
- If it causes a cough, there is a closely related option (an ARB) that usually suits instead.
Disadvantages
- A persistent dry cough is common and leads some people to switch.
- It must not be used in pregnancy and is stopped if pregnancy is planned.
- It needs blood tests to monitor the kidneys and potassium.
- Rarely it can cause angioedema (swelling of the face, lips or throat), which needs urgent attention.
Practical use
Good to know
Quinapril is taken regularly to keep blood pressure controlled. The first dose can sometimes cause a noticeable drop in blood pressure, so you may be advised to take it at a time when you can rest. A persistent dry, tickly cough is a well-known effect and, if it bothers you, your prescriber can switch you to a related medicine (an ARB) that is less likely to cause it. Blood tests are done to check your kidneys and potassium. It must not be used in pregnancy, and you should seek urgent help if your lips, tongue or throat swell (angioedema).
Who should not take it / use with caution
- Women who are pregnant, planning pregnancy or breastfeeding.
- People who have had angioedema (severe swelling) with an ACE inhibitor before.
- People with certain narrowings of the kidney arteries or severe kidney problems, used with caution and monitoring.
Monitoring
- Blood tests for kidney function and potassium when starting, after changes and periodically.
- Regular blood-pressure checks.
- Watching for cough or any swelling of the face, lips or throat.
Side effects
- A persistent dry, tickly cough.
- Dizziness, especially after the first dose or when standing.
- Headache or tiredness.
- Rarely, angioedema (swelling of the face, lips, tongue or throat) needing urgent help, or a rise in blood potassium.
Key interactions
- Anti-inflammatory painkillers (NSAIDs such as ibuprofen), which can reduce its effect and affect the kidneys.
- Potassium supplements, potassium-containing salt substitutes and certain water tablets, which can raise potassium.
- Other blood-pressure-lowering medicines and lithium, which need extra care.
Available as: Tablets.
Answers
Quinapril: frequently asked questions
Why do I have a dry cough on quinapril?
A dry, tickly cough is a well-known effect of ACE inhibitors like quinapril. It is harmless but can be annoying. If it bothers you, tell your prescriber, who can usually switch you to a closely related medicine (an ARB) that is much less likely to cause a cough.
Can I take quinapril in pregnancy?
No — ACE inhibitors such as quinapril should not be used in pregnancy. If you are pregnant or planning a pregnancy, tell your prescriber so it can be changed to a safer option.
Why do I need blood tests on quinapril?
Blood tests check your kidney function and potassium level, as ACE inhibitors can affect both. They are usually done when you start, after any change and from time to time afterwards.
What is angioedema and what should I do?
Angioedema is a rare but serious swelling of the face, lips, tongue or throat. If this happens, stop the medicine and seek urgent medical help straight away.
Should I avoid certain salts on quinapril?
Yes — avoid salt substitutes that are high in potassium unless your prescriber says otherwise, as quinapril can raise potassium and these add to that effect.
The wider class
About ACE inhibitors
Quinapril belongs to the ace inhibitors class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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