药物名称和成分

中文药名: 喹那普利片
英文名:Quinapril Hydrochloride Tablets
主要成分:本品的主要成份是S-2[N-[（S）-1-乙氧羰基-3-苯丙基]-L-丙氨酰]-1，2，3，4-四氢-3-异喹啉酸盐酸盐
性状:本品为咖啡色薄膜包衣片。
生产厂家

Pfizer辉瑞公司
药理作用

本品为无巯基、长效、口服血管紧张素转换酶（ACE）抑制剂，口服后在肝脏水解成具有活性的喹那普利拉，可抑制ACE，阻止血管紧张素I转换为血管紧张素Ⅱ，从而使血管紧张素Ⅱ所介导的血管收缩作用减弱，降低动脉的血管阻力，同时抑制醛固酮的合成，减少醛固酮所产生的水和钠的潴留，使血压下降。 本品具有持续24小时的长效降压作用，具有降低动脉静脉外周阻力的作用，也能对充血性心力衰竭发挥疗效，是治疗心衰除洋地黄及利尿剂外的主要辅助药。
药代动力学

口服本品后，喹那普利很快被吸收并水解成活性的喹那普利拉，喹那普利和喹那普利拉分别于给药后1小时和2小时血药浓度达到峰值，喹那普利拉浓度比喹那普利高四倍，半衰期分别为0.8小时和1.9小时。喹那普利主要从肾脏排泄，61％由尿排泄，37％由粪排泄。
适应症

高血压、充血性心力衰竭。
用法用量

本品口服后其吸收不受食物影响。 对轻中度高血压推荐起始剂量为每日10mg，每日一次，如降压效果不满意，可增至每日20～30mg，最大剂量为每日40mg，每日一次或分二次服用，维持剂量一般为每日10mg。本品增量时通常要间隔1～2周。对已服用利尿剂的患者，起始剂量应减半。 对重度高血压及药物增量后血压下降仍不满意的患者，可加用小剂量的利尿剂（如噻嗪类）或钙拮抗剂。 充血性心力衰竭患者在应用利尿剂、强心甙治疗的基础上，推荐本品起始剂量为5mg/日，注意监测患者是否有症状性低血压，剂量可逐渐加量至每次10～20mg，每日二次。
任何疑问，请遵医嘱！
不良反应

临床试验表明，大多数患者都可服用本品，治疗高血压，常见的不良反应为：干咳、头痛、眩晕、疲劳和感觉异常。 其它不良反应有：恶心、呕吐、消化不良、腹泻、低血压、皮疹、水肿和瘙痒。 偶有血清肌酐及血BUN升高。
禁忌症

1．对本品或相关成分过敏者。
2．既往应用某一种血管紧张素转换酶抑制剂治疗时曾出现血管神经性水肿者。
3．孕妇。
注意事项

1．首剂低血压反应。 对服用利尿剂、长期限盐、有腹泻或呕吐症状，而使血容量不足的患者，有可能发生有症状的低血压。无并发症及诱因的高血压患者极少发生首剂低血压。对心衰并出现首剂低血压反应的患者，如须继续用药，应减少剂量或暂停使用。
2．主动脉瓣狭窄及肥厚性心肌病。 此类患者左室射血受阻，应慎用本品。
3．肾功能不全： 肾功能不全的病人需要减少本品的剂量或减少用药的次数，并且要注意尿素氮、血清肌酐和血钾的变化。如肌酐清除率<40ml/min，起始剂量应减少为5mg/日，并可逐渐增量至理想剂量。如肌酐清除率<15ml/min，剂量应再减半，并增加用药间隔时间。一些双侧肾动脉狭窄或只有单侧肾并伴肾动脉狭窄的病人曾出现血尿素氮和血清肌酐增高，通常停止治疗可予逆转。 ≥65岁的老年病人，虽然单一年龄因素不能影响本品的疗效和安全性，但肾功能随年龄增加而下降，其起始剂量应为5mg/日，直到增量至理想剂量。
4．过敏及血管神经性水肿 对血管紧张素转换酶抑制剂发生过敏者虽有报道，但罕见。如发生在面部、四肢，应停药，一般不须特殊治疗，如发生在咽喉部，因可引起气道阻塞，除应立即停药外，应立即给予必要的治疗，如皮下注射1:1000肾上腺素0.3～0.5ml，及保证呼吸道畅通。
5．哺乳妇女 本品可分泌至乳汁中，故哺乳期慎用。
6．过量用药 过量服用本品后如出现明显低血压，可静滴生理盐水；已合并肾功能不全者应作透析治疗；如服用本品不久，应催吐、洗胃。
7．药物的相互作用
（1）与利尿剂合用时因血容量不足或因低钠可引起低血压。
（2）应避免同时应用保钾利尿剂，如氨苯蝶啶等，因可使血钾升高。
（3）与洋地黄类药如地高辛、β受体-阻滞剂如阿替洛尔、钙拮抗剂如硝苯吡啶等合用不影响相互的药代动力学。
贮藏

遮光、密封保存。

生产厂家: Pfizer

包装规格
10mg*90 片
20mg*90 片
40mg*84 片
5mg*90 片

Accupril
Generic name: Quinapril hydrochloride
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Why is Accupril prescribed?

Accupril is used in the treatment of high blood pressure. It can be taken alone or in combination with a thiazide type of water pill such as hydrochlorothiazide. Accupril is in a family of drugs known as "ACE inhibitors." It works by preventing a chemical in your blood called angiotensin I from converting into a more potent form that increases salt and water retention in your body. Accupril also enhances blood flow throughout your blood vessels. Along with other drugs, Accupril is also prescribed in the treatment of congestive heart failure.
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Most important fact about Accupril

You must take Accupril regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Accupril; and you must continue taking it even if you are feeling well. Accupril does not cure high blood pressure; it merely keeps it under control.
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How should you take Accupril?

You can take Accupril with or without meals.

Alcohol may increase the effect of Accupril, and could cause dizziness or fainting. Avoid alcoholic beverages until you have checked with your doctor.

Take Accupril exactly as prescribed, and see your doctor regularly to make sure the drug is working properly without unwanted side effects. Do not stop taking this drug without first consulting your doctor.

If you miss a dose.
Take the forgotten dose as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never try to "catch up" by doubling the dose.
Storage instructions...
Accupril can be stored at room temperature. Protect from light.
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What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Accupril.

Side effects may include:
Dizziness, headache
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Why should Accupril not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Accupril or similar drugs, such as captopril and enalapril maleate, you should not take this medication. Make sure your doctor is aware of any drug reactions you have experienced.
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Special warnings about Accupril

If you develop swelling of the face, lips, tongue, or throat, or of your arms and legs, or have difficulty swallowing or breathing, you should contact your doctor immediately. You may need emergency treatment.

If you develop abdominal pain with or without nausea and vomiting, contact your doctor. ACE inhibitors such as Accupril have been known to cause intestinal swelling.

You may feel light-headed, especially during the first few days of Accupril therapy. If this occurs, notify your doctor. If you actually faint, stop taking the medication until you have consulted with your doctor.

Vomiting, diarrhea, and heavy perspiration can all deplete your body fluid; and dehydration can cause your blood pressure to drop. If this leads to light-headedness or fainting, you should check with your doctor.

Inform your doctor or dentist that you are taking Accupril before undergoing surgery or anesthesia.

Do not use potassium supplements or salt substitutes containing potassium without consulting your doctor.

If you develop a sore throat, fever, or any other sign of infection, contact your doctor immediately. It could indicate a more serious illness.

If you are taking Accupril, your doctor will do a complete assessment of your kidney function and will watch it closely as long as you are taking this drug.

If you notice a yellow tinge to your skin and the whites of your eyes, stop taking the drug and notify your doctor immediately. This could be a sign of liver damage.

The safety and effectiveness of Accupril in children have not been established.
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Possible food and drug interactions when taking Accupril

If Accupril is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Accupril with the following:

Diuretics Lithium Magnesium Potassium-sparing diuretics Potassium supplements Salt substitutes containing potassium Tetracycline
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Special information if you are pregnant or breastfeeding

ACE inhibitors such as Accupril have been shown to cause injury and even death to the unborn child when used in pregnancy during the second and third trimesters. If you are pregnant, your doctor should discontinue Accupril as soon as possible. If you plan to become pregnant, make sure your doctor knows you are taking this medication. Accupril appears in breast milk and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.
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Recommended dosage for Accupril

HIGH BLOOD PRESSURE

The usual starting dose is 10 or 20 milligrams taken once a day. If you have any problems with your kidneys or if you are also taking a diuretic, your starting dose may be lower. For adults over age 65, the usual starting dose is 10 milligrams. Depending on how your blood pressure responds, your doctor may increase your dose up to a total of 80 milligrams a day taken once a day or divided into two doses.

CONGESTIVE HEART FAILURE

The usual starting dose is 5 milligrams taken twice a day. Your doctor may increase the dose from week to week, up to as much as 20 to 40 milligrams daily, divided into 2 equal doses. If you have kidney problems, the dosage will be lower.
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Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

A severe drop in blood pressure is the primary sign of an Accupril overdose.