Essential hypertension.
Heart failure - as an auxiliary preparation in combination with diuretics, especially in severe heart failure - in combination with digitalis preparations.
- Hypersensitivity to the components of the preparation.
- a history of angioedema or other angioedema (for example, as a result of previous treatment with ACE inhibitors).
- Combination with sacubitril / valsartan, due to an increased risk of angioedema.
- Bilateral stenosis of the renal arteries or stenosis of the artery of a single kidney.
- after kidney transplantation.
- Hemodynamically significant aortic or mitral valve stenosis or hypertrophic cardiomyopathy.
- primary hyperaldosteronism.
- Pregnancy (see Section "Use during pregnancy or lactation").
- Breast-feeding (see Section "Use during pregnancy or lactation").
Do not use preparations containing aliskiren together with quinapril in patients with diabetes mellitus or renal insufficiency (glomerular filtration rate GFR <60 ml / min / 1.73 m2) (see sections "Interaction with other medicinal products and other types of interactions" and "Pharmacological ").
During therapy with Accupro, dialysis or hemofiltration using field (acrylonitrile, sodium-2-methylallylsulfonate) -high-flow membranes (for example "AN69") is contraindicated, since there is a risk of developing hypersensitivity reactions (anaphylactic reactions), including life-threatening shock, during dialysis or hemofiltration.
If emergency dialysis or hemofiltration is necessary, the preparation should first be replaced with another preparation that is not an ACE inhibitor, or alternative dialysis membranes should be used (see section "Peculiarities of use").
Life-threatening hypersensitivity reactions have been observed during low-density lipoprotein apheresis (for severe hypercholesterolemia) with dextran sulfate and concomitant use of an ACE inhibitor.
Sometimes life-threatening hypersensitivity reactions (eg, low blood pressure, shortness of breath, vomiting, allergic skin reactions) may occur during treatment to reduce or eliminate the tendency to develop allergic reactions (desensitizing therapy) to insect toxins (such as bee or wasp stings) , and concomitant use of an ACE inhibitor.
If low-density lipoprotein (LDL) apheresis or desensitization therapy for insect toxins is required, the preparation should be temporarily replaced with other preparations intended for the treatment of arterial hypertension or heart failure.
active ingredient: quinapril;
1 tablet contains quinapril hydrochloride in amounts equivalent to 5 mg or 10 mg or 20 mg quinapril;
Excipients: magnesium carbonate; gelatin; lactose monohydrate, crospovidone; magnesium stearate candelilla wax; Opadry white OY-S-7331 (hypromellose, titanium dioxide (E 171), hydroxypropyl methylcellulose, polyethylene glycol 400).
Accupro can be taken with or without food; the daily dose can be used at a time or divided into 2 doses. The duration of use is determined by the doctor.
Doses.
Notes.
At the beginning of treatment with Accupro, an excessive decrease in blood pressure may occur, in particular in patients with a deficiency of salts and / or fluids (for example, in case of vomiting, diarrhea, treatment with diuretics), heart failure, acute myocardial infarction, unstable angina pectoris or severe arterial hypertension.
If possible, salt and/or fluid deficiency should be corrected or the diuretic should be reduced or discontinued accordingly before starting treatment with Accupro. In such patients, treatment should be started with a low single dose of quinapril 2.5 mg in the morning and blood pressure should be carefully monitored.
After the first dose, as well as with an increase in the dose of quinapril and / or loop diuretics, medical observation should be carried out for at least 6:00 to avoid the development of an uncontrolled hypotensive reaction.
In patients with malignant hypertension or severe heart failure, adjustments to Accupro therapy should be made in a hospital setting.
In other cases, the dosage recommendations below should be followed unless otherwise indicated.
Essential hypertension. The usual starting dose is 10 mg quinapril per day. If this dose does not lead to normalization of pressure, it can be increased to 20 mg per day. This dose can be taken at one time or divided into 2 doses (morning and evening). It is undesirable to increase the dose within 3 weeks. The usual maintenance dose is 10 mg quinapril per day, the maximum dose should not exceed 20 mg quinapril twice daily (40 mg).
Heart failure. Accupro can be used as an adjunct to diuretic or cardiac glycoside therapy. The recommended starting dose of quinapril is 2.5 mg morning and evening. The dosage can only be increased gradually, depending on the individual patient's response to treatment. The usual maintenance dose is 10-20 mg quinapril per day, the maximum dose should not exceed 20 mg quinapril twice a day.
Moderate renal impairment (creatinine clearance 30-60 ml/min) and patients over 65 years of age.
The initial dose is 5 mg quinapril, the maintenance dose is usually 5-10 mg quinapril per day. The maximum dose should not exceed 20 mg quinapril per day.
Severe renal dysfunction (creatinine clearance 10-30 ml/min).
The initial dose is quinapril 2.5 mg (respectively ½ coated tablet, Accupro 5 mg), the maintenance dose is usually also 2.5 mg quinapril per day (respectively ½ coated tablet, Accupro 5 mg). The maximum dose is 5 mg quinapril per day. The interval between two doses should be at least 24 hours due to the extended half-life.
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