Accupril (Quinapril) - Oral

What Is Accupril?

Accupril (quinapril) is a prescription drug used to treat high blood pressure. It can also be used along with other medicines to manage heart failure.

Accupril is in a drug class known as angiotensin-converting enzyme (ACE) inhibitors.

It works by decreasing chemicals that narrow the blood vessels. This helps blood flow more smoothly, lowering blood pressure and helping your heart pump blood more efficiently. 

Accupril is available under both the brand and generic name. It comes in an oral tablet form.

Drug Facts

  • Generic Name: Quinapril
  • Brand Name: Accupril
  • Drug Availability: Prescription
  • Therapeutic Classification: Antihypertensive
  • Available Generically: Yes
  • Controlled Substance: N/A
  • Administration Route: Oral
  • Active Ingredient: Quinapril
  • Dosage Form: Tablet

What Is Accupril Used For?

The Food and Drug Administration (FDA) approved Accupril to lower blood pressure.

Lowering blood pressure can reduce the risk of cardiovascular events, such as heart attack and stroke. Accupril can also be used in combination with other medications (such as diuretics and/or digoxin) to manage heart failure.

Accupril is a single-ingredient drug containing quinapril. It may be used alone or combined with a diuretic called a thiazide diuretic, such as hydrochlorothiazide. Accuretic is another prescription drug containing both quinapril hydrochlorothiazide in a single tablet. 

This article will focus on the single-ingredient tablet Accupril (quinapril).

Accupril (Quinapril) Drug Information - Illustration by Zoe Hansen

Verywell / Zoe Hansen

How to Take Accupril

Read the patient information leaflet that comes with your Accupril prescription. Ask your healthcare provider if you have any questions. 

Take Accupril as directed. Your healthcare provider will tell you how often you should check your blood pressure and if you need any blood work to check your kidney or liver function. Take Accupril every day, even if you feel well. Many people with high blood pressure do not have any symptoms. You may have to take blood pressure medicine for a long time or even the rest of your life. 

Notify your healthcare provider if you experience vomiting, or diarrhea or notice increased sweating. These are signs of dehydration, which can lead to very low blood pressure and other problems such as electrolyte imbalance or kidney problems. 

If you have any type of surgery, tell your surgeon that you take Accupril.

Storage

Accupril should be stored at room temperature (68 and 77 degrees Fahrenheit), away from heat, direct light, and moisture. Keep Accupril in its original labeled container and out of the reach of children and pets.

Off-Label Uses

Healthcare providers may prescribe Accupril to treat other conditions. When a drug is prescribed for purposes not listed on the product label, it is known as off-label use. 

In some cases, Accupril is prescribed to slow the progression of kidney disease in people with diabetes.

How Long Does Accupril Take to Work?

A single dose of Accupril reaches its highest levels in the body within one hour. Effects on blood pressure are generally seen within one or two weeks. Effects on heart failure may take up to six months.

What Are the Side Effects of Accupril?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

The most common side effects of Accupril are:

  • A dry cough
  • Low blood pressure
  • Dizziness (avoid getting up too fast from a sitting or lying down position)
  • Headache 
  • Fatigue 
  • High levels of potassium in the blood
  • High levels of uric acid in the blood
  • Nausea and vomiting
  • Abdominal pain
  • Muscle and joint pain
  • Upper respiratory infection symptoms
  • Sensitivity to sunlight
  • Increased levels of BUN and creatinine (kidney function tests)

A cough associated with ACE inhibitors such as Accupril can be bothersome, but usually goes away once the medicine is stopped. Let your healthcare provider know if you start taking Accupril and develop a cough. They may need to change the medication.

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Hypersensitivity reaction or anaphylaxis: Symptoms can include rash, hives, swelling around the lips, tongue, and face, and difficulty breathing
  • Angioedema (swelling under the skin - this can occur in the face, lips, or tongue, or in the stomach, which would cause symptoms of nausea, vomiting or diarrhea)
  • Severely low blood pressure
  • High levels of potassium in the blood
  • Kidney problems or kidney failure
  • Liver problems
  • Neutropenia or agranulocytosis, a low amount of certain types of white blood cells, which can make you more susceptible to infection
  • Inflammation of the pancreas (symptoms include pain, fever, nausea, vomiting)
  • Stevens-Johnson syndrome, a serious and life-threatening condition with symptoms of fever, red and purple rash, and blisters

Long-Term Side Effects

While many people take quinapril without any long-term problems, some side effects can occur after taking quinapril for a while. 

Some long-term side effects can be mild, such as:

  • Cough
  • Back/muscle pain
  • Numbness and tingling
  • Sun sensitivity 
  • Hair loss.

Moderate long-term side effects may include:

  • Swelling
  • Impotence
  • Orthostatic hypotension (feeling dizzy when going from sitting or lying down to standing up)
  • Depression
  • Liver problems
  • Low white blood cell counts.

Severe long-term or delayed side effects can include:

  • Kidney failure
  • More severe liver problems or liver failure
  • Stomach bleed
  • Serious or life-threatening skin reactions

Report Side Effects

Accupril may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Accupril Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For high blood pressure:
      • Adults—At first, 10 or 20 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 40 to 80 mg per day, taken as a single dose or divided into two doses.
      • Children—Use and dose must be determined by your doctor.
    • For heart failure:
      • Adults—At first, 5 milligrams (mg) two times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 20 to 40 mg per day, divided into two doses.
      • Children—Use and dose must be determined by your doctor.

Modifications

Certain circumstances may require a change in your Accupril dose or require you to stop taking Accupril altogether. Consult your healthcare provider if you:

  • Are pregnant or breastfeeding
  • Are aged 65 years or older
  • Have kidney problems

Pregnancy and Breastfeeding 

People who are pregnant or planning to become pregnant should not take Accupril. Accupril can cause harm or death to the fetus. People who already take Accupril and find out they are pregnant should stop taking the medication and call their healthcare provider. 

Before using Accupril, consult with your healthcare provider if you are breastfeeding. 

Older Adults

Accupril dosing should start at the lower end for adults who are 65 years and older. 

In adults 65 years or older, Accupril dosing should start at the low end. Your healthcare provider may monitor kidney function. 

Kidney Problems

The prescribing information recommends dosage adjustments based on creatinine clearance.

Missed Dose

If you miss a dose of Accupril, take it as soon as possible. Skip the missed dose if it is almost time for the next dose. Do not take two doses together.

Overdose: What Happens If I Take Too Much Accupril?

Taking too much Accupril can cause:

  • Lightheadedness or fainting
  • Low blood pressure
  • Kidney problems
  • Electrolyte imbalances (too much potassium and too little sodium in the blood).

What Happens If I Overdose on Accupril?

If you think you or someone else may have overdosed on Accupril, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Accupril, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away.

You should not use this medicine together with sacubitril. Do not use this medicine and sacubitril/valsartan (Entresto®) within 36 hours of each other.

This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat while you are using this medicine.

Call your doctor right away if you have severe stomach pain (with or without nausea or vomiting). This could be a symptom of a condition called intestinal angioedema.

Dizziness, lightheadedness, or fainting may also occur, especially when you get up from a lying or sitting position or if you have been taking a diuretic (water pill). Make sure you know how you react to the medicine before you drive, use machines, or do other things that could be dangerous if you are dizzy or not alert. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Check with your doctor right away if you have lower back or side pain, decreased frequency or amount of urine, bloody urine, increased thirst, swelling of the face, fingers, or lower legs, weight gain, or increased blood pressure. These could be symptoms of a serious kidney problem.

Check with your doctor if you have a fever, chills, or sore throat. These may be symptoms of an infection resulting from low white blood cells.

Hyperkalemia (high potassium in the blood) may occur while you are using this medicine. Check with your doctor right away if you have the following symptoms: abdominal or stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, shortness of breath, or weakness or heaviness of the legs. Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium. .

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.

This medicine may be less effective in black patients. Black patients also have an increased risk of swelling of the hands, arms, face, mouth, or throat. Talk with your doctor if you have concerns about this.

Do not take other medicines unless they have been discussed with your doctor. This especially includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

What Are Reasons I Shouldn’t Take Accupril?

Accupril is not appropriate for everyone. 

Your healthcare provider may not prescribe you Accupril if you:

  • Are allergic to quinapril or any of the inactive ingredients of Accupril
  • Have a history of angioedema (swelling under the skin), such as angioedema from another medication in the ACE inhibitor class. 
  • Are pregnant or plan to become pregnant
  • Take another drug called sacubitril, or Entresto (sacubitril and valsartan)
  • Take Tekturna (aliskiren), a drug used in people with diabetes

You may need more careful monitoring while using Accupril if you have:

  • Kidney problems or are on dialysis
  • Low sodium levels
  • Low blood pressure
  • Severe heart failure
  • Aortic stenosis (narrowing of the heart’s aortic valve)
  • Hypertrophic cardiomyopathy (when the heart muscle becomes abnormally thick, making it harder to pump blood)
  • Coronary artery disease (buildup of plaque in the blood vessels)
  • Cerebrovascular disease (conditions that affect blood flow to the brain)
  • Collagen vascular disease (an autoimmune disorder where the immune system attacks its own skin, tissues, and organs)

When used as a single therapy, some antihypertensive medications have lesser effects on blood pressure in Black people than in people who are not Black. This is because people who are Black have a greater likelihood of having low plasma renin levels. Renin is an enzyme that helps regulate your blood pressure. 

People who are 65 years and older may also require closer monitoring while taking Accupril.

What Other Medications Interact With Accupril?

Tell your healthcare provider about your medicines, including prescription and over-the-counter medications and vitamins or supplements. 

This information will ensure your healthcare provider can safely prescribe Accupril. Some examples of drugs that may interact with Accupril include:

  • Aliskiren
  • Angiotensin receptor blockers such as valsartan, olmesartan, losartan
  • Clonidine 
  • Drugs that increase potassium levels such as potassium chloride and spironolactone
  • Gold injections used to treat arthritis
  • Lithium 
  • Other ACE inhibitors such as lisinopril, ramipril, or enalapril
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, celecoxib, meloxicam, and naproxen
  • Sacubitril
  • Tacrolimus 
  • Tetracycline

Accupril should also not be taken within 36 hours of switching to or from Entresto (sacubitril and valsartan). 

Avoid drinking alcohol or using salt substitutes or potassium supplements while on the medication.

What Medications Are Similar?

Other drugs in the ACE inhibitor category work in the same way and have similar side effects as Accupril. Examples of ACE inhibitors include:

  • Altace (ramipril)
  • Lotensin (benazepril)
  • Vasotec (enalapril)
  • Zestril (lisinopril)

Angiotensin II receptor blockers (ARBs) work on the same system as ACE inhibitors but at a different point. Examples of ARBs include:

  • Avapro (irbesartan)
  • Benicar (olmesartan)
  • Cozaar (losartan)
  • Diovan (valsartan)
  • Micardis (telmisartan)

Other medications used to treat high blood pressure include:

  • Alpha blockers such as Cardura (doxazosin) and Hytrin (terazosin)
  • Alpha/beta-blockers such as Coreg (carvedilol)
  • Beta-blockers such as Tenormin (atenolol), Bystolic (nebivolol), Inderal (propranolol), Lopressor (metoprolol tartrate), and Toprol XL (metoprolol succinate extended-release)
  • Calcium channel blockers such as Calan (verapamil), Cardizem (diltiazem), and Norvasc (amlodipine)
  • Diuretics such as Lasix (furosemide) and hydrochlorothiazide

This list is a list of drugs also prescribed for high blood pressure. It is NOT a list of drugs recommended to take with quinapril. Ask your pharmacist or a healthcare provider if you have questions.

Frequently Asked Questions

  • What is Accupril used for?

    Accupril is an ACE inhibitor. It contains the ingredient quinapril. Accupril can be used to lower blood pressure, which reduces the risk of having a heart attack or stroke. Accupril can also be used with other medicines to manage heart failure.

  • How does Accupril work?

    Accupril decreases the chemicals in the body that tighten the blood vessels. Doing this helps blood flow more smoothly, lowering blood pressure and helping the heart pump blood more efficiently.

  • What drugs should not be taken with Accupril?

    Accupril should not be taken with drugs that increase potassium, such as potassium chloride or spironolactone. It should not be taken with other ACE inhibitors, ARB blockers, or aliskiren. Accupril and sacubitril also should not be taken together. Accupril has other drug interactions, too. Consult your healthcare provider for a full list of drug interactions.

  • How long does it take for Accupril to work?

    Accupril will reduce blood pressure in about one to two weeks. When used for heart failure, Accupril may take up to six months to reach its full effect.

  • What are the side effects of Accupril?

    Some of Accupril’s more common side effects include a dry cough, low blood pressure, dizziness, headache, fatigue, and muscle and joint pain. Accupril can also cause severe and long-term side effects. Before taking Accupril, talk to your healthcare provider about what side effects to expect and how to address them.

  • How do I stop taking Accupril?

    Your healthcare provider will advise you on how long to take Accupril.

How Can I Stay Healthy While Taking Accupril

Before taking Accupril, discuss all medical conditions and medical history with your healthcare provider. Prepare a list of all the medications you take. This helps your provider ensure that Accupril is being prescribed safely for you. 

In addition to taking your medication, talk to your healthcare provider about the non-pharmaceutical measures you can take to help reduce your blood pressure. These can include:

  • Smoking cessation
  • Diet changes, such as reducing salt intake
  • Reducing stress
  • Getting enough sleep
  • Limiting caffeine and alcohol

Having high blood pressure generally does not cause symptoms, so you may not notice anything different when taking Accupril. Continue taking Accupril unless your healthcare provider tells you to stop or if you have severe side effects. If you have trouble remembering to take your dose, try using a pill organizer and an app or alarm to remind you when to take your medicine.

A dry cough is a common side effect of ACE inhibitors such as Accupril. The cough can be bothersome and usually goes away when the medicine is stopped. Notify your healthcare provider if you start experiencing a dry cough that becomes worse.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Epocrates. Accupril.

  3. MedlinePlus. Quinapril.

  4. Tandan N, Cassagnol M. Quinapril. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.

  5. Williams SF, Nicholas SB, Vaziri ND, Norris KC. African Americans, hypertension and the renin angiotensin system. World J Cardiol. 2014;6(9):878-889. doi:10.4330/wjc.v6.i9.878

By Karen Berger, PharmD
Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.