Accupril (Quinapril Hydrochloride)
Accupril (Quinapril Hydrochloride) is used for decreasing hypertension and handling center failing. It is used alone or with other drugs.
Dosage and Administration – Accupril
Hypertension: Monotherapy: The recommended starting dose of Accupril in patients not on diuretics is 10 or 20 mg / day. Depending on the clinical response, the dosage can be adjusted (by doubling the dose) for a maintenance dosage of 20 to 40 mg / day, administered in a single dose or can be divided into two doses. Generally dosage adjustments must be made at intervals of four weeks. The long-term control is maintained in many patients under a single daily dose. Have been employed doses up to 80 mg daily in some patients. Concomitant use with diuretics: the patients should continue treatment with diuretics, the recommended starting dose is 5 mg Accupril, and should subsequently be adjusted (as described below) to obtain optimal response (see Drug Interactions). Renal: The kinetic data indicate that the apparent half-life of elimination of quinaprilat increases as it reduces creatinine clearance. The recommended initial doses based on clinical and pharmacokinetic data in patients with renal failure are: creatinine clearance> 60 ml / min: maximum recommended initial dose: 10 mg, 30-60 ml / min: 5 mg, 10-30 ml / min : 2.5 mg, <10 ml / min: not yet enough experience to allow specific recommendations for dosing in these patients. Age alone does not appear to affect the efficacy or safety profile of Accupril. Therefore, the recommended starting dose of Accupril in elderly patients is 10 mg, administered once a day, followed by titration to achieve optimal response. Congestive heart failure: Accupril is indicated as adjunctive treatment with diuretics and / or cardiac glycosides. The recommended starting dose for patients with congestive heart failure is 5 mg once or twice a day, after which the patient should be closely monitored for the symptomatic hypotension. If the initial dose is well tolerated Accupril, the dosage can be adjusted to individual an effective dose, usually 10 to 40 mg / day divided in two equal doses, with concomitant therapy. Renal: kinetic data indicate that elimination of Accupril is dependent on the level of renal function. The recommended starting dose is 5 mg Accupril in patients with a creatinine clearance greater than 30 mL / min and 2.5 mg in patients with a creatinine clearance less than 30 ml / min. If the initial dose is well tolerated, Accupril can be managed from the next day on a regimen of twice daily. Failing excessive hypotension or significant deterioration of renal function, the dosage may be increased at weekly intervals based on clinical and hemodynamic responses. – Overdosage no reports of overdose in humans. There is no specific information on the treatment of overdosage with Accupril. The most common clinical manifestations are symptoms attributable to severe hypotension, which should normally be treated with volume expansion intravenously. Treatment is symptomatic and supportive, according to established medical care. Hemodialysis and peritoneal dialysis have little effect on the elimination of quinapril and quinaprilat. Elderly patients: Elderly patients exhibited increased area under the curve and maximum levels for quinaprilat compared to values in younger patients, this appears to be related to decreased renal function rather than age alone. In controlled and uncontrolled studies in patients aged 65 years or more, there were no overall differences in efficacy or safety between elderly and younger patients. However, it can not be ruled out greater sensitivity of some older individuals.
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