Captopril is used in adults alone or in combination with other medications to treat high blood pressure (hypertension) and congestive heart failure.

Captopril is also used to improve survival and reduce the risk of heart failure after a heart attack in patients with a heart condition called left ventricular hypertrophy (enlargement of the walls of the left side of the heart). Captopril is also used to treat kidney disease (nephropathy) caused by diabetes in patients with type 1 diabetes and retinopathy (eye disease).

Captopril belongs to a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It decreases certain chemicals that tighten the blood vessels, so blood flows more smoothly and the heart can pump blood more efficiently.

Warnings

Do not use captopril if you are pregnant. Stop using captopril and tell your doctor right away if you become pregnant.

If you have diabetes, do not use captopril together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo).

Tell your doctor about all your other medicines. Some drugs should not be used with captopril.

Before taking this medicine

You should not use this medicine if you are allergic to captopril or to any other ACE (angiotensin converting enzyme) inhibitor such as benazepril, fosinopril, enalapril, lisinopril, moexipril, perindopril, quinapril, ramipril, or trandolapril.

If you have diabetes, do not take captopril with any medication that contains aliskiren (a blood pressure medicine).

Do not take captopril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

To make sure captopril is safe for you, tell your doctor if you have ever had:

• heart failure, heart problems;
• severe allergic reaction such as angioedema;
• stomach pain;
• low blood pressure;
• low white blood cell counts;
• a connective tissue disease such as Marfan syndrome, Sjogren’s syndrome, lupus, scleroderma, or rheumatoid arthritis;
• if you are on a low-salt diet;
• to take medicines that weaken the immune system such as cancer medicine, steroids, and medicines to prevent organ transplant rejection;
• diabetes;
• liver disease; or
• kidney disease (or if you are on dialysis).

You may also need to avoid taking captopril with aliskiren if you have kidney disease.

Stop using this medicine and tell your doctor right away if you become pregnant. Captopril can cause injury or death to the unborn baby if you use the medicine during your second or third trimester.

Do not breastfeed.

How should I take captopril?

Take captopril exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Take on an empty stomach, at least 1 hour before a meal.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking captopril. This can lead to very low blood pressure, an electrolyte imbalance, or kidney failure.

Your blood pressure will need to be checked often, and you may need frequent blood tests.

captopril may cause false results on a urine test. Tell the laboratory staff that you use captopril.

Tell your doctor if you have a planned surgery.

If you have high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms.

Store tightly closed at room temperature, away from moisture and heat.

Dosing information

Usual Adult Dose for Hypertension:

Initial dose: 25 mg orally 2 to 3 times a day one hour before meals

Maintenance dose: May increase every 1 to 2 weeks up to 50 mg orally three times a day. If blood pressure remains uncontrolled after 1 to 2 weeks at this dose, add a thiazide diuretic (loop diuretic if severe renal impairment exists) and titrate to its highest usual antihypertensive dose before further increases of captopril.

Maximum dose: 450 mg/day

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 25 mg orally three times a day (6.25 to 12.5 mg orally three times a day if hypotensive, hyponatremic, or hypovolemic)

Target maintenance dose: 50 mg orally three times a day for at least two weeks to ensure a satisfactory response

Maximum dose: 450 mg/day

Comments:
-Most patients experience satisfactory clinical improvement at 50 or 100 mg orally three times a day.
-Should generally be used in conjunction with other medicines, according to Guideline-directed medical therapy.

Usual Adult Dose for Left Ventricular Dysfunction:

Initial dose: 6.25 mg orally once as early as three days post-myocardial infarction, followed by 12.5 mg orally three times a day; increase to 25 mg orally three times a day over the next several days, and then increase to target dose over the next several weeks as tolerated.

Target maintenance dose: 50 mg orally three times a day

Use: To improve survival following myocardial infarction in clinically stable patients with left ventricular dysfunction manifested as an ejection fraction of 40% or less and to reduce the incidence of overt heart failure and subsequent hospitalizations for congestive heart failure in these patients.

Usual Adult Dose for Diabetic Nephropathy:

25 mg orally three times a day

Comments: Other antihypertensives may be used in conjunction with this drug if additional blood pressure reduction is required.

Use: Treatment of diabetic nephropathy (proteinuria greater than 500 mg/day) in patients with type I insulin-dependent diabetes mellitus and retinopathy.

Usual Adult Dose for Hypertensive Emergency:

25 mg orally 2 to 3 times a day; continue diuretic therapy and stop other antihypertensives upon initiation of this drug; may increase dose every 24 hours or less until satisfactory blood pressure or maximum dose is reached.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking captopril?

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Do not take potassium supplements or use salt substitutes, unless your doctor has told you to.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor’s instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Avoid strenuous exercise if you are being treated for heart failure. Ask your doctor about your risk.

Captopril side effects

Get emergency medical help if you have signs of an allergic reaction to captopril: severe stomach pain, hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Captopril may cause serious side effects. Call your doctor at once if you have:

• chest pain, fast, slow, or uneven heart rate;
• a light-headed feeling, like you might pass out;
• heart problems – swelling, rapid weight gain, feeling short of breath;
• kidney problems – swelling, urinating less, feeling tired or short of breath;
• signs of infection – fever, chills, sore throat, body aches, unusual tiredness, loss of appetite, bruising or bleeding;
• high blood potassium – nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement;
• low blood sodium – headache, confusion, problems with thinking or memory, weakness, feeling unsteady; or
• low white blood cell counts – fever, mouth sores, skin sores, sore throat, cough.

Common captopril side effects may include:

• cough;
• low blood pressure;
• flushing (sudden warmth, redness, or tingly feeling);
• low blood cell counts;
• decreased sense of taste; or
• mild skin itching or rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

What other drugs will affect captopril?

Captopril can harm your kidneys, especially if you also use certain medicines for infections, cancer, or osteoporosis.

Tell your doctor about all your other medicines, especially:

• a diuretic or “water pill” that may increase blood potassium such as spironolactone, triamterene, amiloride;
• NSAIDs (nonsteroidal anti-inflammatory drugs) – aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;
• medicine to prevent organ transplant rejection such as temsirolimus, sirolimus, or everolimus; or
• heart or blood pressure medication.

Benazepril is used alone or in combination with other medications to treat high blood pressure in adults and children at least 6 years old.

Lowering blood pressure may lower your risk of a stroke or heart attack.

Benazepril may also be used for purposes not listed in this medication guide.

Benazepril side effects

Get emergency medical help if you have signs of an allergic reaction: hives, severe stomach pain, difficulty breathing, swelling of your face, lips, tongue, or throat.

Benazepril may cause serious side effects. Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• kidney problems–swelling, urinating less, feeling tired or short of breath;
• high blood potassium–nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement; or
• liver problems–loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects of benazepril may include:

• headache; or
• cough.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Warnings

Do not use if you are pregnant. Stop using benazepril and tell your doctor right away if you become pregnant.

Tell your doctor about all your other medicines. Some drugs should not be used with benazepril.

Before taking this medicine

You should not use benazepril if you are allergic to it or to any other ACE (angiotensin converting enzyme) inhibitor such as captopril, fosinopril, enalapril, lisinopril, moexipril, perindopril, quinapril, ramipril, or trandolapril.

Do not take benazepril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use benazepril together with any medication that contains aliskiren (a blood pressure medicine).

Do not take benazepril if you have a history of angioedema (severe allergic reaction).

Tell your doctor if you have ever had:

• heart disease, heart problems such as a recent heart attack;
• stomach pain;
• low blood pressure;
• if you are on a low-salt diet;
• diabetes;
• liver disease; or
• kidney disease (or if you are on dialysis).

You may also need to avoid taking benazepril with aliskiren if you have kidney disease.

Stop using this medicine and tell your doctor right away if you become pregnant. Benazepril can cause injury or death to the unborn baby if you use the medicine during your second or third trimester.

Do not breastfeed.

How should I take benazepril?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You may take benazepril with or without food.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking benazepril. This can lead to very low blood pressure, an electrolyte imbalance, or kidney failure.

Your blood pressure will need to be checked often and you may need frequent blood tests. Your treatment may also include diet, exercise, lifestyle changes, and other medications. Follow your doctor’s instructions very carefully.

Tell your doctor if you have a planned surgery.

Keep using benazepril even if you feel well. High blood pressure often has no symptoms.

Store tightly closed at room temperature, away from moisture and heat.

Benazepril dosing information

Usual Adult Dose for Hypertension:

Initial dose: With a diuretic: 5 mg orally once a day; without a diuretic: 10 mg orally once a day
Maintenance dose: 20 to 40 mg/day orally as a single dose or in two equally divided doses
Maximum dose: 80 mg/day

Comments:
-The divided dose regimen was more effective in controlling pre-dosing blood pressure.
-If discontinuing a diuretic prior to initiating this drug to reduce the likelihood of hypotension, conclude diuretic therapy 2 to 3 days prior to starting this drug.

Usual Pediatric Dose for Hypertension:

6 YEARS OR OLDER:
Initial dose: 0.2 mg/kg orally once a day as monotherapy
Maximum dose: 0.6 mg/kg; 40 mg/day

Comments:
-Doses between 0.1 and 0.6 mg/kg once a day have been studied; doses greater than 0.1 mg/kg were shown to reduce blood pressure; doses above 0.6 mg/kg or 40 mg/day have not been studied in pediatric patients.
-Prepare a suspension for pediatric patients who cannot swallow tablets or for whom the calculated dosage does not correspond to available tablet strengths.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking benazepril?

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Do not take potassium supplements or use salt substitutes, unless your doctor has told you to.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor’s instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

What other drugs will affect benazepril?

Benazepril can harm your kidneys, especially if you also use certain medicines for infections, cancer, or osteoporosis.

Tell your doctor about all your other medicines, especially:

• a diuretic or “water pill” that may increase blood potassium such as spironolactone, triamterene, or amiloride;
• NSAIDs (nonsteroidal anti-inflammatory drugs)–aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;
• insulin or diabetes medications;
• medicine to prevent organ transplant rejection such as temsirolimus, sirolimus, or everolimus; or
• heart or blood pressure medication.

What is lisinopril?

Lisinopril is used alone or in combination with other medications to treat high blood pressure in adults and children 6 years of age and older.

Lisinopril is also used in adults to treat congestive heart failure and to improve survival after a heart attack.

Lisinopril belongs to a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly and the heart can pump blood more efficiently.

High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys, and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

Warnings

Do not use lisinopril if you are pregnant. It could harm the unborn baby. Stop using this medicine and tell your doctor right away if you become pregnant.

You should not use this medicine if you have ever had angioedema. Do not take lisinopril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use lisinopril together with any medication that contains aliskiren (such as Amturnide, Tekturna, Tekamlo).

You may also need to avoid taking lisinopril with aliskiren if you have kidney disease.

Before taking this medicine

You should not use lisinopril if you are allergic to it or to any other ACE (angiotensin converting enzyme) inhibitor such as captopril, fosinopril, enalapril, benazepril, moexipril, perindopril, quinapril, ramipril, or trandolapril.

Do not take lisinopril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not take lisinopril with any medication that contains aliskiren (a blood pressure medicine).

Do not take lisinopril if you have a history of angioedema (severe allergic reaction).

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• heart disease, heart problems such as a recent heart attack;
• low blood pressure;
• low white blood cell count;
• stomach pain;
• if you are on a low-salt diet;
• diabetes;
• liver disease; or
• kidney disease (or if you are on dialysis).

You may also need to avoid taking lisinopril with aliskiren if you have kidney disease.

Stop using this medicine and tell your doctor right away if you become pregnant. Lisinopril can cause injury or death to the unborn baby if you use the medicine during your second or third trimester.

Do not breastfeed.

How should I take lisinopril?

Take lisinopril exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose..

You may take lisinopril with or without food.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

Your blood pressure will need to be checked often and you may need frequent blood tests.

Tell your doctor if you have a planned surgery.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking lisinopril. This can lead to very low blood pressure, an electrolyte imbalance, or kidney failure.

If you have high blood pressure, keep using lisinopril even if you feel well. High blood pressure often has no symptoms.

Store tightly closed at room temperature, away from moisture and heat. Do not freeze.

Dosing information

Usual Adult Dose for Hypertension:

Initial dose: 10 mg orally once a day; 5 mg orally once a day
Maintenance dose: 20 to 40 mg orally once a day
Maximum dose: 80 mg orally once a day

Comments:
-The initial dose is 5 mg orally once a day in patients receiving a diuretic.
-The 80 mg dose is used but does not appear to give greater effect.
-If blood pressure is not controlled with lisinopril alone, a low dose of a diuretic may be added (e.g., hydrochlorothiazide, 12.5 mg). After the addition of a diuretic, it may be possible to reduce the dose of lisinopril.

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 2.5 to 5 mg orally once a day
Maintenance dose: Dosage should be increased as tolerated
Maximum dose: 40 mg orally once a day

Comments:
-The diuretic dose may need to be adjusted to help minimize hypovolemia, which may contribute to hypotension. The appearance of hypotension after the initial dose of lisinopril does not preclude subsequent careful dose titration with the drug.

Usual Adult Dose for Myocardial Infarction:

Initial dose: 5 mg orally (within 24 hours of the onset of acute myocardial infarction)
Subsequent doses: 5 mg orally after 24 hours, then 10 mg orally after 48 hours.
Maintenance dose: 10 mg orally once a day. Dosing should continue for at least 6 weeks.

Comments:
-Therapy should be initiated at 2.5 mg in patients with a low systolic blood pressure (less than or equal to 120 mm Hg and greater than 100 mmHg) during the first 3 days after the infarct. If prolonged hypotension occurs (systolic blood pressure less than 90 mmHg for more than 1 hour) therapy should be withdrawn.

Uses: Reduction of mortality in acute myocardial infarction

Usual Adult Dose for Diabetic Nephropathy:

Initial dose: 10 to 20 mg orally once a day
Maintenance dose: 20 to 40 mg orally once a day
Dosage may be titrated upward every 3 days

Comments:
-Not an approved indication.

Usual Geriatric Dose for Hypertension:

Initial dose: 2.5 to 5 mg orally once a day
Maintenance dose: Dosages should be increased at 2.5 mg to 5 mg per day at 1 to 2 week intervals.
Maximum dose: 40 mg orally once a day

Usual Pediatric Dose for Hypertension:

Pediatric patients greater than or equal to 6 years of age:
Initial dose: 0.07 mg/kg orally once a day (Maximum initial dose is 5 mg once a day)
Maintenance dose: Dosage should be adjusted according to blood pressure response at 1 to 2 week intervals.
Maximum dose: Doses above 0.61 mg/kg or greater than 40 mg have not been studied in pediatric patients

Comments:
-This drug is not recommended in pediatric patients less than 6 years old or in pediatric patients with glomerular filtration rate less than 30 mL/min.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking lisinopril?

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Do not use potassium supplements or salt substitutes, unless your doctor has told you to.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor’s instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Lisinopril side effects

Get emergency medical help if you have signs of an allergic reaction to lisinopril: severe stomach pain, hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Lisinopril may cause serious side effects. Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• high blood potassium – nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement;
• low white blood cell counts – fever, mouth sores, skin sores, sore throat, cough;
• kidney problems – swelling, urinating less, feeling tired or short of breath; or
• liver problems – loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common lisinopril side effects may include:

• headache, dizziness;
• low blood pressure, cough; or
• chest pain.

What is perindopril?

Perindopril is an ACE inhibitors. ACE stands for angiotensin converting enzyme.

Perindopril is used to treat high blood pressure (hypertension) and to prevent heart attack in people with coronary artery disease.

Perindopril may also be used for purposes not listed in this medication guide.

Perindopril side effects

Get emergency medical help if you have signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat. You may be more likely to have an allergic reaction if you are African-American.

Perindopril may cause serious side effects. Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• fever, chills, body aches, flu symptoms, sores in your mouth and throat;
• little or no urination;
• swelling, rapid weight gain;
• high potassium–nausea, slow or unusual heart rate, weakness, loss of movement;
• pale skin, easy bruising or bleeding; or
• jaundice (yellowing of the skin or eyes).

Common side effects of perindopril may include:

• dizziness;
• back pain; or
• cough.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Warnings

Do not use if you are pregnant. If you become pregnant, stop taking perindopril and tell your doctor right away.

You should not use perindopril if you have ever had angioedema. Do not take perindopril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use perindopril together with any medication that contains aliskiren (a blood pressure medicine).

Before taking this medicine

You should not use this medicine if you are allergic to perindopril or if:

• you have hereditary angioedema;
• you recently took a heart medicine called sacubitril; or
• you are allergic to any other ACE inhibitor, such as benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, quinapril, ramipril, or trandolapril.

Do not take perindopril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use perindopril together with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking perindopril with aliskiren if you have kidney disease.

Tell your doctor if you have ever had:

• kidney disease (or if you are on dialysis);
• liver disease;
• heart disease or congestive heart failure;
• diabetes; or
• a connective tissue disease such as Marfan syndrome, Sjogren’s syndrome, lupus, scleroderma, or rheumatoid arthritis.

Do not use if you are pregnant, and tell your doctor right away if you become pregnant. Perindopril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

How should I take perindopril?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take each dose with a full glass of water. Drink plenty of liquids while you are taking perindopril.

You may take perindopril with or without food.

Your blood pressure will need to be checked often. Your kidney or liver function may also need to be checked.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking perindopril. This can lead to very low blood pressure, electrolyte disorders, or kidney failure.

If you need surgery, tell the surgeon ahead of time that you are using perindopril.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture and heat.

Perindopril dosing information

Usual Adult Dose for Coronary Artery Disease:

Initial dose: 4 mg orally once a day for 2 weeks, then increase to maintenance dose as tolerated.
Maintenance dose: 8 mg orally once a day

Use: Treatment of patients with stable coronary artery disease to reduce the risk of cardiovascular mortality or nonfatal myocardial infarction.

Usual Adult Dose for Hypertension:

Initial dose: 4 mg orally once a day
Maintenance dose: 4 to 8 mg orally per day in 1 or 2 divided doses
Maximum dose: 16 mg/day

Comments: In patients treated with a diuretic, consider reducing the diuretic dose prior to starting this drug.

Usual Geriatric Dose for Coronary Artery Disease:

Greater than 70 Years:
Initial dose:
-Week 1: 2 mg orally once a day
-Week 2: 4 mg orally once a day, then increase to maintenance dose as tolerated.
Maintenance dose: 8 mg orally once a day

Use: Treatment of patients with stable coronary artery disease to reduce the risk of cardiovascular mortality or nonfatal myocardial infarction.

Usual Geriatric Dose for Hypertension:

Initial dose: 4 mg orally per day in 1 or 2 divided doses

Comments: Experience with doses above 8 mg is limited; administer with careful blood pressure monitoring and dose titration.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking perindopril?

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Do not use potassium supplements or salt substitutes, unless your doctor has told you to.

What other drugs will affect perindopril?

Tell your doctor about all your other medicines, especially:

• lithium;
• a diuretic or “water pill”;
• gold injections to treat arthritis; or
• NSAIDs (nonsteroidal anti-inflammatory drugs)–aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

What is Qbrelis?

Qbrelis is used alone or in combination with other medications to treat high blood pressure in adults and children at least 6 years old.

Qbrelis is also used in adults to treat congestive heart failure and to improve survival after a heart attack.

Qbrelis may also be used for purposes not listed in this medication guide.

Qbrelis side effects

Get emergency medical help if you have signs of an allergic reaction: severe stomach pain, hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Qbrelis may cause serious side effects. Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• high blood potassium–nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement;
• low white blood cell counts–fever, mouth sores, skin sores, sore throat, cough;
• kidney problems–swelling, urinating less, feeling tired or short of breath; or
• liver problems–loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects of Qbrelis may include:

• headache, dizziness;
• low blood pressure, cough; or
• chest pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Warnings

Do not use if you are pregnant. Stop using Qbrelis and tell your doctor right away if you become pregnant.

Tell your doctor about all your other medicines. Some drugs should not be used with Qbrelis.

Before taking this medicine

You should not use Qbrelis if you are allergic to it or to any other ACE (angiotensin converting enzyme) inhibitor such as captopril, fosinopril, enalapril, benazepril, moexipril, perindopril, quinapril, ramipril, or trandolapril.

Do not take Qbrelis within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not take Qbrelis with any medication that contains aliskiren (a blood pressure medicine).

Do not take Qbrelis if you have a history of angioedema (severe allergic reaction).

Tell your doctor if you have ever had:

• heart disease, heart problems such as a recent heart attack;
• low blood pressure;
• low white blood cell count;
• stomach pain;
• if you are on a low-salt diet;
• diabetes;
• liver disease; or
• kidney disease (or if you are on dialysis).

You may also need to avoid taking Qbrelis with aliskiren if you have kidney disease.

Stop using this medicine and tell your doctor right away if you become pregnant. Qbrelis can cause injury or death to the unborn baby if you use the medicine during your second or third trimester.

Do not breastfeed.

How should I take Qbrelis?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You may take Qbrelis with or without food.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

Your blood pressure will need to be checked often and you may need frequent blood tests.

Tell your doctor if you have a planned surgery.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking Qbrelis. This can lead to very low blood pressure, an electrolyte imbalance, or kidney failure.

If you have high blood pressure, keep using Qbrelis even if you feel well. High blood pressure often has no symptoms.

Store tightly closed at room temperature, away from moisture and heat. Do not freeze.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking Qbrelis?

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Do not use potassium supplements or salt substitutes, unless your doctor has told you to.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor’s instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

What is quinapril?

Quinapril is used in adults alone or in combination with other medications to treat high blood pressure (hypertension). Lowering blood pressure may lower your risk of a stroke or heart attack.

Quinapril is also used in adults together with other medications to treat heart failure.

Quinapril may also be used for purposes not listed in this medication guide.

Quinapril side effects

Get emergency medical help if you have signs of an allergic reaction: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Quinapril may cause serious side effects. Call your doctor at once if you have:

• chest pain, fast, slow, or uneven heart rate;
• a light-headed feeling, like you might pass out;
• heart problems–swelling, rapid weight gain, feeling short of breath;
• kidney problems–swelling, urinating less, feeling tired or short of breath;
• liver problems–loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes), abnormal liver function tests;
• signs of infection–fever, chills, sore throat, body aches, unusual tiredness, loss of appetite, bruising or bleeding; or
• high blood potassium–nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement.

Common side effects of quinapril may include:

• headache;
• nausea, vomiting, stomach pain;
• cough; or
• dizziness, tiredness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Warnings

Do not use if you are pregnant. Stop using quinapril and tell your doctor right away if you become pregnant.

You should not use quinapril if you have ever had angioedema. Do not take quinapril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use quinapril together with any medication that contains aliskiren (a blood pressure medicine).

Before taking this medicine

You should not use quinapril if you are allergic to it, or if:

• have a history of angioedema; or
• you are allergic to any other ACE inhibitor, such as benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, ramipril, or trandolapril.

Do not take quinapril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use quinapril together with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking quinapril with aliskiren if you have kidney disease.

Tell your doctor if you have ever had:

• a connective tissue disease such as Marfan syndrome, Sjogren’s syndrome, lupus, scleroderma, or rheumatoid arthritis;
• heart problems;
• low blood pressure;
• high blood levels of potassium (hyperkalemia);
• if you are on a low-salt diet;
• low white blood cell counts;
• diabetes;
• kidney disease (or if you are on dialysis); or
• liver disease.

Do not use if you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant. Quinapril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

Ask a doctor if it is safe to breastfeed while using this medicine.

How should I take quinapril?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Your blood pressure will need to be checked often. Your kidney or liver function may also need to be tested.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking quinapril. This can lead to very low blood pressure, electrolyte disorders, or kidney failure.

Tell your doctor if you have a planned surgery.

If you have high blood pressure, keep using quinapril even if you feel well. High blood pressure often has no symptoms.

Store tightly closed at room temperature, away from moisture and heat.

Quinapril dosing information

Usual Adult Dose for Hypertension:

Initial dose: 10 or 20 mg orally once a day in patients not on diuretics
Maintenance dose: 20 to 80 mg orally per day, administered as a single dose or in two equally divided doses

Use:
-Treatment of hypertension

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 5 mg orally twice a day
Maintenance dose: 20 to 40 mg orally per day administered in two equally divided doses

Comments:
-This dose may improve symptoms of heart failure, but increases in exercise duration have generally required higher doses.
-If the initial dosage is well tolerated, patients should then be titrated at weekly intervals until an effective dose.

Use:
-Management of heart failure as adjunctive therapy when added to conventional therapy including diuretics and/or digitalis

Usual Geriatric Dose for Congestive Heart Failure:

10 mg orally once a day

Comments: Dose should be titrated the same way as for other adult patients.

Uses:
-Treatment of hypertension
-Management of heart failure as adjunctive therapy when added to conventional therapy including diuretics and/or digitalis

Usual Geriatric Dose for Hypertension:

10 mg orally once a day

Comments: Dose should be titrated the same way as for other adult patients.

Uses:
-Treatment of hypertension
-Management of heart failure as adjunctive therapy when added to conventional therapy including diuretics and/or digitalis

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking quinapril?

Do not take potassium supplements or use salt substitutes, unless your doctor has told you to.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor’s instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Avoid strenuous exercise if you are being treated for heart failure. Ask your doctor about your risk.

What other drugs will affect quinapril?

Tell your doctor about all your other medicines, especially:

• lithium;
• a diuretic or “water pill”;
• gold injections to treat arthritis;
• temsirolimus, sirolimus, or everolimus; or
• NSAIDs (nonsteroidal anti-inflammatory drugs)–aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

What is ramipril?

Ramipril is used to treat high blood pressure (hypertension) or congestive heart failure to reduce the risk of cardiovascular events, strokes, and myocardial infarctions. Ramipril is an ACE inhibitor. ACE stands for angiotensin-converting enzyme.

Ramipril may also be used for purposes not listed in this medication guide.

Warnings

Do not use ramipril if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away.

You should not use ramipril if you have ever had angioedema. Do not take this medicine within 36 hours before or after taking medicine that contains sacubatril (such as Entresto).

If you have diabetes, do not use ramipril together with any medication that contains aliskiren (such as Tekturna or Tekamlo).

Before taking this medicine

You should not use ramipril if you are allergic to it, or if:

• you have a history of angioedema;
• you recently took a heart medicine called sacubatril; or
• if you are allergic to any other ACE inhibitor, such as benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, or trandolapril.

Do not take ramipril within 36 hours before or after taking medicine that contains sacubatril (such as Entresto).

If you have diabetes, do not use ramipril together with any medication that contains aliskiren (such as Tekturna or Tekamlo).

You may also need to avoid taking ramipril with aliskiren if you have kidney disease.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• kidney disease (or if you are on dialysis);
• liver disease;
• a connective tissue disease such as Marfan syndrome, Sjogren’s syndrome, lupus, scleroderma, or rheumatoid arthritis; or
• if you are also taking telmisartan (Micardis).

Do not use if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away. Ramipril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control.

It is not known whether ramipril passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

How should I take ramipril?

Take ramipril exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Ramipril can be taken with or without food.

Swallow the tablet whole.

You may open the capsule and sprinkle the medicine into a half-cup (4 ounces) of water, apple juice, or applesauce to make swallowing easier. Swallow without chewing. You may store the mixture for up to 24 hours at room temperature, or up to 48 hours in a refrigerator.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking ramipril. This can lead to very low blood pressure, electrolyte disorders, or kidney failure.

Your blood pressure will need to be checked often, and you may need frequent blood tests to check your potassium levels.

Drink plenty of water each day while you are taking this medication.

If you need surgery, tell the surgeon ahead of time that you are using this medicine.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid?

Do not use salt substitutes or potassium supplements while taking ramipril, unless your doctor has told you to.

Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of ramipril.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Ramipril side effects

Get emergency medical help if you have any signs of an allergic reaction to ramipril: hives; severe stomach pain; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• jaundice (yellowing of your skin or eyes);
• little or no urination;
• fever, chills, sore throat, cold or flu symptoms; or
• high potassium – nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement.

Common ramipril side effects may include:

• headache;
• cough; or
• dizziness, weakness, tired feeling.