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adverse reactions
ADVERSE REACTIONS Hypertension Quinapril hydrochloride has been evaluated for safety in 4960 subjects and patients. Of these, 3203 patients, including 655 elderly patients, participated in controlled clinical trials. Quinapril hydrochloride has been evaluated for long-term safety in over 1400 patients treated for 1 year or more. Adverse experiences were usually mild and transient. In placebo-controlled trials, discontinuation of therapy because of adverse events was required in 4.7% of patients with hypertension. Adverse experiences probably or possibly related to therapy or of unknown relationship to therapy occurring in 1% or more of the 1563 patients in placebo-controlled hypertension trials who were treated with quinapril hydrochloride are shown below. Adverse Events in Placebo-Controlled Trials Quinapril Hydrochloride (N=1563) Incidence (Discontinuance) Placebo (N=579) Incidence (Discontinuance) Headache 5.6 (0.7) 10.9 (0.7) Dizziness 3.9 (0.8) 2.6 (0.2) Fatigue 2.6 (0.3) 1 Coughing 2 (0.5) 0 Nausea and/or Vomiting 1.4 (0.3) 1.9 (0.2) Abdominal Pain 1 (0.2) 0.7 Heart Failure Quinapril hydrochloride has been evaluated for safety in 1222 quinapril hydrochloride treated patients. Of these, 632 patients participated in controlled clinical trials. In placebo-controlled trials, discontinuation of therapy because of adverse events was required in 6.8% of patients with congestive heart failure. Adverse experiences probably or possibly related or of unknown relationship to therapy occurring in 1% or more of the 585 patients in placebo-controlled congestive heart failure trials who were treated with quinapril hydrochloride are shown below. Quinapril Hydrochloride (N=585) Incidence (Discontinuance) Placebo (N=295) Incidence (Discontinuance) Dizziness 7.7 (0.7) 5.1 (1) Coughing 4.3 (0.3) 1.4 Fatigue 2.6 (0.2) 1.4 Nausea and/or Vomiting 2.4 (0.2) 0.7 Chest Pain 2.4 1 Hypotension 2.9 (0.5) 1 Dyspnea 1.9 (0.2) 2 Diarrhea 1.7 1 Headache 1.7 1 (0.3) Myalgia 1.5 2 Rash 1.4 (0.2) 1 Back Pain 1.2 0.3 See . , PRECAUTIONS Cough Hypertension and/or Heart Failure Clinical adverse experiences probably, possibly, or definitely related, or of uncertain relationship to therapy occurring in 0.5% to 1% (except as noted) of the patients with CHF or hypertension treated with quinapril hydrochloride (with or without concomitant diuretic) in controlled or uncontrolled trials (N=4847) and less frequent, clinically significant events seen in clinical trials or postmarketing experience (the rarer events are in italics) include (listed by body system): back pain, malaise, viral infections, General: anaphylactoid reaction palpitation, vasodilation, tachycardia, Cardiovascular: heart failure, hyperkalemia, myocardial infarction, cerebrovascular accident, hypertensive crisis, angina pectoris, orthostatic hypotension, cardiac rhythm disturbances, cardiogenic shock Hematology: hemolytic anemia flatulence, dry mouth or throat, constipation, Gastrointestinal: gastrointestinal hemorrhage, pancreatitis, abnormal liver function tests, dyspepsia somnolence, vertigo, syncope, nervousness, depression, insomnia, paresthesia Nervous/Psychiatric: alopecia, increased sweating, pemphigus, pruritus, Integumentary: exfoliative dermatitis, photosensitivity reaction, dermatopolymyositis urinary tract infection, impotence, Urogenital: acute renal failure, worsening renal failure Respiratory: eosinophilic pneumonitis amblyopia, edema, arthralgia, pharyngitis, Other: agranulocytosis, hepatitis, thrombocytopenia Angioedema Angioedema has been reported in patients receiving quinapril hydrochloride (0.1%). Angioedema associated with laryngeal edema may be fatal. If angioedema of the face, extremities, lips, tongue, glottis, and/or larynx occurs, treatment with quinapril hydrochloride should be discontinued and appropriate therapy instituted immediately. (See .) WARNINGS Clinical Laboratory Test Findings Hematology (See ) WARNINGS Hyperkalemia (See ) PRECAUTIONS Creatinine and Blood Urea Nitrogen Increases (>1.25 times the upper limit of normal) in serum creatinine and blood urea nitrogen were observed in 2% and 2%, respectively, of all patients treated with quinapril hydrochloride alone. Increases are more likely to occur in patients receiving concomitant diuretic therapy than in those on quinapril hydrochloride alone. These increases often remit on continued therapy. In controlled studies of heart failure, increases in blood urea nitrogen and serum creatinine were observed in 11% and 8%, respectively, of patients treated with quinapril hydrochloride; most often these patients were receiving diuretics with or without digitalis.