OVERDOSE
No data are available with respect to overdosage in humans.
Doses of 1440 to 4280 mg/kg of quinapril cause significant
lethality in mice and rats.
The most likely clinical manifestation would be symptoms
attributable to severe hypotension.
Laboratory determinations of serum levels of quinapril
and its metabolites are not widely available, and such
determinations have, in any event, no established role
in the management of quinapril overdose.
No data are available to suggest physiological maneuvers
(e.g., maneuvers to change pH of the urine) that might
accelerate elimination of quinapril and its metabolites.
Hemodialysis and peritoneal dialysis have little effect
on the elimination of quinapril and quinaprilat. Angiotensin
II could presumably serve as a specific antagonist-antidote
in the setting of quinapril overdose, but angiotensin
II is essentially unavailable outside of scattered research
facilities. Because the hypotensive effect of quinapril
is achieved through vasodilation and effective hypovolemia,
it is reasonable to treat quinapril overdose by infusion
of normal saline solution.
CONTRAINDICATIONS
Quinapril HCl is contraindicated in patients who are hypersensitive
to this product and in patients with a history of angioedema
related to previous treatment with an ACE inhibitor.
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