Chemical: Drug
quinapril

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PharmGKB contains no Clinical Variants that meet the highest level of criteria.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

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The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

List of all variant annotations for quinapril

Gene ? Variant?
(147)
Alternate Names ? Chemicals ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
No VIP available CA VA
rs1799752 NC_000017.10:g.61565890_61565891insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, NC_000017.10:g.61565890_61565891insG, NC_000017.11:g.63488529_63488530insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, NC_000017.11:g.63488529_63488530insG, NG_011648.1:g.16457_16458insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, NG_011648.1:g.16457_16458insG, NM_000789.3:c.2306-119_2306-118insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, NM_000789.3:c.2306-119_2306-118insG, NM_001178057.1:c.584-119_584-118insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, NM_001178057.1:c.584-119_584-118insG, NM_152830.2:c.584-119_584-118insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, NM_152830.2:c.584-119_584-118insG, XM_005257110.1:c.1757-119_1757-118insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, XM_005257110.1:c.1757-119_1757-118insG, XM_006721737.2:c.644-119_644-118insATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC, XM_006721737.2:c.644-119_644-118insG
- > ATACAGTCACTTTTTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCC
- > G
indel
No VIP available No Clinical Annotations available VA
rs5186 NC_000003.11:g.148459988A>C, NC_000003.12:g.148742201A>C, NG_008468.1:g.49331A>C, NM_000685.4:c.*86A>C, NM_004835.4:c.*86A>C, NM_009585.3:c.*86A>C, NM_031850.3:c.*86A>C, NM_032049.3:c.*86A>C, rs17231380, rs3192044, rs3732563, rs386597902, rs59796105
A > C
SNP
No VIP available CA VA
rs699 NC_000001.10:g.230845794A>G, NC_000001.11:g.230710048A>G, NG_008836.1:g.9543T>C, NM_000029.3:c.803T>C, NP_000020.1:p.Met268Thr, rs17856353, rs3182295, rs386606420, rs4714, rs61617185
A > G
SNP
M268T
No VIP available No Clinical Annotations available VA
rs71647871 NC_000016.10:g.55823658C>T, NC_000016.9:g.55857570C>T, NG_012057.1:g.14506G>A, NM_001025194.1:c.428G>A, NM_001025195.1:c.431G>A, NM_001266.4:c.428G>A, NP_001020365.1:p.Gly143Glu, NP_001020366.1:p.Gly144Glu, NP_001257.4:p.Gly143Glu, NW_003315945.1:g.47536C>T, XM_005255774.1:c.431G>A, XM_005276867.1:c.431G>A, XM_011522816.1:c.431G>A, XM_011546995.1:c.431G>A, XP_005255831.1:p.Gly144Glu, XP_005276924.1:p.Gly144Glu, XP_011521118.1:p.Gly144Glu, XP_011545297.1:p.Gly144Glu
C > T
SNP
G143E
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 147

Overview

Generic Names
  • Quinapril Hcl
  • Quinapril Hydrochloride
  • Quinaprilum [Latin]
Trade Names
  • Accupril
  • Accuprin
  • Accupro
  • Acequin
  • Acuitel
  • Korec
  • Quinazil
Brand Mixture Names

PharmGKB Accession Id

PA451205

Type(s):

Drug

Description

Quinapril is a prodrug that belongs to the angiotensin-converting enzyme (ACE) inhibitor class of medications. It is metabolized to quinaprilat (quinapril diacid) following oral administration. Quinaprilat is a competitive inhibitor of ACE, the enzyme responsible for the conversion of angiotensin I (ATI) to angiotensin II (ATII). ATII regulates blood pressure and is a key component of the renin-angiotensin-aldosterone system (RAAS). Quinapril may be used to treat essential hypertension and congestive heart failure.

Source: Drug Bank

Indication

For the treatment of hypertension and as adjunct therapy in the treatment of congestive heart failure. May also be used to slow the rate of progression of renal disease in hypertensive individuals with diabetes mellitus and microalbuminuria or overt nephropathy.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

There are two isoforms of ACE: the somatic isoform, which exists as a glycoprotein comprised of a single polypeptide chain of 1277; and the testicular isoform, which has a lower molecular mass and is thought to play a role in sperm maturation and binding of sperm to the oviduct epithelium. Somatic ACE has two functionally active domains, N and C, which arise from tandem gene duplication. Although the two domains have high sequence similarity, they play distinct physiological roles. The C-domain is predominantly involved in blood pressure regulation while the N-domain plays a role in hematopoietic stem cell differentiation and proliferation. ACE inhibitors bind to and inhibit the activity of both domains, but have much greater affinity for and inhibitory activity against the C-domain. Quinaprilat, the principle active metabolite of quinapril, competes with ATI for binding to ACE and inhibits and enzymatic proteolysis of ATI to ATII. Decreasing ATII levels in the body decreases blood pressure by inhibiting the pressor effects of ATII as described in the Pharmacology section above. Quinaprilat also causes an increase in plasma renin activity likely due to a loss of feedback inhibition mediated by ATII on the release of renin and/or stimulation of reflex mechanisms via baroreceptors.

Source: Drug Bank

Pharmacology

Quinapril is a nonpeptide, non-sulfhydryl prodrug that is deesterified to quinaprilat (quinapril diacid), its major active metabolite following oral administration. Quinaprilat lowers blood pressure by antagonizing the effect of the RAAS. The RAAS is a homeostatic mechanism for regulating hemodynamics, water and electrolyte balance. During sympathetic stimulation or when renal blood pressure or blood flow is reduced, renin is released from the granular cells of the juxtaglomerular apparatus in the kidneys. In the blood stream, renin cleaves circulating angiotensinogen to ATI, which is subsequently cleaved to ATII by ACE. ATII increases blood pressure using a number of mechanisms. First, it stimulates the secretion of aldosterone from the adrenal cortex. Aldosterone travels to the distal convoluted tubule (DCT) and collecting tubule of nephrons where it increases sodium and water reabsorption by increasing the number of sodium channels and sodium-potassium ATPases on cell membranes. Second, ATII stimulates the secretion of vasopressin (also known as antidiuretic hormone or ADH) from the posterior pituitary gland. ADH stimulates further water reabsorption from the kidneys via insertion of aquaporin-2 channels on the apical surface of cells of the DCT and collecting tubules. Third, ATII increases blood pressure through direct arterial vasoconstriction. Stimulation of the Type 1 ATII receptor on vascular smooth muscle cells leads to a cascade of events resulting in myocyte contraction and vasoconstriction. In addition to these major effects, ATII induces the thirst response via stimulation of hypothalamic neurons. ACE inhibitors inhibit the rapid conversion of ATI to ATII and antagonize RAAS-induced increases in blood pressure. ACE (also known as kininase II) is also involved in the enzymatic deactivation of bradykinin, a vasodilator. Inhibiting the deactivation of bradykinin increases bradykinin levels and may sustain the effects of quinaprilat by causing increased vasodilation and decreased blood pressure.

Source: Drug Bank

Food Interaction

High salt intake may attenuate the antihypertensive effect of quinapril.|Herbs that may attenuate the antihypertensive effect of quinapril include: bayberry, blue cohash, cayenne, ephedra, ginger, ginseng (American), kola and licorice.|Do not take with a high-fat meal.|Quinapril may decrease the excretion of potassium. Salt substitutes containing potassium may increase the risk of hyperkalemia.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic.

Source: Drug Bank

Protein Binding

97%

Source: Drug Bank

Absorption

Peak plasma concentrations of quinapril occur within one hour following oral administration. The extent of absorption is at least 60%. The rate and extent of quinapril absorption are diminished moderately (approximately 25-30%) when ACCUPRIL tablets are administered during a high-fat meal.

Source: Drug Bank

Half-Life

Elimination half life is 2 hours with a prolonged terminal phase of 25 hours.

Source: Drug Bank

Toxicity

Overdose may lead to severe hypotension. LD 50=1739mg/kg (orally in mice). The most common adverse effects observed in controlled clinical trials were dizziness, cough, chest pain, dyspnea, fatigue, and nausea/vomiting.

Source: Drug Bank

Route of Elimination

Quinaprilat is eliminated primarily by renal excretion, up to 96% of an IV dose

Source: Drug Bank

Chemical Properties

Chemical Formula

C25H30N2O5

Source: Drug Bank

Isomeric SMILES

CCOC(=O)[C@H](CCc1ccccc1)N[C@@H](C)C(=O)N2Cc3ccccc3C[C@H]2C(=O)O

Source: OpenEye

Canonical SMILES

CCOC(=O)[C@H](CCC1=CC=CC=C1)N[C@@H]

Source: Drug Bank

Average Molecular Weight

438.5161

Source: Drug Bank

Monoisotopic Molecular Weight

438.21547208

Source: Drug Bank

SMILES

CCOC(=O)[C@H](CCC1=CC=CC=C1)N[C@@H](C)C(=O)N1CC2=CC=CC=C2C[C@H]1C(O)=O

Source: Drug Bank

InChI String

InChI=1S/C25H30N2O5/c1-3-32-25(31)21(14-13-18-9-5-4-6-10-18)26-17(2)23(28)27-16-20-12-8-7-11-19(20)15-22(27)24(29)30/h4-12,17,21-22,26H,3,13-16H2,1-2H3,(H,29,30)/t17-,21-,22-/m0/s1

Source: Drug Bank

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

EvidenceGene
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
ACE
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
AGT
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
AGTR1
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
CES1
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
NR1I2

Drug Targets

Gene Description
ACE (source: Drug Bank )

Drug Interactions

Interaction Description
amiloride - quinapril Increased risk of hyperkaliemia (source: Drug Bank )
amiloride - quinapril Increased risk of hyperkaliemia (source: Drug Bank )
lithium - quinapril The ACE inhibitor increases serum levels of lithium (source: Drug Bank )
lithium - quinapril The ACE inhibitor increases serum levels of lithium (source: Drug Bank )
quinapril - amiloride Increased risk of hyperkaliemia (source: Drug Bank )
quinapril - amiloride Increased risk of hyperkaliemia (source: Drug Bank )
quinapril - drospirenone Increased risk of hyperkaliemia (source: Drug Bank )
quinapril - lithium The ACE inhibitor increases serum levels of lithium (source: Drug Bank )
quinapril - lithium The ACE inhibitor increases serum levels of lithium (source: Drug Bank )
quinapril - potassium Increased risk of hyperkaliemia (source: Drug Bank )
quinapril - potassium Increased risk of hyperkaliemia (source: Drug Bank )
quinapril - spironolactone Increased risk of hyperkaliemia (source: Drug Bank )
quinapril - spironolactone Increased risk of hyperkaliemia (source: Drug Bank )
quinapril - tetracycline Quinapril can reduce the absorption of tetracycline (source: Drug Bank )
quinapril - tetracycline Quinapril may decrease the absorption of tetracycline. (source: Drug Bank )
quinapril - tizanidine Tizanidine increases the risk of hypotension with the ACE inhibitor (source: Drug Bank )
quinapril - tizanidine Tizanidine increases the risk of hypotension with the ACE inhibitor (source: Drug Bank )
quinapril - triamterene Increased risk of hyperkaliemia (source: Drug Bank )
quinapril - triamterene Increased risk of hyperkaliemia (source: Drug Bank )
tetracycline - quinapril Quinapril can reduce the absorption of tetracycline (source: Drug Bank )
tetracycline - quinapril Quinapril may decrease the absorption of tetracycline. (source: Drug Bank )
tizanidine - quinapril Tizanidine increases the risk of hypotension with the ACE inhibitor (source: Drug Bank )
tizanidine - quinapril Tizanidine increases the risk of hypotension with the ACE inhibitor (source: Drug Bank )
treprostinil - quinapril Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use. (source: Drug Bank )
triamterene - quinapril Increased risk of hyperkaliemia (source: Drug Bank )
triamterene - quinapril Increased risk of hyperkaliemia (source: Drug Bank )
trovafloxacin - quinapril Quinapril may decrease the absorption of orally administered Trovafloxacin. The Quinapril formulation contains magnesium ions that may intefere with Trovafloxacin absorption. Administer Trovafloxacin 2 hours before or 6 hours after the Quinapril dose to minimize the interaction. (source: Drug Bank )

Curated Information ?

EvidenceDisease
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Coronary Artery Disease

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
May Prevent
Contraindicated With

Publications related to quinapril: 6

No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Effect of carboxylesterase 1 c.428G > A single nucleotide variation on the pharmacokinetics of quinapril and enalapril. British journal of clinical pharmacology. 2015. Tarkiainen E Katriina, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Machine learning methods and docking for predicting human pregnane X receptor activation. Chemical research in toxicology. 2008. Khandelwal Akash, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
The angiotensin-converting enzyme gene insertion/deletion polymorphism and effects of quinapril and atorvastatin on haemostatic parameters in patients with coronary artery disease. Thrombosis and haemostasis. 2005. Potaczek Daniel P, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Vascular effects of quinapril completely depend on ACE insertion/deletion polymorphism. Journal of the renin-angiotensin-aldosterone system : JRAAS. 2004. Voors Adriaan A, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Quinapril prevents restenosis after coronary stenting in patients with angiotensin-converting enzyme D allele. Circulation journal : official journal of the Japanese Circulation Society. 2002. Okumura Kenji, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Influence of angiotensinogen M253T gene polymorphism and an angiotensin converting enzyme inhibitor on restenosis after percutaneous coronary intervention. Atherosclerosis. 2002. Toyofyuku Mamoru, et al. PubMed

LinkOuts

Web Resource:
Wikipedia
National Drug Code Directory:
0378-1117-77
DrugBank:
DB00881
ChEBI:
8713
KEGG Compound:
C07398
KEGG Drug:
D03752
PubChem Compound:
54892
PubChem Substance:
46506309
9602
Drugs Product Database (DPD):
1947672
ChemSpider:
49565
Therapeutic Targets Database:
DAP000588
FDA Drug Label at DailyMed:
43ed2312-ab65-4a1e-bfa2-76602a6b7c53

Clinical Trials

These are trials that mention quinapril and are related to either pharmacogenetics or pharmacogenomics.

No trials loaded.

NURSA Datasets

provided by nursa.org

No NURSA datasets available.

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Sources for PharmGKB drug information: DrugBank, PubChem.