THE PHARMACOKINETICS OF QUINAPRIL AND QUINAPRILAT IN PATIENTS WITH CONGESTIVE-HEART-FAILURE

The pharmacokinetics of quinapril and its active metabolite quinaprila t were studied in 12 patients with congestive heart failure (CHF) afte r multiple oral doses of 10 mg quinapril twice daily. Six patients had an ejection fraction of < 35% and six had an ejection fraction betwee n 35%-50%. Increases in the apparent elimination half-life and in AUC( 0,12h) values of quinaprilat were associated with smaller ejection fra ctions, decreased creatinine clearance, and increased patient age. Com parison with data from age-matched controls having comparable renal fu nction suggests that creatinine clearance is the major determinant of quinaprilat clearance. CHF per se appears to have minimal effect. Dosi ng of quinapril in patients with CHF should be based on their renal fu nction.