Quinapril

APO-QUINAPRIL/HCTZ (quinapril hydrochloride and hydrochlorothiazide) is indicated for the treatment of essential hypertension in patients for whom combination therapy is appropriate. APO-QUINAPRIL/HCTZ is not indicated for initial therapy.

Patients in whom quinapril and hydrochlorothiazide are initiated simultaneously can develop symptomatic hypotension (see 7 WARNINGS AND PRECAUTIONS, Cardiovascular, - Hypotension and 9 DRUG INTERACTIONS). Patients should be titrated on the individual drugs.

If the fixed combination represents the dosage determined by this titration, the use of APO-QUINAPRIL/HCTZ may be more convenient in the management of patients. If during maintenance therapy dosage adjustment is necessary, it is advisable to use individual drugs.

1 Pediatrics (<18 years of age) Pediatrics (<18 years of age): No data are available to Health Canada; therefore, Health Canada has not authorized an indication for pediatric use. 2 Geriatrics (> 65 years of age) Therapeutic effects appear to be the same for elderly (>65 years of age) and younger adult patients given the same daily dosages, with no increase in adverse events in elderly patients.

Hypertension For the treatment of all grades of essential hypertension. Quinapril film coated tablets is effective as monotherapy or concomitantly with diuretics in patients with hypertension. Congestive Heart Failure For the treatment of congestive heart failure when given concomitantly with a diuretic and/or cardiac glycoside.

Treatment of congestive heart failure with Quinapril film coated tablets should always be initiated under close medical supervision.