Imidapril Qualigen (Imidapril Hydrochloride)

• Imidapril is an ACE inhibitor that acts on the renin‑angiotensin system to manage conditions related to high blood pressure.
• Hypertension: Reduces systolic and diastolic blood pressure, decreasing cardiovascular risk.
• Chronic heart failure: Improves ventricular function and reduces symptoms of fluid overload.
• Post‑myocardial infarction left ventricular dysfunction: Helps prevent adverse remodeling and supports cardiac recovery.

• Imidapril inhibits the angiotensin‑converting enzyme (ACE), preventing the conversion of angiotensin I to the potent vasoconstrictor angiotensin II. This results in vasodilation, reduced aldosterone secretion, decreased sodium and water retention, and ultimately lower systemic blood pressure.

Imidapril may cause a range of adverse reactions, which are categorized by frequency and severity.

Common Side Effects

• Cough: dry, persistent throat irritation.
• Dizziness or light‑headedness: especially after first doses.
• Headache: mild to moderate intensity.
• Fatigue: general feeling of tiredness.
• Hypotension: especially in volume‑depleted patients.
• Taste disturbances: altered or metallic taste.

Serious or Rare Side Effects

• Angioedema: swelling of face, lips, tongue or airway.
• Severe hypotension: marked drop in blood pressure leading to fainting.
• Neutropenia: significant reduction in white blood cells.
• Hepatic dysfunction: elevated liver enzymes or jaundice.
• Renal impairment: worsening kidney function.
• Anaphylactic reactions: systemic allergic response.

• When prescribing Imidapril, clinicians should consider several safety measures to minimize risks.
• Monitor blood pressure: check regularly during initiation and dose adjustments.
• Assess renal function: evaluate serum creatinine and eGFR before and during therapy.
• Check electrolytes: especially potassium levels to avoid hyperkalaemia.
• Avoid use in pregnancy: contraindicated due to potential fetal harm.
• Caution in elderly: start with lower dose and monitor for hypotension.
• Store at room temperature: keep in original packaging, protect from moisture and direct sunlight.

Imidapril can interact with other medicines, altering its effectiveness or increasing adverse effects.

Major Interactions (Avoid)

• Aliskiren (in diabetic patients): combined use may increase risk of renal impairment.
• Potassium‑sparing diuretics (e.g., spironolactone): may cause hyperkalaemia.
• NSAIDs (e.g., ibuprofen): can reduce antihypertensive effect and impair renal function.
• Lithium: increased lithium levels leading to toxicity.
• Dual ACE inhibitor/ARB therapy: heightened risk of hypotension and renal dysfunction.

Moderate Interactions (Monitor Closely)

• Thiazide diuretics: may enhance hypotensive effect.
• Beta‑blockers: additive blood pressure lowering.
• Calcium channel blockers: possible increased incidence of cough.
• Rifampin: may reduce plasma concentration of Imidapril.
• Antidiabetic agents: monitor blood glucose as ACE inhibitors can affect glycemic control.