Quinapril and Hydrochlorothiazide

Quinapril and hydrochlorothiazide is a prescription medication used to treat high blood pressure. It is a single product containing 2 medications: quinapril and hydrochlorothiazide. Quinapril belongs to a group of drugs called angiotensin-converting enzyme (ACE) inhibitors. Quinapril works by blocking the ACE enzyme, which helps blood vessels to relax and lowers blood pressure. Hydrochlorothiazide belongs to a group of drugs called thiazide diuretics, which work by stopping reabsorption of salt into your body. This prevents fluid from building up in the body.

This medication comes in tablet form. It is given once daily, with or without food.

Common side effects include headache, coughing, and muscle pain. 

Quinapril and hydrochlorothiazide can also cause tiredness (fatigue) and dizziness. Do not drive or operate heavy machinery until you know how this medication affects you. 

Quinapril and hydrochlorothiazide is a prescription medication used to treat high blood pressure.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. 

Quinapril and Hydrochlorothiazide may be found in some form under the following brand names:

• Accuretic

• Quinaretic

Serious side effects have been reported with quinapril and hydrochlorothiazide. See the "Quinapril and hydrochlorothiazide Precautions" section. 

Common side effects of quinapril and hydrochlorothiazide include the following:

• headache
• dizziness
• coughing
• tiredness (fatigue)
• muscle pain
• viral infection
• stuffy nose (rhinitis)
• nausea and/or vomiting
• stomach (abdominal) pain
• back pain
• diarrhea
• infection that affects the nose, throat, and airways (upper respiratory infection)
• difficulty sleeping (insomnia)
• sleepiness (somnolence)
• Inflammation of the airway which carries air to and from the lungs (bronchitis)
• indigestion
• abnormal physical weakness or lack of energy (asthenia)
• widening of blood vessels (vasodilation)
• feeling like your surroundings are spinning (vertigo)
• chest pain

This is not a complete list of quinapril and hydrochlorothiazide side effects. Ask your doctor or pharmacist for more information. 

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. 

Tell your doctor about all the medicines you take including prescription and nonprescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you are taking:

• certain medications that also lower blood pressure such as angiotensin-­converting enzyme (ACE) inhibitors like enalapril (Vasotec, Vaseretic) and angiotensin receptor II blockers (ARBs) like valsartan (Diovan)
• aliskiren (Tekturna)
• potassium supplements or potassium-containing salt substitutes
• potassium­ sparing diuretics such as spironolactone (Aldactone), triamterene (Dyrenium), and amiloride (Midamor)
• lithium (Lithobid)
• antibiotics in the tetracycline class tetracycline (Diabecline), doxycycline (Doryx, Oracea), and minocycline (Solodyn)
• injectable gold (sodium aurothiomalate)
• nonsteroidal anti-inflammatory drugs (NSAIDS) such as naproxen (Aleve) and ibuprofen (Advil)
• mTOR inhibitors such as everolimus (Afinitor) and temsirolimus (Torisel)
• digoxin (Lanoxin)
• alcohol, a class of drugs called barbiturates, or a type of pain medications called narcotics
• diabetic medications
• cholestyramine (Questran) and colestipol (Colestid)
• medicines that provide relief for inflamed areas of the body (corticosteroids) such as methylprednisolone (Medrol) and dexamethasone (Decadron)
• substances that raise blood pressure (pressor amines) such as norepinephrine (Levophed)
• medicines that relax skeletal muscles such as cyclobenzaprine (Flexeril) and carisoprodol (Soma)

Do not drink alcohol while on this medication.

This is not a complete list of quinapril and hydrochlorothiazide drug interactions. Ask your doctor or pharmacist for more information. 

Serious side effects have been reported with quinapril and hydrochlorothiazide or its ingredients including the following:

• Allergic reactions. Tell your healthcare provider right away if you have some or all of the following symptoms:
  • swelling of the face, limbs, lips, tongue, throat
  • difficulty breathing
  • stomach (abdominal) pain (intestinal angioedema) with or without nausea or vomiting
• Low blood pressure.
• Lowered white blood cell count (neutropenia/agranulocytosis) increasing the risk of infections
• Harm to an unborn baby (fetal toxicity). Do not take quinapril and hydrochlorothiazide if you are pregnant or will become pregnant.
• Liver damage
• An autoimmune disease in which the body's immune system mistakenly attacks healthy tissue (systemic lupus erythematosus)
• A condition in which close objects appear clearly, but far ones don't (myopia) or a buildup of pressure in the eye that can cause blindness (glaucoma). Tell your healthcare provider right away if you experience  visual changes or eye pain.
• Imbalances in the levels of salts and fluids in your body (electrolyte and fluid imbalance). Tell your healthcare provider right away if you have some or all of the following symptoms:
  • dry mouth
  • thirst
  • weakness
  • drowsiness
  • restlessness
  • muscle pains or cramps
  • low blood pressure
  • low output of urine
  • fast heart rate
  • nausea
  • vomiting

Quinapril and hydrochlorothiazide can also cause tiredness (fatigue) and dizziness. Do not drive or operate heavy machinery until you know how this medication affects you. 

Do not take quinapril and hydrochlorothiazide if you:

• are allergic to quinapril and hydrochlorothiazide or to any of its ingredients or to other sulfonamide-derived drugs
• kidneys are unable to produce urine (anuric)
• history of a type of swelling that affects deeper layers of your skin, often around your eyes and lips (angioedema) with other ACE inhibitors
• are diabetic and also using aliskiren (Tekturna)

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of quinapril and hydrochlorothiazide, salt substitutes containing potassium should be avoided. 

Before taking quinapril and hydrochlorothiazide, tell your doctor about all of your medical conditions. Especially tell your doctor if:

• are allergic to quinapril and hydrochlorothiazide or to any of its ingredients or to other sulfonamide-derived drugs
• kidneys are unable to produce urine (anuric) or have kidney problems
• history of a type of swelling that affects deeper layers of your skin, often around your eyes and lips (angioedema) with other ACE inhibitors
• are diabetic, especially if you are taking aliskiren (Tekturna)
• you are about to have major surgery
• you are breastfeeding or plan to breastfeed
• you are pregnant or planning to become pregnant

Tell you doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. 

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category D. When pregnancy is detected, discontinue quinapril and hydrochlorothiazide as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the unborn baby.

Tell your doctor is you are breastfeeding or plan to breastfeed. 

Quinapril and hydrochlorothiazide have been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from quinapril and hydrochlorothiazide, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered. 

• Take quinapril and hydrochlorothiazide exactly as prescribed. 
• Quinapril and hydrochlorothiazide comes in a tablet form and is taken by mouth once daily with or without food. 

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• your blood pressure
• previous medications used and the doses tried
• how you respond to this medication
• your other medical conditions

The usual dose range of quinapril and hydrochlorothiazide to treat high blood pressure is quinapril 10 to 80 mg and hydrochlorothiazide 12.5 to 50 mg once daily.

If you take too much quinapril and hydrochlorothiazide, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away. 

• Store at room temperature, 68–77°F (20–25°C).
• Dispense in a tight container.
• Keep this and all medications out of the reach of children. 

WARNING: FETAL TOXICITY

• When pregnancy is detected, discontinue quinapril and hydrochlorothiazide as soon as possible.
• Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.