Hydrochlorothiazide and quinapril

Hydrochlorothiazide is a type of diuretic (water pill). Quinapril belongs to a group of medicines called ACE inhibitors (ACE means angiotensin converting enzyme).

Hydrochlorothiazide and quinapril is a combination medicine used to treat high blood pressure (hypertension). Reducing blood pressure may help lower your risk of having a stroke or a heart attack.

Hydrochlorothiazide and quinapril may also be used for other reasons not mentioned in this medication guide.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may change your dose from time to time. Use the medicine exactly as directed.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking hydrochlorothiazide and quinapril. This can lead to very low blood pressure, electrolyte disorders, or kidney failure.

Your blood pressure will need to be checked often, and you may need occasional blood tests.

If you need surgery, tell your surgeon that you are currently using this medicine.

Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture, heat, and light.

Do not use if you are pregnant. If you become pregnant, stop taking hydrochlorothiazide and quinapril and tell your doctor right away.

You should not use this medicine if you have ever had angioedema, if you are unable to urinate, or if you are allergic to sulfa drugs or to any ACE inhibitor. Do not take hydrochlorothiazide and quinapril within 36 hours before or after taking any medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use hydrochlorothiazide and quinapril together with any medication that contains aliskiren (a blood pressure medicine).

You should not use this medicine if you are allergic to hydrochlorothiazide or quinapril, or if:

• you have a history of angioedema;
• you are unable to urinate;
• you recently took a heart medicine called sacubitril; or
• you have ever had a severe allergic reaction to any ACE inhibitor (benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril).

Do not take hydrochlorothiazide and quinapril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use hydrochlorothiazide and quinapril together with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking hydrochlorothiazide and quinapril with aliskiren if you have kidney disease.

Tell your doctor if you have ever had:

• kidney disease (or if you are on dialysis);
• cirrhosis or other liver disease;
• glaucoma;
• congestive heart failure;
• gout;
• lupus;
• an allergy to sulfa drugs or penicillin; or
• if you are on a low-salt diet.

Do not use if you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant. Quinapril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

You should not breastfeed while using hydrochlorothiazide and quinapril.

Hydrochlorothiazide and quinapril is not approved for use by anyone younger than 18 years old.

Get emergency medical help if you have signs of an allergic reaction (hives, severe stomach pain, difficulty breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

You may be more likely to have an allergic reaction if you are African-American.

Hydrochlorothiazide and quinapril may cause serious side effects. Call your doctor right away if you have:

• a light-headed feeling, like you might faint;
• blurred vision, tunnel vision, eye pain, or seeing halos around lights;
• swelling, weight gain, shortness of breath;
• sudden weakness or feeling unwell, fever, chills, sore throat, mouth sores, trouble swallowing;
• high potassium—nausea, tingling feeling, chest pain, irregular heartbeats, loss of movement;
• low potassium level—leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or feeling limp; or
• low levels of sodium—headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.

Common side effects of hydrochlorothiazide and quinapril may include:

• cough;
• headache, dizziness;
• feeling tired; or
• muscle pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Usual Adult Dose for Hypertension:

Hydrochlorothiazide 12.5 to 25 mg-quinapril 10 to 20 mg orally once a dayComments:-The initial dosage of hydrochlorothiazide-quinapril should be based on the patient requirements for each drug individually.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Hydrochlorothiazide may increase your risk of skin cancer. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Your doctor may want you to have skin examinations regularly.

Drinking alcohol can further lower your blood pressure and may increase certain side effects of hydrochlorothiazide and quinapril.

Do not use salt substitutes or potassium supplements while taking this medicine, unless your doctor has told you to.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Tell your doctor about all your other medicines, especially:

• any other blood pressure medication;
• lithium;
• everolimus, sirolimus, temsirolimus;
• an antibiotic--demeclocycline, doxycycline, minocycline, eravacycline, omadacycline, sarecycline, tetracycline; or
• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may affect hydrochlorothiazide and quinapril, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.