Qbrelis

Qbrelis is used by itself or with other medicines to treat high blood pressure in adults and children who are at least 6 years old.

Qbrelis is also used in adults to treat congestive heart failure and to help improve survival after a heart attack.

Qbrelis may also be used for 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 occasionally change your dose. Use the medicine exactly as directed.

You may take Qbrelis with or without food.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

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

Tell your doctor if you have a planned surgery.

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 Qbrelis. This can lead to very low blood pressure, an electrolyte imbalance, or kidney failure.

If you have high blood pressure, keep using Qbrelis even if you feel well. High blood pressure often has no symptoms.

Store tightly closed at room temperature, away from moisture and heat. Do not freeze.

Do not use if you are pregnant. Stop using Qbrelis and tell your doctor right away if you become pregnant.

You should not use Qbrelis if you are allergic to it or to any other ACE (angiotensin converting enzyme) inhibitor such as captopril, fosinopril, enalapril, benazepril, moexipril, perindopril, quinapril, ramipril, or trandolapril.

Do not take Qbrelis within 36 hours before or after taking any medicine that contains sacubitril (like Entresto).

If you have diabetes, do not take Qbrelis with any medication that contains aliskiren (a blood pressure medicine).

Do not take Qbrelis if you have a history of angioedema (severe allergic reaction).

Tell your doctor if you have ever had:

• heart disease, heart problems such as a recent heart attack;
• low blood pressure;
• low white blood cell count;
• stomach pain;
• if you are on a low-salt diet;
• diabetes;
• liver disease; or
• kidney disease (or if you are on dialysis).

You may also need to avoid taking Qbrelis with aliskiren if you have kidney disease.

Stop using this medicine and tell your doctor right away if you become pregnant. Qbrelis can cause injury or death to the unborn baby if you use the medicine during your second or third trimester.

Do not breastfeed.

Get emergency medical help if you have signs of an allergic reaction: severe stomach pain, hives, difficulty breathing, swelling of your face, lips, tongue, or throat.

Qbrelis may cause serious side effects. Call your doctor right away if you have:

• a light-headed feeling, like you might pass out;
• high blood potassium—nausea, weakness, tingling feeling, chest pain, irregular heartbeats, loss of movement;
• low white blood cell counts—fever, mouth sores, skin sores, sore throat, cough;
• kidney problems—swelling, urinating less, feeling tired or short of breath; or
• liver problems—loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects of Qbrelis may include:

• headache, dizziness;
• low blood pressure, cough; or
• chest 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 FDA at 1-800-FDA-1088.

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

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

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

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

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.

Qbrelis can damage your kidneys, especially if you are also taking certain medicines for infections, cancer, or osteoporosis.

Inform your doctor about all your other medicines, especially:

• a diuretic or "water pill" that may raise blood potassium like spironolactone, triamterene, or amiloride;
• NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;
• insulin or diabetes medications;
• medicine to stop organ transplant rejection such as temsirolimus, sirolimus, or everolimus; or
• heart or blood pressure medication.

This is not a complete list. Other drugs may interact with Qbrelis, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are included here.