Quinaretic

Pronunciation: KWIN-a-pril/HYE-droe-KLOR-oh-THYE-a-zide
Generic Name: Quinapril/Hydrochlorothiazide
Brand Name: Examples include Accuretic and Quinaretic

When used during the second and third trimesters of pregnancy, Quinaretic can cause injury or death to the fetus. If you think you may be pregnant, contact your doctor right away.

Quinaretic is used for:

Treating high blood pressure. It may also be used for other conditions as determined by your doctor.

Quinaretic is an angiotensin-converting enzyme (ACE) inhibitor and thiazide diuretic combination. It works by causing blood vessels to relax (widen) and increasing the excretion of excess fluid, which lowers blood pressure.

Do NOT use Quinaretic if:

• you are allergic to any ingredient in Quinaretic or any other sulfonamide medicine (eg, glyburide, probenecid, sulfamethoxazole)


• you have a history of angioedema (swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness) caused by treatment with an ACE inhibitor


• you are pregnant


• you have severe kidney problems or are unable to urinate


• you are taking dextran sulfate, dofetilide, or ketanserin

Contact your doctor or health care provider right away if any of these apply to you.

Before using Quinaretic:

Some medical conditions may interact with Quinaretic. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are able to become pregnant


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have a history of heart problems (eg, heart failure, aortic stenosis), blood vessel problems (eg, in the brain or heart), blood flow problems, bone marrow problems, kidney problems (eg, renal artery stenosis), liver problems, or angioedema (swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness)


• if you have a history of a stroke, recent heart attack, or kidney transplant


• if you have an autoimmune disease (eg, rheumatoid arthritis, lupus, scleroderma)


• if you are dehydrated or have low blood volume


• if you have high potassium levels, low blood sodium levels, high blood cholesterol or lipid levels, gout, or are on a low-salt (sodium) diet


• if you have diabetes, especially if you are also taking aliskiren


• if you are receiving treatments to reduce sensitivity to bee or wasp stings


• if you are scheduled to have major surgery or to receive anesthesia, have recently had a certain type of nerve surgery (sympathectomy), or are on dialysis


• if you have never taken another medicine for high blood pressure

Some MEDICINES MAY INTERACT with Quinaretic. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Aldosterone blockers (eg, eplerenone), aliskiren, potassium-sparing diuretics (eg, amiloride, spironolactone), potassium supplements, or salt substitutes containing potassium because the risk of high blood potassium levels may be increased


• Angiotensin receptor blockers (eg, losartan) because the risk of serious kidney problems and high blood potassium levels may be increased


• Gold-containing medicines (eg, auranofin, sodium aurothiomalate) because flushing, nausea, vomiting, and low blood pressure may occur


• Adrenocorticotropic hormone (ACTH), barbiturates (eg, phenobarbital), corticosteroids (eg, prednisone), diazoxide, diuretics (eg, furosemide), narcotic pain medicines (eg, codeine), or other medicines for high blood pressure (eg, propranolol, verapamil) because they may increase the risk of Quinaretic's side effects


• Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, indomethacin) or salicylates (eg, aspirin) because they may decrease the effectiveness of Quinaretic


• Dextran sulfate, digoxin, dofetilide, ketanserin, lithium, or thiopurines (eg, azathioprine) because the risk of their side effects may be increased by Quinaretic


• Insulin, oral hypoglycemics (eg, glyburide), or tetracycline because their effectiveness may be decreased by Quinaretic

This may not be a complete list of all interactions that may occur. Ask your health care provider if Quinaretic may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Quinaretic:

Use Quinaretic as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Quinaretic by mouth with or without food.


• Quinaretic may increase the amount of urine or cause you to urinate more often when you first start taking it. To keep this from disturbing your sleep, try to take your dose before 6 pm.


• If you are taking a tetracycline antibiotic, a quinolone antibiotic (eg, ciprofloxacin, levofloxacin), or colestipol or cholestyramine for high cholesterol, ask your doctor or pharmacist how to take it with Quinaretic. This product contains magnesium, which can interfere with absorption of these medicines.


• Take Quinaretic on a regular schedule to get the most benefit from it.


• Taking Quinaretic at the same time each day will help you remember to take it.


• Continue to take Quinaretic even if you feel well. Do not miss any doses.


• If you miss a dose of Quinaretic, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Quinaretic.

Important safety information:

• Quinaretic may cause drowsiness, dizziness, light-headedness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use Quinaretic with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Quinaretic may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.


• Report any light-headedness or fainting to your doctor immediately. Your risk of light-headedness or fainting may be increased if you experience diarrhea, vomiting, or excessive sweating, if you do not drink enough fluids, or if you are on a low-salt (sodium) diet.


• Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.


• Quinaretic has magnesium in it. Before you start any new medicine, check the label to see if it has magnesium in it too. If it does or if you are not sure, check with your doctor or pharmacist.


• Quinaretic may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Quinaretic. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.


• Quinaretic may cause a serious side effect called angioedema. Black patients may be at greater risk of developing this side effect. Contact your doctor at once if you develop swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness.


• Quinaretic contains hydrochlorothiazide, a sulfonamide, which can cause certain eye problems (myopia, angle-closure glaucoma). Your risk may be increased if you are allergic to sulfonamide medicines (eg, sulfamethoxazole) or to penicillin antibiotics (eg, amoxicillin). Untreated angle-closure glaucoma can lead to permanent vision loss. If these eye problems occur, symptoms usually occur within hours to weeks of starting Quinaretic. Contact your doctor immediately if you experience symptoms such as vision changes (eg, decreased vision clearness) or eye pain.


• Dehydration, excessive sweating, vomiting, or diarrhea may lead to a fall in blood pressure. Contact your health care provider at once if any of these symptoms occur.


• Check with your doctor before you use a salt substitute or a product that has potassium in it.


• Quinaretic may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.


• It may take 1 to 2 weeks for Quinaretic to work. Do not stop taking Quinaretic without checking with your doctor.


• Tell your doctor or dentist that you take Quinaretic before you receive any medical or dental care, emergency care, or surgery.


• Diabetes patients - Quinaretic may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.


• Quinaretic may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.


• Quinaretic may interfere with certain lab tests, including parathyroid function tests. Be sure your doctor and lab personnel know you are taking Quinaretic.


• Lab tests, including liver and kidney function, blood pressure, complete blood cell counts, and blood electrolytes, may be performed while you take Quinaretic. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Quinaretic with caution in the ELDERLY; they may be more sensitive to its effects.


• Quinaretic should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: Quinaretic may cause birth defects and fetal or newborn death if you take it while you are pregnant. Do not become pregnant while you take it. If you think you may be pregnant, contact your doctor right away. Quinaretic is found in breast milk. Do not breast-feed while you are taking Quinaretic.

Possible side effects of Quinaretic:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness or light-headedness; fatigue; headache; nausea; persistent dry cough; tiredness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty swallowing or breathing; tightness in the chest; swelling of the hands, mouth, face, lips, throat, or tongue; unusual hoarseness); chest pain; darkening of urine; decrease in the amount of urine; drowsiness; dry mouth; eye pain; fainting; fast, slow, or irregular heartbeat; muscle pain, weakness, or cramping; numbness of arm or leg; restlessness; severe or persistent dizziness or light-headedness; severe or persistent nausea, vomiting, or diarrhea; shortness of breath; slurred speech; stomach pain (with or without nausea or vomiting); sudden, severe headache or vomiting; symptoms of infection (eg, chills, fever, sore throat); symptoms of low blood sodium levels (eg, confusion, mental or mood changes, seizures, sluggishness); unusual bruising or bleeding; unusual joint pain; unusual thirst; unusual tiredness or weakness; unusual weight gain; vision changes (eg, decreased vision clearness); yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Quinaretic side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; severe dizziness or light-headedness; symptoms of blood electrolyte problems (eg, confusion; irregular heartbeat; mental or mood changes; muscle pain, weakness, or cramping; seizures; sluggishness); symptoms of dehydration (eg, dry mouth or eyes; decrease in the amount of urine; fast heartbeat; unusual thirst, tiredness, or weakness).

Proper storage of Quinaretic:

Store Quinaretic at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Quinaretic out of the reach of children and away from pets.

General information:

• If you have any questions about Quinaretic, please talk with your doctor, pharmacist, or other health care provider.


• Quinaretic is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Quinaretic. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Quinaretic resources

• Quinaretic Side Effects (in more detail)
• Quinaretic Use in Pregnancy & Breastfeeding
• Drug Images
• Quinaretic Drug Interactions
• Quinaretic Support Group
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• Quinaretic Prescribing Information (FDA)


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