Warnings and Precautions With Quinapril-Hydrochlorothiazide

• There are a number of medicines that quinapril-hydrochlorothiazide can interact with (see Drug Interactions With Quinapril-Hydrochlorothiazide).
   
• Quinapril-hydrochlorothiazide is more likely than other drugs to cause allergic reactions. For example, there have been reports of severe allergic reactions occurring in people who were taking quinapril-hydrochlorothiazide during dialysis. There have also been reports of severe reactions in people getting bee or wasp venom to protect against stings. Finally, people with a history of asthma or allergies are more likely to have an allergic reaction to quinapril-hydrochlorothiazide.

Make sure to discuss these risks with your healthcare provider. Also, seek emergency medical attention immediately if you notice things such as hives, an unexplained rash, difficulty breathing, or swelling of the face or throat.

• Medicines (including quinapril-hydrochlorothiazide) that contain an ACE inhibitor may cause swelling (angioedema) of the head and neck, including the tongue, lips, eyes, or throat. This occurs more frequently in African Americans than in Caucasians. Seek emergency medical care immediately if you notice swelling in the head or neck area, experience wheezing, or have difficulty breathing or swallowing.
   
• In addition to head and neck angioedema, medicines like quinapril-hydrochlorothiazide have also been known to cause swelling in the intestines. This is known as intestinal angioedema. Symptoms may include stomach pain with or without vomiting. Seek medical attention immediately if you develop any of these symptoms.
   
• Quinapril-hydrochlorothiazide may cause extreme low blood pressure in some people. Extreme low blood pressure is more likely to happen when the medicine is first started or if the dosage is changed. It is also more likely to happen in people who are taking a diuretic, are on dialysis, have congestive heart failure, have diarrhea or vomiting, or sweat a lot. This is why it is important to drink fluids regularly while taking this drug. If you have any possible symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting, contact your healthcare provider. If you have fainted, stop taking quinapril-hydrochlorothiazide until you have talked to your healthcare provider.

Also, make sure not to drive, operate any heavy machinery, or perform any other tasks that require alertness before you know how quinapril-hydrochlorothiazide affects you.

• People on quinapril-hydrochlorothiazide can be at increased risk of infections. Talk to your healthcare provider if you develop a sore throat, fever, or any other sign of infection.
   
• Quinapril-hydrochlorothiazide is a pregnancy Category C medicine for the first trimester and a pregnancy Category D medicine for the second and third trimesters, meaning that it poses health risks to your unborn child. Let your healthcare provider know if you are pregnant or thinking of becoming pregnant. If you become pregnant while taking quinapril-hydrochlorothiazide, contact your healthcare provider immediately (see Accuretic and Pregnancy for more information).
   
• Medicines (including quinapril-hydrochlorothiazide) that contain an ACE inhibitor are known to cause a cough. If a cough becomes bothersome, talk to your healthcare provider about alternate treatment options for your condition (see Accupril Cough).
   
• While taking quinapril-hydrochlorothiazide, do not use potassium supplements or salt substitutes with potassium unless you have discussed this with your doctor. This is because in some people taking quinapril-hydrochlorothiazide, potassium in the blood can increase or decrease to dangerous levels.
   
• Medicines like quinapril-hydrochlorothiazide have been known to cause a decrease in kidney function, especially in certain people, such as those with severe congestive heart failure. Let your healthcare provider know if you have symptoms such as a decrease in urine output, drowsiness, headache, or back pain. Your healthcare provider will also regularly check your kidney function with a blood test.
   
• In clinical studies, medicines that contain an ACE inhibitor, including quinapril-hydrochlorothiazide, have rarely been known to cause liver failure. Contact your healthcare provider immediately if you notice things such as nausea, tiredness, lethargy, itchy or yellowing skin, abdominal pain, or flu-like symptoms.
   
• Quinapril-hydrochlorothiazide may affect electrolytes in the blood (including sodium, potassium, magnesium, and chloride). Therefore, your healthcare provider will regularly check these levels. If you notice any symptoms of a possible electrolyte imbalance, contact your healthcare provider. These symptoms may include:

• Dry mouth
• Increased thirst
• Weakness
• Tiredness
• Restlessness
• Seizures
• Confusion
• Muscle pain or cramps
• Decrease in urine output
• Weak or irregular heartbeat
• Nausea
• Vomiting.

• Because of the hydrochlorothiazide, quinapril-hydrochlorothiazide is more likely to worsen systemic lupus erythematosus or, in some cases, even cause the condition.
   
• Because of the hydrochlorothiazide, quinapril-hydrochlorothiazide is also known to worsen gout.
   
• Quinapril-hydrochlorothiazide may cause high blood sugar (hyperglycemia) in people with diabetes or, in some cases, even cause diabetes in people without a history of the condition.
   
• Quinapril-hydrochlorothiazide may increase levels of cholesterol and triglycerides in the blood.
   
• Quinapril-hydrochlorothiazide passes through breast milk. Therefore, if you are nursing, talk with your healthcare provider about whether you should discontinue quinapril-hydrochlorothiazide or stop breastfeeding.
   

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