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Brand name:

Accuretic

Pronounced: AK-you-REH-tik
Generic ingredients: Quinapril hydrochloride, Hydrochlorothiazide

Why is this drug prescribed?

Accuretic combines two types of blood pressure medication. The first, quinapril hydrochloride, is an ACE (angiotensin-converting enzyme) inhibitor. It works by preventing a chemical in your blood called angiotensin I from converting into a more potent form (angiotensin II) that increases salt and water retention in the body and causes the blood vessels to constrict---two actions that tend to increase blood pressure.

To aid in clearing excess water from the body, Accuretic also contains hydrochlorothiazide, a diuretic that promotes production of urine. Diuretics often wash too much potassium out of the body along with the water. However, the ACE inhibitor part of Accuretic tends to keep potassium in the body, thereby canceling this unwanted effect.

Accuretic is not used for the initial treatment of high blood pressure. It is saved for later use, when a single blood pressure medication is not sufficient for the job. In addition, some doctors are using Accuretic along with other drugs to treat congestive heart failure.

Most important fact about this drug

You must take Accuretic regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Accuretic; and you must continue taking it even if you are feeling well. Accuretic does not cure high blood pressure; it merely keeps it under control.

How should you take this medication?

You can take Accuretic with or without meals.

Take Accuretic exactly as prescribed, and see your doctor regularly to make sure the drug is working properly without unwanted side effects. Do not stop taking this drug without first consulting your doctor.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Store at room temperature in a tightly closed container. Protect from moisture and light.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Accuretic.

• More common side effects may include:
  Cough, dizziness, headache

• Less common side effects may include:
  Abdominal pain, back pain, bronchitis, chest pain, diarrhea, drowsiness, fatigue, indigestion, insomnia, muscle aches, nausea and/or vomiting, runny nose, sore throat, stomach pain, upper respiratory infection, vertigo (loss of balance), viral infection, weakness

• Rare side effects may include:
  Abnormal skin sensations (such as burning or prickling), bleeding in the stomach or intestines, bull's eye rash, crushing chest pain, difficult or labored breathing, dizziness upon standing, dry mouth or throat, extremely high blood pressure, hair loss, heart attack, heart failure, hives, impotence, increased sweating, inflammation of the pancreas, inflammation of the sinuses, irregular heartbeat, itchy skin, joint pain, kidney failure, nervousness, sensitivity to light, severe allergic reactions, skin blistering or peeling, slow or rapid heartbeat, stroke, vague feeling of illness

Why should this drug not be prescribed?

If you are unable to urinate, avoid this medication.

You should not take this medication if you are sensitive to or have ever had an allergic reaction to any of the following: Accupril, thiazide diuretics such as HydroDIURIL and Esidrix, ACE inhibitors such as Capoten and Vasotec, or sulfa or other sulfonamide-derived drugs such as Bactrim and Septra. If you have a history of allergies, you may be at greater risk for an allergic reaction to this medication. Make sure your doctor is aware of any drug reactions you have experienced.

Special warnings about this medication

If you develop swelling of the face, lips, tongue or throat, or of your arms and legs, or have difficulty swallowing or breathing, stop taking the medication and contact your doctor immediately. You may need emergency treatment.

You may feel light-headed, especially during the first few days of Accuretic therapy. If this occurs, notify your doctor. If you actually faint, stop taking the medication until you have consulted with your doctor.

Dehydration, excessive sweating, vomiting, or diarrhea can all deplete your body's fluids and cause your blood pressure to drop. If this leads to light-headedness or fainting, you should check with your doctor.

Inform your doctor or dentist that you are taking Accuretic before undergoing surgery or anesthesia.

Do not use potassium supplements or salt substitutes containing potassium without consulting your doctor.

If you develop any type of infection such as a sore throat or fever, contact your doctor immediately. It could indicate a more serious illness.

If you are taking Accuretic, your doctor will do a complete assessment of your kidney function and will watch it closely as long as you are taking this drug. If you have kidney disease, Accuretic should be used with caution.

Caution is warranted, too, if you have liver disease. If you notice a yellow tinge to your skin and the whites of your eyes, stop taking the drug and notify your doctor. This could be a sign of liver damage.

Accuretic may increase your blood sugar levels if you have diabetes. It can also trigger gout or the connective tissue disease lupus erythematosus. Use Accuretic cautiously if you have any of these problems.

The safety and effectiveness of Accuretic in children have not been established.

Possible food and drug interactions when taking this medication

If Accuretic is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Accuretic with the following:

Barbiturates such as phenobarbital
Cholestyramine (Questran)
Colestipol (Colestid)
Corticosteroids such as prednisone or ACTH
Diabetes medications such as insulin or Micronase
Digoxin (Lanoxin)
Diuretics such as HydroDIURIL and Lasix
Lithium (Eskalith, Lithobid)
Narcotics such as Percocet
Nonsteroidal anti-inflammatory drugs such as Naprosyn
Norepinephrine (Levophed)
Other high blood pressure medications such as Aldomet
Potassium-sparing diuretics such as Aldactone, Dyazide, and Moduretic
Potassium supplements such as Slow-K and K-Dur
Salt substitutes containing potassium
Tetracycline (Achromycin V, Sumycin)

Alcohol may increase the effect of Accuretic, and could cause dizziness or fainting. Check with your doctor before drinking alcoholic beverages.

Special information if you are pregnant or breastfeeding

ACE inhibitors such as the one in Accuretic have been shown to cause injury and even death to the unborn child when used in pregnancy during the second and third trimesters. If you are pregnant, your doctor should discontinue this medication as soon as possible. If you plan to become pregnant, make sure your doctor knows you are taking this medication. The diuretic component of Accuretic, when taken during pregnancy, can cause jaundice (yellowing of the skin and whites of the eyes) and abnormal bruising and bleeding in newborns.

Accuretic appears in breast milk and could affect a nursing infant. Because of potential harm to the baby, you'll need to choose between breastfeeding and continuing your treatment with Accuretic.

Recommended dosage

ADULTS

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

• Symptoms of Accuretic overdose may include:
  A severe drop in blood pressure, dry mouth, excessive thirst, muscle pain or cramps, nausea and vomiting, weak or irregular heartbeat, weakness and dizziness