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Generic Name:

hydrochlorothiazide-quinapril, Oral tablet

All Brands

  • Accuretic
SECTION 1 of 4

Highlights for hydrochlorothiazide-quinapril

Oral tablet
1

Quinapril/hydrochlorothiazide is a combination of two medications in a single form that work in different ways to treat hypertension (high blood pressure). Lowering your blood pressure will reduce your chance of having a stroke or heart attack.

2

This drug shouldn’t be the first medication you take to treat high blood pressure. If your blood pressure isn’t controlled with quinapril or hydrochlorothiazide alone, you can try this combination tablet.

3

You shouldn’t take this drug if you’re pregnant or plan to become pregnant. It can harm or be fatal to your unborn baby.

4

The standard starting dose is 10 mg quinapril/12.5 mg hydrochlorothiazide or 20 mg quinapril/12.5 mg hydrochlorothiazide taken by mouth once per day. If your blood pressure is still high after 2–3 weeks, your doctor may increase your dose.

5

Common side effects include cough, headache, dizziness, tiredness, nausea, vomiting, diarrhea, stomach pain, and dry mouth.

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to effects that may be dangerous.

Use during pregnancy warning: You shouldn’t take this drug if you’re pregnant or plan to become pregnant. Quinapril works by acting on your renin-angiotensin system. This helps to control your body’s blood pressure. If this drug is taken during pregnancy, it can harm or be fatal to your unborn child. If you become pregnant, stop taking this drug and call your doctor right away.

Allergic reaction (angioedema)

This drug can cause sudden swelling of your face, eyes, lips, or tongue. If you have swelling or trouble breathing, stop taking this drug and call your doctor right away.

Hypotension (low blood pressure)

This drug can cause low blood pressure, especially during the first few days of taking it. Tell your doctor if you feel lightheaded, dizzy, or like you’re going to faint. You may be more likely to have low blood pressure if you:

  • aren’t drinking enough fluids
  • are sweating heavily
  • have diarrhea or are vomiting

Cough

This drug may cause a persistent, dry cough. This cough usually goes away after you stop taking the medication.

What is Quinapril/hydrochlorothiazide?

This drug is a prescription drug. It’s available as an oral tablet.

This drug is available as a generic drug. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

This drug is a combination of two drugs in a single form. It is important to know about all the drugs in the combination because they each may have unique traits.

This drug may be taken as part of a combination therapy with other drugs used to treat high blood pressure.

Why it's used

This drug is used to treat high blood pressure. Lowering your blood pressure will help reduce your chance of having a stroke or heart attack.

How it works

This drug is a combination of two drugs in a single form.

More Details

How it works

This drug is a combination of two drugs in a single form. Quinapril belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors. Hydrochlorothiazide belongs to a class of drugs called thiazide diuretics. A class of drugs is a group of medications that work in a similar way. They are often used to treat similar conditions.

  • Quinapril prevents the production of angiotensin II, a chemical in your body that causes blood vessels to tighten and narrow. This drug helps to relax and widen your blood vessels, which then lowers your blood pressure.
  • Hydrochlorothiazide works in your kidneys to remove sodium (salt) and water from your body. This helps lower your blood pressure.
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SECTION 2 of 4

hydrochlorothiazide-quinapril Side Effects

Oral tablet

More Common Side Effects

The most common side effects that occur with quinapril/hydrochlorothiazide include:

  • persistent cough

  • headache

  • dizziness

  • tiredness

  • nausea

  • vomiting

  • diarrhea

  • stomach pain

  • dry mouth

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have any of these serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

  • allergic reaction. The severity of your allergic reaction may be related to your race. Ask your healthcare provider for more information about this topic. Symptoms include:

    • swelling of your face, lips, tongue, throat, arms, hands, legs, or feet
    • trouble swallowing or breathing
    • stomach pain with or without nausea or vomiting
  • skin reactions. Symptoms include:

    • painful rash
    • blistering or peeling of your skin
  • fluid and electrolyte imbalance. This drug may cause an imbalance in the amount of electrolytes in your body. Symptoms include:

    • dry mouth
    • feeling thirsty
    • weakness
    • tiredness
    • drowsiness
    • restlessness
    • confusion
    • seizures
    • muscle pains or cramps
    • low blood pressure (hypotension)
    • a decrease in the amount of urine you produce (oliguria)
    • a fast heart rate (tachycardia)
    • nausea and vomiting
  •  dangerously low blood pressure (hypotension). Symptoms include:

    • dizziness
    • lightheadedness
    • feeling like you’re going to faint
  • heart failure. Symptoms may include:

    • swelling of your ankles and legs
    • weight gain
    • shortness of breath
  • liver damage. Symptoms may include:

    • yellowing of your skin and whites of your eyes
    • extreme tiredness
    • severe nausea
    • loss of appetite
    • dark-colored urine
  • low white blood cells. This can increase your risk of infection. Your risk may be higher if you have kidney problems and have lupus or scleroderma. Symptoms include:

    • flu-like symptoms
    • fever
    • chills
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug may cause tiredness and dizziness. You shouldn’t drive, use machinery, or do other tasks that require alertness until you know how this medication affects you.

This drug may also cause lightheadedness, especially during the first few days when you start taking it. If this happens, let your doctor know. If you faint while taking this medication, stop taking it and tell your doctor right away.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

hydrochlorothiazide-quinapril May Interact with Other Medications

Oral tablet

Quinapril/hydrochlorothiazide can interact with other medications, herbs, or vitamins you might be taking. An interaction is when a substance changes the way a drug works. This can be harmful or cause the drugs that you take to not work as well. To help prevent interactions, your doctor should manage all of your medications carefully. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

Quinapril/hydrochlorothiazide may cause a sudden drop in blood pressure. You may feel dizzy, lightheaded, or faint, especially when you stand up from a sitting or lying position. Drinking alcohol while taking this medication can worsen these effects.

Medications that might interact with this drug

High blood pressure or heart failure drugs

These drugs may increase your risk for low blood pressure, high potassium levels in your blood, and kidney problems when taken with quinapril/hydrochlorothiazide.

These drugs include:

  • angiotensin II receptor blockers (ARBs), such as:
    • azilsartan (Edarbi, Edarbyclor)
    • candesartan (Atacand, Atacand HCT)
    • eprosartan (Teveten HCT)
    • irbesartan (Avapro, Avalide)
    • losartan (Cozaar, Hyzaar)
    • olmesartan (Benicar, Benicar HCT, Tribenzor, Azor)
    • telmisartan (Micardis, Micardis HCT, Twynsta)
    • valsartan (Diovan, Diovan HCT, Exforge, Exforge HCT)
  • angiotensin-converting enzyme (ACE) inhibitors, such as:
    • benazepril (Lotensin, Lotrel)
    • captopril 
    • enalapril (Vasotec, Epaned)
    • fosinopril (Monopril)
    • lisinopril (Prinivil, Zestril, Prinzide, Zestoretic)
    • moexipril (Univasc)
    • perindopril (Aceon)
    • ramipril (Altace)
    • trandolapril (Mavik, Tarka)
  • direct renin inhibitor, such as:  
    • aliskiren (Tekturna, Tekturna HCT): Never take this medication with quinapril/hydrochlorothiazide if you have diabetes.

Water pills (diuretics)

These medications can increase your risk of very low blood pressure when taken with quinapril/hydrochlorothiazide. You may feel dizzy, lightheaded, or faint.

These drugs include:

  • bumetanide
  • chlorothiazide (Diuril)
  • chlorthalidone        
  • ethacrynate (Edecrin)
  • furosemide (Lasix)
  • hydrochlorothiazide (Microzide)
  • indapamide
  • methyclothiazide
  • metolazone (Zaroxolyn)
  • torsemide (Demadex)

These medications may increase the potassium levels in your blood when taken with quinapril/hydrochlorothiazide.

These drugs include:

  • spironolactone (Aldactone)
  • amiloride
  • triamterene (Dyrenium)

Potassium supplements

These medications may increase the potassium levels in your blood when taken with quinapril/hydrochlorothiazide.

These drugs include:

  • potassium chloride (Klor-Con, Klor Con M, K-Tab, Micro-K)
  • potassium gluconate
  • potassium bicarbonate (Klor-Con EF)

Antibiotics

These drugs may not work as well when taken with quinapril/hydrochlorothiazide.

These drugs include:

  • doxycycline (Adoxa, Doryx, Vibramycin)
  • minocycline (Minocin, Solodyn)
  • tetracycline

Injectable gold

If you’re on injectable gold (sodium aurothiomalate) and quinapril/hydrochlorothiazide, you may have a nitritoid reaction. This may cause reddening and warmth in your face (flushing), nausea, vomiting, dizziness, lightheadedness, fainting.

Cancer and organ transplant drugs (immunosuppressants)

Taking these medications with quinapril/hydrochlorothiazide can increase your risk of severe swelling (angioedema).

These drugs include:

  • everolimus (Afinitor)
  • temsirolimus (Torisel)

Barbiturates and narcotics

Taking these drugs with quinapril/hydrochlorothiazide may increase your risk of having very low blood pressure, especially when standing up from a sitting or lying position.

These drugs include:

  • barbiturates, such as:
    • amobarbital
    • butabarbital
    • pentobarbital
    • phenobarbital
    • secobarbital
  • narcotics, such as:
    • codeine
    • hydrocodone
    • morphine
    • oxycodone

Diabetes drugs

Quinapril/hydrochlorothiazide may raise your blood sugar levels (hyperglycemia). If you have diabetes, you may need to test your blood sugar more often. Your doctor may need to adjust the doses of your diabetes medications.

These drugs include:

  • insulin
  • glipizide (Glucotrol)
  • glyburide (Diabeta)
  • pioglitazone (Actos)
  • rosiglitazone (Avandia)
  • acarbose (Precose)
  • miglitol (Glyset)
  • sitagliptin (Januvia)
  • saxagliptin (Onglyza)

Cholesterol drugs

These medications may reduce the amount of quinapril/hydrochlorothiazide that’s absorbed by your body. This means that it may not work as well to lower your blood pressure. If you have to take both of these drugs, take them 4 hours apart.

These drugs include:

  • colestipol (Colestid)
  • cholestyramine (Questran)

Corticosteroids

Taking these drugs together can decrease levels of potassium in your body (hypokalemia).

These drugs include:

  • betamethasone
  • budesonide
  • dexamethasone
  • hydrocortisone
  • methylprednisolone
  • prednisolone
  • prednisone

Muscle disorder drugs

You may be more sensitive to these medications’ effects when you take them with quinapril/hydrochlorothiazide.

These drugs include:

  • Skeletal muscle relaxants, such as:
    • tubocurarine

Pain and osteoarthritis drugs

These drugs may decrease the effectiveness of quinapril/hydrochlorothiazide. This means that it may not work as well to lower your blood pressure. Taking these medications together may also increase your risk of kidney problems.

These drugs include:

  • non-steroidal anti-inflammatory drugs (NSAIDs) and selective cyclooxygenase-2 inhibitors (COX-2 Inhibitors), such as:
    • celecoxib (Celebrex)
    • diclofenac (Cataflam, Voltaren)
    • etodolac
    • fenoprofen (Nalfon)
    • flurbiprofen
    • ibuprofen (Advil, Motrin)
    • indomethacin (Indocin)
    • ketoprofen
    • ketorolac
    • meclofenamate
    • mefenamic acid (Ponstel)
    • meloxicam (Mobic)
    • nabumetone
    • naproxen (Aleve, Naprosyn)
    • oxaprozin (Daypro)
    • piroxicam (Feldene)
    • sulindac (Clinoril)
    • tolmetin

Bipolar disorder and mania drugs

Quinapril/hydrochlorothiazide can increase the levels lithium in your body. This may cause more side effects.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
dehydration
People who are dehydrated

This drug may significantly lower your blood pressure if you’re dehydrated. Your doctor will monitor you closely.

abnormal blood potassium
People with abnormal blood potassium levels

Quinapril, a component of this medication, may increase your potassium levels in your blood. Hydrochlorothiazide, the other component of this drug, can decrease your potassium levels. If you already have abnormal potassium levels, use this drug with caution. Your doctor will check your blood potassium levels regularly.

kidney problems
People with kidney problems

This drug can worsen your kidney function or cause new kidney problems. Your doctor may reduce your dose or have you stop taking this drug. If you have severe kidney disease, you shouldn’t take this drug. Your doctor may do blood tests to see how the drug is affecting your kidneys. You may also be more sensitive to this drug if you have a history of kidney problems.

If you have kidney problems, you are also at increased risk of high blood potassium. Very high levels of potassium can cause heart rhythm problems. This can be life-threatening.

urination problems
People with urination problems

If you don’t make any urine (anuria), you shouldn’t take this drug. Doing so may cause kidney failure.

liver problems
People with liver problems

Use this drug with caution if you have severe liver disease. This drug may cause a fluid and electrolyte imbalance in your body. This can lead to other severe liver problems and you may need medical help right away.

sulfa allergy
People with sulfa allergy

If you’re allergic to sulfa medications, you may be allergic to this drug. If you have a sulfa allergy, tell your doctor before taking this drug.

diabetes
People with diabetes

This drug may raise your blood sugar (hyperglycemia). You may need to test your blood sugar more often. Your doctor may adjust the doses of your diabetes medications while you take this drug. Also, don’t take this drug with the medication aliskiren (Tekturna) if you have diabetes.

gout
People with gout

This drug may increase your uric acid levels and cause a gout attack. Tell your doctor if you have a history of gout attacks. They will monitor your uric acid levels.

systemic lupus erythematosus
People with systemic lupus erythematosus

This drug can cause low white blood cell counts. This raises your risk of infection. Your risk is higher if you have lupus. If you take this drug, tell your doctor any time you have a fever or sore throat.

scleroderma
People with scleroderma

This drug can cause low white blood cell counts. This raises your risk of infection. Your risk is higher if you have scleroderma. If you take this drug, tell your doctor any time you have a fever or sore throat.

pregnant women
Pregnant women

This drug is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

breastfeeding
Women who are breast-feeding

This drug may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

for seniors
For seniors

As you age, your organs (such as your liver or kidneys) may not work as well as they did compared to when you were younger. More of this drug may stay in your body longer, putting you at risk for side effects. Your doctor may adjust your dose.

for children
For children

This medicine hasn’t been studied in children and shouldn’t be used in children younger than 18 years.

call doctor
When to call the doctor

If you plan to have any surgeries or procedures, let your doctor know that you’re taking this drug. You may need to temporarily stop taking this drug before having your surgery.

allergies
Allergies

This drug may cause a serious allergic reaction. Symptoms include:

  • swelling of the skin, the layers under the skin, and your mucous membranes (inside your mouth)
  • itching and hives
  • reddening and warmth to your skin (flushing)  
  • swelling of your throat or tongue
  • wheezing or trouble breathing
  • a weak, fast heart rate (your pulse may be hard to find)
  • nausea, vomiting, or diarrhea
  • dizziness or fainting

Call 9-1-1 or go to the nearest emergency room if you develop these symptoms.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

SECTION 4 of 4

How to Take hydrochlorothiazide-quinapril (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your doctor will tell you what dosage is right for you. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Hypertension

Brand: Accuretic

Form: Oral tablet
Strengths:
  • 10 mg quinapril/12.5 mg hydrochlorothiazide
  • 20 mg quinapril/12.5 mg hydrochlorothiazide
  • 20 mg quinapril/25 mg hydrochlorothiazide

Brand: quinapril/hydrochlorothiazide

Form: Oral tablet
Strengths:
  • 10 mg quinapril/12.5 mg hydrochlorothiazide
  • 20 mg quinapril/12.5 mg hydrochlorothiazide
  • 20 mg quinapril/25 mg hydrochlorothiazide
Adult dosage (ages 18–64 years)
  • starting dose: 10 mg quinapril/12.5 mg hydrochlorothiazide or 20 mg quinapril/12.5 mg hydrochlorothiazide taken by mouth once per day.
  • dose increases: If your blood pressure is still high after 2–3 weeks, your doctor may increase your dose.
Child dosage (ages 0–17 years)

This medicine hasn’t been studied in children and shouldn’t be used in children younger than 18 years.

Senior dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug comes with serious risks if you don't take it as prescribed.

If you don't take it at all

If you don’t take this drug, your blood pressure won’t be controlled. This will raise your risk of a heart attack or stroke.

If you stop taking it suddenly

If you stop taking this drug, your blood pressure won’t be controlled. This will raise your risk of having a heart attack or stroke.

If you don't take it on schedule

Not taking this drug every day, skipping days, or taking doses at different times of the day also comes with risks. Your blood pressure might fluctuate too much and not be controlled. This may increase your risk for a heart attack or stroke.

What to do if you miss a dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, then wait and only take one dose at that time.

Never try to catch up by taking two doses at once. This could cause toxic side effects.

If you take too much

If you take too much of this drug, you may have the following symptoms:

  • low blood pressure, which may cause dizziness, lightheadedness, and fainting
  • urinating more often than normal. This can make you dehydrated.
  • dry mouth
  • muscle cramps
  • dizziness
  • a weak or irregular heart rate

If you think that you’ve taken too much of this drug, call your doctor or go to the emergency room right away.

How to tell this drug is working

You may be able to tell this drug is working if you check your blood pressure and it’s lower. Your doctor will also monitor your blood pressure regularly.

This drug is used for long-term treatment.

Important considerations for taking this drug
can cut or crush
You can crush or cut the tablet
storage
Store this drug carefully
See Details
refillable
Prescription is refillable
travel
Travel
See Details
self-management
Self-management
See Details
clinical monitoring
Clinical monitoring
See Details
sun sensitivity
Sun sensitivity
See Details
not usually stocked
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead.
hidden costs
Hidden costs
See Details

Store this drug carefully

  • Store this drug at room temperature. Keep it from 68°F (20°C) to 77°F (25°C). Keep it away from high temperature.
  • Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry it with you or in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt this medication.
  • You may need to show airport security staff the pharmacy prescription label for your medication. Be sure to carry with you the box your medication came in, which has this label.
  • Don’t put this medicine in your glove compartment or leave it in the car, especially when the temperature is hot or freezing.

Self-management

You may need to check your blood pressure at home. To do this, you may need to buy a home blood pressure monitor. These are available at most pharmacies. You should keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor appointments.

Clinical monitoring

While you’re being treated with this drug, your doctor may check your:

  • blood pressure
  • kidney function
  • electrolyte levels, such as blood potassium levels

Sun sensitivity

Hydrochlorothiazide, a component of this medication, can make you more sensitive to the sun’s effects. You should:

  • avoid being in direct sunlight for long periods of time.
  • wear protective clothing that covers most areas of your body.
  • use sunscreen whenever you’re outdoors.

Hidden costs

You may need to purchase a home blood pressure monitor to check your blood pressure at home.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other options that may work for you.


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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on September 25, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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