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This document outlines essential safety and warning information for those considering or currently using Accuretic (quinapril/hydrochlorothiazide). Please review these details carefully and consult your healthcare provider if you have any concerns.

• Pregnancy Risk: Quinapril can cause serious harm to an unborn baby and should not be used during pregnancy. It's crucial to use effective birth control while taking this medication. If you become pregnant or plan to become pregnant, inform your healthcare provider immediately to discuss safer alternatives for managing blood pressure.

• Angioedema Risk: This medication may lead to angioedema, a rare but serious condition characterized by swelling of the face, throat, and tongue, which can obstruct breathing. This risk is higher for individuals who have experienced angioedema before or are of Black descent.

• Low Blood Pressure: Accuretic may cause a significant drop in blood pressure, particularly when standing up quickly, leading to dizziness or lightheadedness. This is more common when starting the medication or increasing the dose. Risks include dehydration, prolonged diarrhea or vomiting, low salt levels, and high doses of diuretics.

• Kidney Damage: There is a risk of kidney impairment, especially in individuals with pre-existing kidney issues, such as renal artery stenosis, or severe heart failure. Stay hydrated and discuss any other kidney-damaging medications with your doctor.

• Liver Damage: Rarely, quinapril may cause liver problems. Symptoms like fatigue, stomach pain, or yellowing of the skin should be reported promptly. Regular liver function tests may be recommended by your healthcare provider.

• Electrolyte and Metabolic Changes: This medication can alter sodium, potassium, and magnesium levels, as well as blood sugar and cholesterol levels. Monitoring by your healthcare provider is advised.

• Vision Problems: Some individuals may experience changes in vision shortly after starting hydrochlorothiazide. Report any vision changes immediately to your healthcare provider and discontinue use.

• Lupus: There is a rare possibility that this medication may induce or exacerbate lupus. If symptoms such as fatigue, joint pain, or facial rash occur, contact your healthcare provider.

Contraindications:

• Do not use Accuretic if you are taking aliskiren and have diabetes, or if you have recently taken Entresto.
• Avoid use if you have an allergy to sulfa medications or ACE inhibitors, a history of severe swelling (angioedema), or if you are unable to urinate.

For any further questions or in case of an overdose, seek immediate medical attention.

When taking this medication, you might experience some common side effects such as tiredness, headache, dizziness, or lightheadedness. These are generally mild and occur as your body gets used to the medication. If these symptoms persist or worsen, it's advisable to consult your healthcare provider. A dry cough may also occur. To minimize dizziness or lightheadedness, try rising slowly from sitting or lying positions.

Other side effects that some people report include nausea, vomiting, stomach pain, indigestion, muscle pain, and back pain. Although these are less common, if they become severe, seeking medical advice is recommended. It's important to be aware that this medication can cause dehydration and electrolyte imbalance, which can manifest as unusual thirst, muscle cramps, or confusion. Contact your healthcare provider if you experience these symptoms.

On a more serious note, there are some rare but severe side effects that require immediate medical attention. These include symptoms of serious allergic reactions like rash, severe swelling (angioedema), or difficulty breathing. Additionally, signs of kidney problems such as reduced urination or swelling in the extremities, liver issues indicated by yellowing of the skin or eyes, and dangerously low blood pressure should not be ignored. Always contact a healthcare professional promptly if you encounter these serious symptoms.

While these side effects can be concerning, it's important to remember that many people using this medication do not experience serious side effects. If you notice any other unusual effects, consulting with your healthcare provider for guidance is always a good practice.

Accuretic, which contains Quinapril and Hydrochlorothiazide, can interact with a variety of medications. It is crucial to inform your healthcare provider about all the medications and supplements you are currently taking, whether they are prescribed, over-the-counter, vitamins, or herbal products. Below are key interactions to be aware of:

1. Medications to Avoid: It is advised not to use Accuretic with Aliskiren, Dofetilide, and sacubitril. Your doctor might choose alternative treatments in such cases.

2. Medications Requiring Caution: Certain drugs may require careful monitoring or dose adjustments when used with Accuretic. These include, but are not limited to, Everolimus, Sirolimus, Lithium, and various non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen and Naproxen. These combinations might be necessary for your treatment but come with increased risks.

3. Special Considerations: Accuretic contains components that might elevate potassium levels, especially when used with other medications like Losartan, Valsartan, or birth control pills containing drospirenone. It also contains Magnesium, which can interfere with the absorption of certain antibiotics (like Ciprofloxacin and doxycycline), thyroid medications (such as Levothyroxine), and osteoporosis drugs (such as Alendronate). It's important to seek guidance from your doctor or pharmacist on how to manage the timing of these medications.

4. Allergy Desensitization: If undergoing bee or wasp sting allergy desensitization injections, inform your doctor if you are taking Accuretic, as serious reactions may occur.

5. Lab Test Interference: Accuretic may affect the results of certain lab tests, such as those for parathyroid function. Ensure all your healthcare providers and lab personnel are aware that you are taking this medication.

It’s important to consult with your healthcare provider for personalized advice and to discuss any potential interactions or changes to your medication regimen.