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Accuretic (quinapril / hydrochlorothiazide) is a medication that requires careful consideration due to its associated risks and precautions. Below is essential safety information to ensure its safe use:

• Pregnancy Risks: Accuretic can cause serious harm, potentially life-threatening, to an unborn baby if used during pregnancy. It is crucial not to use this medication if you are pregnant. If you become pregnant or are planning to become pregnant, stop taking the medication immediately and consult your healthcare provider for safer alternatives to manage blood pressure.

• Angioedema (Swelling): This medication can lead to a rare but severe side effect known as angioedema, characterized by swelling of the face, throat, and tongue, which can obstruct breathing. This risk is heightened in individuals with a history of angioedema or those of African descent.

• Low Blood Pressure: Accuretic may cause a significant drop in blood pressure, particularly upon standing quickly, leading to dizziness, fatigue, or lightheadedness. This effect is more likely when initiating treatment or increasing the dose, especially in those with dehydration, prolonged vomiting or diarrhea, low salt levels, or those on high diuretic doses.

• Kidney Damage: The medication can impair kidney function, with increased risk in individuals with renal artery stenosis or severe heart failure. Those with existing kidney conditions or on medications affecting renal health are also more susceptible.

• Liver Damage: Although rare, quinapril can lead to liver issues, including bile duct blockage, which may progress to liver failure. Regular monitoring through blood tests is advised, and any symptoms such as fatigue, stomach pain, or yellowing of the skin or eyes should be reported immediately.

• Electrolyte, Blood Sugar, and Cholesterol Changes: Accuretic might alter the levels of electrolytes such as sodium, potassium, and magnesium, as well as affect blood sugar and cholesterol levels.

• Vision Problems: Hydrochlorothiazide, part of this combination medication, may cause rare vision changes. If you experience any changes in vision or eye pain, contact your healthcare provider promptly and discontinue use. Those with allergies to sulfa or penicillin are at higher risk.

• Lupus: This medication may induce or exacerbate lupus symptoms, such as fatigue, joint pain, or a facial rash. Notify your healthcare provider if these occur, particularly if you have a history of lupus.

Contraindications:

Avoid using Accuretic if any of the following conditions apply:

• Concurrent use with aliskiren (Tekturna) in diabetic patients.
• Use within 36 hours of taking Entresto (sacubitril/valsartan).
• Inability to urinate.
• Allergies to sulfa medications or ACE inhibitors.
• History of angioedema.

Please consult your healthcare provider to discuss these warnings and contraindications to ensure this medication is appropriate for your condition.

Common side effects:

• tiredness
• headache
• dizziness
• lightheadedness
• dry cough

Less common but important to monitor:

• nausea
• vomiting
• stomach pain
• indigestion
• muscle or back pain
• dehydration
• electrolyte imbalance
• unusually dry mouth
• thirst
• muscle cramps or weakness
• irregular heartbeats
• confusion

Serious side effects:

• angioedema
• severe allergic reaction
• dangerously low blood pressure
• serious kidney problems
• liver problems

Accuretic, which contains Quinapril and Hydrochlorothiazide, may interact with various medications and substances. It's crucial to inform your doctor or pharmacist about all medicines, including over-the-counter drugs, vitamins, and herbal supplements, that you are currently taking. Here’s a summary of potential interactions:

1. Medications to Avoid:

   • Aliskiren, Dofetilide, and Sacubitril: These should not be used with Accuretic, as they can lead to adverse effects.

2. Medications Requiring Caution:

   • Lithium and Gold Injections: These might pose risks when taken with Accuretic and require monitoring.
   • Everolimus and Sirolimus: These can increase the risk of infections.
   • Drugs that raise potassium levels, such as ARBs (e.g., Losartan, Valsartan) and birth control pills with drospirenone: Caution is advised as they can affect potassium balance.

3. Absorption Interference:

   • Magnesium in Accuretic can interfere with the absorption of certain antibiotics (like Ciprofloxacin, Levofloxacin), tetracyclines (like doxycycline, Minocycline), thyroid medications (like Levothyroxine), and osteoporosis drugs (like Alendronate). Timing the doses properly can help minimize this issue.

4. Blood Pressure Concerns:

   • Some products, including cough-and-cold remedies, diet aids, and NSAIDs (like Ibuprofen or Naproxen), may increase blood pressure. Consult with your pharmacist for safe usage.

5. Serious Reactions:

   • Bee or wasp sting allergy desensitization: A severe reaction may occur if combined with quinapril/hydrochlorothiazide. Ensure all healthcare providers are aware of your medication regimen.

6. Lab Test Interference:

   • Accuretic might affect certain lab tests, such as those evaluating parathyroid function. Inform lab personnel and your healthcare providers if you are using this medication.

Always discuss with your healthcare provider to manage these interactions effectively and ensure safe treatment.