What side effects are possible with this medication?

A side effect is an unwanted response to a medication when it is taken in normal doses. A side effect may be mild or severe, temporary or permanent, but does not occur in everyone. The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away over time. If you develop any of these side effects (or any other side effects not listed here) or they change in intensity, speak to your doctor or pharmacist for advice on managing them and on the risks and benefits of the medication.

• cough (dry, persistent)
• dizziness
• diarrhea
• drowsiness

Click here to learn about serious side effects that can potentially occur with any medication. These examples are provided for information purposes only and are not meant to be exhaustive. Always consult your doctor for sound medical advice specific to your particular medication and treatment.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Angioedema: Angioedema (swelling of the mouth, lips, tongue, eye, or throat causing difficulty swallowing or breathing) has been reported in a small number of people who take quinapril. If any of these symptoms occur, stop taking this medication and get immediate medical attention. If you experience angioedema with quinapril, do not take any other ACE inhibitors (e.g., enalapril, lisinopril, or ramipril). In some cases, swelling can occur in the intestines. Get immediate medical attention if you experience abdominal pain while taking this medication.

Cholesterol: An increase in cholesterol and triglycerides levels may occur when taking hydrochlorothiazide.

Cough: A dry, persistent cough that usually disappears only after stopping quinapril may occur.

Diabetes: This medication may make it more difficult for people with diabetes to control their blood sugar. People who have diabetes should be cautious and monitor their blood sugar carefully while taking this medication. Dose adjustment of antidiabetic medications, including insulin, may be needed.

Fluid and electrolyte balance: Increases in blood levels of potassium may occur for some people who take quinapril - hydrochlorothiazide. The levels of electrolytes such as potassium, sodium, magnesium, and chloride can actually be reduced by the use of hydrochlorothiazide. Your doctor will periodically check to see if these levels are in balance. Warning signs or symptoms of fluid and electrolyte imbalance include:

• confusion
• drowsiness
• dryness of mouth
• lethargy
• low blood pressure
• muscle pains or cramps
• muscular fatigue
• nausea and vomiting
• racing heartbeat
• restlessness
• seizures
• thirst
• weakness

Gout: High levels of uric acid may occur in the blood, which can cause gout (a type of arthritis that causes sudden, severe attacks of joint pain with redness, warmth, and swelling in the affected area) may be brought on in certain people receiving this medication.

Kidney function: This medication can cause changes in kidney function. This is more likely to occur if you have severe heart failure or certain kidney problems. Your doctor may monitor your kidney function, especially at the start of treatment.

Liver function: Changes in liver function and jaundice have occurred in people with or without preexisting liver problems during treatment with this medication. If you develop nausea, vomiting, yellowing of the skin or whites of the eyes, stop taking this medication and get immediate medical attention.

Low blood pressure: Occasionally, blood pressure drops too low after taking quinapril - hydrochlorothiazide. This usually happens after the first or second dose or when the dose is increased. It is more likely to occur for people who take water pills, have a salt-restricted diet, are on dialysis, are suffering from diarrhea or vomiting, or have been sweating excessively and not drinking enough liquids. If low blood pressure causes you to faint or feel lightheaded, contact your doctor.

Lupus: This medication may worsen or activate lupus.

White blood cells: This medication may decrease white blood cell counts, especially if you have impaired kidney function or a collagen vascular disease (e.g., scleroderma, systemic lupus erythematosus). Your doctor may order blood tests to monitor your white blood cell counts while you are taking this medication. Contact your doctor if you experience any signs of infection, such as sore throat or fever.

Pregnancy: Pregnant women should not take this medication. If you become pregnant, stop taking this medication and contact your doctor.

Breast-feeding: It is not known if quinapril passes into breast milk, but hydrochlorothiazide does. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of quinapril - hydrochlorothiazide have not been established for children.

What other drugs could interact with this medication?

There may be an interaction between quinapril - hydrochlorothiazde and any of the following:

• ACTH
• alcohol
• antidiabetes medications (e.g., insulin and oral medication that lower blood sugar)
• barbiturates (e.g., phernobarbital)
• cholestipol
• cholestyramine
• corticosteroids (e.g., prednisone)
• diuretics (water pills; e.g., furosemide, amiloride, spironolactone, triamterene)
• lithium
• medications that lower blood pressure
• muscle relaxants (e.g., tubocurarine)
• narcotic medications (e.g., morphine, codeine)
• nonsteroidal anti-inflammatory medications (e.g., indomethacin)
• norepinehprine
• substances that increase potassium levels (e.g., potassium chloride, salt substitutes containing potassium)
• tetracycline

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.