Accuretic (quinapril / hydrochlorothiazide or HCTZ) is used to treat high blood pressure in adults. It's a tablet that contains two types of blood pressure medications: an angiotensin-converting enzyme (ACE) inhibitor and a thiazide diuretic. This combination medication is taken by mouth once per day. The specific dosage depends on how high your blood pressure is and what blood pressure medications you've taken. Common side effects are headache and dizziness. This combination blood pressure medication is a lower-cost generic only; its brand name Accuretic is no longer available.
High blood pressure in adults
Accuretic is a combination of two medications that work together to lower blood pressure.
Quinapril is an angiotensin-converting enzyme (ACE) inhibitor. It blocks a protein in the body called ACE, which normally play a role in squeezing your blood vessels to raise your blood pressure. By blocking ACE, quinapril helps relax your blood vessels and lower blood pressure.
Hydrochlorothiazide is a thiazide diuretic, which is a water pill. It works in your kidneys to move water and certain electrolytes (like sodium and potassium) into your urine. This helps get rid of extra water from your body, which helps lower blood pressure.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Cough producing mucus
difficulty breathing
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
tightness in the chest
Rare
Black, tarry stools
bleeding gums
blistering, peeling, loosening of skin
blood in the urine or stools
blurred vision
confusion
decreased urination
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fast or irregular heartbeat
increased sensitivity of skin to sunlight
muscle cramps or pain
numbness, tingling, pain, or weakness in the hands or feet
pinpoint red spots on the skin
rapid breathing
seizures
sunken eyes
sweating
thirst
trembling
unusual tiredness or weakness
weakness and heaviness of the legs
wrinkled skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Headache
Rare
Change in vision
discouragement
feeling sad or empty
general feeling of discomfort or illness
impaired vision
irritability
lack of appetite
loss of interest or pleasure
trouble concentrating
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Contains two first-choice medications for lowering blood pressure within a single pill
Taken by mouth once per day at any time of day
Available as a lower-cost generic
Not available as a liquid
More difficult to customize the dose of each individual ingredient since it's a combination medication
Not safe to take while pregnant or breastfeeding
Take Accuretic (quinapril / hydrochlorothiazide) with or without food at any time of day. If the medication hurts your stomach, taking it with food might help.
Be sure to check your blood pressure at home and write down your readings. Share this log with your prescriber at your follow-up visits. This will help your prescriber see how well Accuretic (quinapril / hydrochlorothiazide) is working for you and see whether you need any changes to your treatment plan.
Accuretic (quinapril / hydrochlorothiazide) can cause dizziness or headaches, especially when you first start taking the medication or when you change to a higher dose. These side effects should lessen as you continue taking the medication. Stand up slowly after sitting or lying down to prevent falls.
Dry cough is a well-known side effect of ACE-inhibitors like quinapril. You can have this cough at any time during treatment. Talk to your prescriber if you start having a cough while you're taking this medication and it gets annoying. Switching to a different blood pressure medication might help.
It's best to avoid alcohol or limit how much alcohol you drink when you're taking Accuretic (quinapril / hydrochlorothiazide). Alcohol can make blood pressure medications work less well because drinking alcohol regularly over a longer period of time can raise your blood pressure. Side effects like dizziness can also worsen if you drink alcohol with this medication.
Accuretic (quinapril / hydrochlorothiazide) can make your skin more sensitive to the sun and make it easier for you to get sunburns. Protect your skin by wearing sunscreen and wearing protective clothing when you're outside.
Take Accuretic (quinapril / hydrochlorothiazide) exactly as instructed by your prescriber. Don't lower your dose or stop taking the medication suddenly without talking to your prescriber first. Otherwise, your blood pressure can go up really fast. Your prescriber might need to lower your dose slowly over time to prevent big changes to your blood pressure.
Make sure to tell your care team about all the medications you're taking or planning to take. It's important that your care team checks that your medications are safe for you to take together. Both quinapril and hydrochlorothiazide can interact with many other medications, such as lithium and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil).
Be sure to plan balanced, nutritious meals that have a variety of fruits and vegetables. Eating nutritiously and following a low-salt diet help lower your blood pressure. Speak with your care team for more information on other things you can do to help lower your blood pressure.
Stop taking Accuretic (quinapril / hydrochlorothiazide) and tell your prescriber right away if you're pregnant. This medication isn't safe to take during pregnancy because it can harm your unborn baby. Your prescriber will switch you to a different medication that's safer during pregnancy and recommend lifestyle changes to help lower your blood pressure.
Accuretic (quinapril / hydrochlorothiazide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
The quinapril in this combination medication can cause severe and sometimes life-threatening harm to an unborn baby if it's taken during pregnancy. For this reason, you shouldn't take Accuretic (quinapril / hydrochlorothiazide) if you're pregnant. Stop taking this medication and tell your prescriber right away if you find out that you're pregnant. They'll recommend safer options to help lower your blood pressure. Discuss with your prescriber about these other options if you're thinking of becoming pregnant during treatment.
Risk factors: Black people | Having angioedema in the past
People who take medications that contain an ACE inhibitor like quinapril can experience a rare, but serious side effect called angioedema. This involves swelling in different parts of the body, including the face, throat, and tongue. Swelling of the tongue or throat area can be potentially life-threatening, since it can make it difficult to breathe.
Angioedema can happen at any time while you're taking Accuretic (quinapril / hydrochlorothiazide). The risk for angioedema is higher for Black people than for people of other races and ethnicities. Get medical attention as soon as possible if you notice swelling in the face, lips, tongue, or throat; stomach pain; or difficulty breathing. You'll have to stop taking Accuretic (quinapril / hydrochlorothiazide) if this happens.
Risk factors: Not enough fluid in your body | Having diarrhea or vomiting for a long time | Low salt levels in your body | Taking high doses of diuretic medications
Sometimes, taking Accuretic (quinapril / hydrochlorothiazide) can cause your blood pressure to drop too much, especially when you stand up too fast. This can make you feel dizzy, tired, or lightheaded. This side effect is more common when you first start Accuretic (quinapril / hydrochlorothiazide) or when the dose is raised.
Make sure to stay well hydrated. Sit down slowly while you hold onto something if you feel dizzy. Get medical help right away if you fall and hit your head. Contact your prescriber if you feel too dizzy, lightheaded, tired, or confused while you're taking Accuretic (quinapril / hydrochlorothiazide).
Risk factors: Severe heart failure | Kidney problems | Not enough fluid in your body | Taking other medications that can cause kidney damage
Accuretic (quinapril / hydrochlorothiazide) can affect your kidneys and cause them to work less well. The risk is higher for people who have certain types of kidney problems, such as renal artery stenosis, and people who have very severe heart failure.
Your prescriber might order lab tests every so often to make sure your kidneys are healthy and working properly. Your prescriber might recommend that you stop taking Accuretic (quinapril / hydrochlorothiazide) if you develop kidney problems or if your kidney problems worsen during treatment. Tell your prescriber if you're urinating less often than usual, as this could be a sign that your kidneys aren't working as well.
Rarely, people who took ACE inhibitors like quinapril have developed a blocked bile duct. This condition can lead to liver problems or liver failure. Your prescriber might order blood tests to check your liver health from time to time. Let your care team know right away if you notice symptoms of liver problems, such as tiredness, stomach pain, or yellowing of your skin or whites of the eyes.
Accuretic (quinapril / hydrochlorothiazide) can affect the level of certain electrolytes, like sodium, potassium, and magnesium, in your body. It can also cause changes in your blood sugar levels. In addition, this medication can raise the levels of cholesterol and triglycerides (a type of fat).
You might need blood work done every so often while you're taking Accuretic (quinapril / hydrochlorothiazide). These blood tests check that your electrolyte, blood sugar, and cholesterol levels are in a safe range. Let your care team know if you experience a fast heartbeat, weakness, low energy, muscle pain or cramps, less urination than usual, nausea, or vomiting. These can be signs of electrolyte changes in your body.
Risk factors: Sulfa or penicillin allergies
Although rare, some people experience vision changes within hours or weeks after they start taking hydrochlorothiazide, which is found in this combination medication. Tell your optometrist or prescriber right away about any vision changes or eye pain and stop taking Accuretic (quinapril / hydrochlorothiazide) as soon as possible.
Your prescriber will pick a starting dose based on factors like how high your blood pressure is, which other blood pressure medications you're currently taking or have recently taken, and how high your risk for side effects is.
In general, the typical dose ranges from 10 mg/12.5 mg (quinapril/hydrochlorothiazide) to 40 mg/25 mg (quinapril/hydrochlorothiazide) by mouth once daily.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Taking at the same time as aliskiren (Tekturna) if you have diabetes
Taking at the same time or within 36 hours of Entresto (sacubitril / valsartan)
Not making urine (not urinating)
Allergy to sulfa medications
Allergy to ACE inhibitors
History of angioedema (severe swelling)
High blood pressure in adults
High blood pressure in adults
High blood pressure in adults
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Coucke, E. M., et al. (2022). Biliary obstruction. StatPearls.
Drugs@FDA: FDA-Approved Drugs. (n.d.). Accuretic. U.S. Food and Drug Administration.
Flack, J. M., et al. (2020). Blood pressure and the new ACC/AHA hypertension guidelines. Trends in Cardiovascular Medicine.
Lupin Pharmaceuticals, Inc. (2024). Quinapril HCl and hydrochlorothiazide tablet [package insert]. DailyMed.
National Institute of Diabetes and Digestive and Kidney Diseases. (2014). Renal artery stenosis.
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Quinapril. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury.
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