Hydrochlorothiazide is a thiazide diuretic (water pill). Quinapril is in an ACE inhibitor (ACE stands for angiotensin converting enzyme).

Hydrochlorothiazide and quinapril is a combination medicine used to treat hypertension (high blood pressure). Lowering blood pressure may lower your risk of a stroke or heart attack.

Hydrochlorothiazide and quinapril may also be used for purposes not listed in this medication guide.

Do not use if you are pregnant. If you become pregnant, stop taking hydrochlorothiazide and quinapril and tell your doctor right away.

You should not use this medicine if you have ever had angioedema, if you are unable to urinate, or if you are allergic to sulfa drugs or to any ACE inhibitor. Do not take hydrochlorothiazide and quinapril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use hydrochlorothiazide and quinapril together with any medication that contains aliskiren (a blood pressure medicine).

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking hydrochlorothiazide and quinapril. This can lead to very low blood pressure, electrolyte disorders, or kidney failure.

Your blood pressure will need to be checked often, and you may need occasional blood tests.

If you need surgery, tell your surgeon you currently use this medicine.

Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture, heat, and light.

Usual Adult Dose for Hypertension:

Hydrochlorothiazide 12.5 to 25 mg-quinapril 10 to 20 mg orally once a day

Comments:
-The initial dosage of hydrochlorothiazide-quinapril should be based on the patient requirements for each drug individually.

You should not use this medicine if you are allergic to hydrochlorothiazide or quinapril, or if:

• you have a history of angioedema;

• you are unable to urinate;

• you recently took a heart medicine called sacubitril; or

• you have ever had a severe allergic reaction to any ACE inhibitor (benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril).

Do not take hydrochlorothiazide and quinapril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use hydrochlorothiazide and quinapril together with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking hydrochlorothiazide and quinapril with aliskiren if you have kidney disease.

Tell your doctor if you have ever had:

• kidney disease (or if you are on dialysis);

• cirrhosis or other liver disease;

• glaucoma;

• congestive heart failure;

• gout;

• lupus;

• an allergy to sulfa drugs or penicillin; or

• if you are on a low-salt diet.

Do not use if you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant. Quinapril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

You should not breastfeed while using hydrochlorothiazide and quinapril.

Hydrochlorothiazide and quinapril is not approved for use by anyone younger than 18 years old.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Hydrochlorothiazide may increase your risk of skin cancer. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Your doctor may want you to have skin examinations on a regular basis.

Drinking alcohol can further lower your blood pressure and may increase certain side effects of hydrochlorothiazide and quinapril.

Do not use salt substitutes or potassium supplements while taking this medicine, unless your doctor has told you to.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Get emergency medical help if you have signs of an allergic reaction (hives, severe stomach pain, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

You may be more likely to have an allergic reaction if you are African-American.

Hydrochlorothiazide and quinapril may cause serious side effects. Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• blurred vision, tunnel vision, eye pain, or seeing halos around lights;

• swelling, weight gain, shortness of breath;

• sudden weakness or ill feeling, fever, chills, sore throat, mouth sores, trouble swallowing;

• high potassium--nausea, tingly feeling, chest pain, irregular heartbeats, loss of movement;

• low potassium level--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling; or

• low levels of sodium--headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.

Common side effects of hydrochlorothiazide and quinapril may include:

• cough;

• headache, dizziness;

• tired feeling; or

• muscle pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your other medicines, especially:

• any other blood pressure medication;

• lithium;

• everolimus, sirolimus, temsirolimus;

• an antibiotic--demeclocycline, doxycycline, minocycline, eravacycline, omadacycline, sarecycline, tetracycline; or

• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may affect hydrochlorothiazide and quinapril, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.