Quinapril belongs to the Group of ACE inhibitors. It reduces the production of the high blood pressure-enhancing substance angiotensin in the body. So is also the name of its active ingredient group: ACE inhibitors = angiotensin-converting-enzyme inhibitors. Quinapril reduces blood pressure directly and indirectly leads to an increased water excretion through the kidneys. Together with hydrochlorothiazide increases the blood pressure lowering effect.
Hydrochlorothiazide belongs to the Thiaziden and thiazide drainage equipment. Like all active substances of this group, it acts directly on the kidneys and increases the excretion of water there. By inhibition of transport system for sodium and chloride in the kidney cells is increased salt (sodium + chloride) and in addition water is excreted. To reduce water retention in the connective tissue.
Also, it should be noted that increase the concentration of potassium in the body can be Quinapril, hydrochlorothiazide reduces however. In combination, the potassium concentration is reduced. Regular medical checks of blood potassium value are therefore required.
Warnings and precautions
Before and during the treatment, kidney function must be controlled.
The treatment with the drug should be tightly controlled in the insulin-dependent diabetics.
The drug works in older patients more, this group of patients should be monitored regularly.
The drug can cause birth defects in pregnancy.
During the treatment with the drug, a pregnancy is to prevent reliably.
During the treatment with the drug, the patient to a sufficient fluid intake should be careful.
Duration of therapy requires regular medical checks of all the important laboratory parameters (urea, creatinine, potassium, sodium, urine protein, bilirubin, liver enzymes).
In the event of dizziness, nausea and weakness should the patient temporarily lying down and the legs high store.
The drug could cause a positive in a doping test.
Occurrence of jaundice (jaundice) or sharp increase in liver enzymes therapy is to cancel. Patients need to be monitored by doctors.
In the event of angioneurotischen oedema (swelling of face, lips, tongue, larynx, mucous membranes, eyes), the therapy is to cancel and a doctor must be consulted.
There is an increased alcohol effect, therefore should during treatment alcohol be avoided.
Alcohol enhances the blood pressure lowering effect.
The responsiveness can degrade.
One drawback in machine operation is possible.
One drawback of the participation in the active transport is possible.
Working without a firm grip can be affected.
Remedy ingredients sometimes trigger allergic reactions. Should you perceive signs of an allergic reaction, so you tell your doctor or pharmacist promptly.
What interactions show Quinapril + hydrochlorothiazide?
It is important to note that the interactions can be different depending on the pharmaceutical form of a drug (for example, Tablet, syringe, ointment).
Since Quinapril + hydrochlorothiazide is a combination of two individual active substances, the interaction of both individual substances must be observed!
Following interactions with Quinapril can occur:
Immunosuppressive drugs (means of oppression or weakening the immune response) increase the risk of the occurrence of changes in blood count. Allopurinol (active substance against Gichtanfälle), cytotoxic drugs (cell wachstumshemmende substances), glucocorticoids, and procainamide (active ingredient against cardiac arrhythmia) accelerating changes in the blood count. Regular blood count checks are recommended.
Nonsteroidal reduce the lowering of blood pressure drugs, anti-inflammatory drugs (kortison free anti-inflammatory painkillers) and salt. Anaesthetic and antihypertensives (mean for high blood pressure) increase, however, the lowering of the blood pressure. An individual dose adjustment by the attending physician and close blood pressure checks are required.
Medicines (such as heparin) causing potassium and potassium-sparing Entwässerungsmittel (such as spironolactone, amiloride, triamterene), as well as excess of potassium increase the potassium concentration. Therefore, regular blood potassium checks are recommended.
In addition a combination with lithium (drugs) is not recommended because delayed excretion of lithium. These patients need to be monitored by doctors.
Acrylic fiber methallylsulfonat-high-flux membranes (used in dialysis), Dextransulfat (inserted at the Blutwäsche in strongly increased lipids, LDL Apheresis) and insecticides in the context of desensitization therapy increase the risk for the occurrence of allergic reactions to the shock.
Still, the co-administration of Quinapril and blood sugar-lowering pills and insulin reinforced lower the blood sugar. Close blood glucose control and an individual dose adjustment by the treating physician are recommended in these patients.
It is also important to ensure that the effect of alcohol is reinforced with concurrent administration of Quinapril. Therefore should be avoided during treatment alcohol consumption.
Following interactions with hydrochlorothiazide may occur:
Together with hypotensive means, dewatering agents, beta-blockers (heart beat verlangsamende effect), nitrates, vasodilator means, tranquilizers, phenothiazines (drugs), tricyclic antidepressants (combat depression) and alcohol, the blood pressure lowering effect is reinforced by hydrochlorothiazide. Therefore, regular blood pressure checks and an individual dose adjustment by the doctor is needed.
When ACE inhibitors, an exuberant drop in blood pressure, as well as a deterioration of in renal function is possible. These patients need to be monitored closely by doctors.
Also reduce nonsteroidal anti-inflammatory drugs (kortison free inflammation-inhibiting pain) and drugs the water tract and blood pressure lowering effect of hydrochlorothiazide. Regular monitoring of reoccurrence by the physician is necessary.
Hydrochlorothiazide has many effects on other drugs. Among other things, the toxic effect is reinforced by high-dose Salicylates (pain killer) on the central nervous system. Still, the effect decreases of blood sugar-lowering pills. The effect of uric acid reducing drugs is also reduced. As well, the effect of the Sympathomimetics like epinephrine or norepinephrine (means the activation of the sympathetic nervous system) is weakened. All of these patients need to be monitored very closely by doctors, and the dose is individually adjusted by the attending physician.
Also be reinforced the effects and side effects of heart glykosiden (used in heart muscle weakness) in potassium or magnesium deficiency.
Laxatives and glucocorticoids lead to increased excretion of potassium. The toxic effect of lithium (Psychopharmka) is also increased. Therefore, regular blood checks of the relevant laboratory values by the physician are required.
The effect of curare-like muscle relaxants (means of muscle slacking) reinforced and extended.
Reduces the excretion of quinidine (means against cardiac arrhythmia). Side effects could occur more and more.
Cytostatics (cell wachstumshemmende substances) such as cyclophosphamide, fluorouracil and methotrexate have increasingly toxic on the bone marrow. Regular check-ups by the doctor are necessary.
Also reduced the intake of cholesterol lowering colestipol and cholestyramine. A dosage adjustment may be necessary. The doctor will decide individually.
The following gives details of contra-indications for the purposes of Quinapril + hydrochlorothiazide in General, pregnancy & lactation, and children. It is important to note that the contra-indications can be different depending on the pharmaceutical form of a drug (for example, Tablet, syringe, ointment).
When must Quinapril + hydrochlorothiazide is not used?
Since Quinapril + hydrochlorothiazide is a combination of two individual active substances, the contra-indications of both individual substances must be respected.
Quinapril should not be given a caused allergic reaction with swelling of the skin and mucous membrane (angioneurotic oedema, Quincke’s oedema) in the preliminary Krankengeschichte of the patient and a hypersensitivity to Quinapril or other ACE inhibitors.
The gift of Quinapril is forbidden in bilateral renal artery reduction (renal artery stenosis) or unilateral renal artery reduction during a single kidney and after a kidney transplant. Concomitant use of Quinapril and Poly(acrylnitril,_natrium-2-methallylsulfonat) high-flux membranes (during dialysis used) is not allowed.
Quinapril should be prescribed not for primary hyperaldosteronism (the hormone excreted of kidney disorder). Here, ACE inhibitors are ineffective.
Also, this active substance not at heart-related shock, heart valve reduction with influence on the circulation (Mitralklappen-or aortic stenosis), and pathological enlargement of the heart muscle (hypertrophic cardiomyopathy) with restricted blood out flow from the heart may be administered.
The use of Quinapril also exclude liver disease or severe liver dysfunction such as hepatic coma and liver failure. Continue this active substance may be used not in very severe renal impairment (with creatinine clearance below 10 millilitres per minute), Blutwäsche (dialysis) and known brain blood flow disorder.
Additional contraindications for Quinapril are LDL Apheresis with Dextransulfat in the context of a blood cleansing of cholesterol and other therapies, which can cause blood in contact with negatively charged surfaces. In addition, treatment with Quinapril not in importance at the same time Desensibilierungstherapie with insecticides may be.
In moderate renal impairment (with creatinine clearance below 30 ml per minute), elevated urine protein (about one gram per day), blood salt disorders (disorders of electrolyte) and patients with impaired immune response or connective tissue remodeling diseases Quinapril may be applied only after very critical medical risk benefit. Regular monitoring by the attending physician is required. The same is true for acute myocardial infarction.
The use of Quinapril should be reconsidered critically at concurrent therapy with drugs, which suppress the immune reaction, and allopurinol (Gichtmittel), procainamide (means against cardiac arrhythmias) or lithium (combat depression). The doctor will individually decide on a treatment in these cases.
Quinapril can carefully after medical assessment of benefit and risk as well as appropriate medical supervision in salt and fluid deprivation, impaired renal function (with creatinine clearance 30 to 60 ml per minute), heavy (and kidney-related) high blood pressure, very severe heart muscle weakness and be applied in patients over 65 years of age. Closely during treatment by the doctor to monitor the blood pressure and the relevant laboratory values.
Contra-indications of hydrochlorothiazide: hydrochlorothiazide should not be given during hypersensitivity to the active substance or other thiazides or sulfonamides.
In severe renal impairment, acute Nierenkörperchenentzündung, liver failure coma as well as potassium deficiency, lack of sodium, low blood volume, excess of calcium and also with gout taking hydrochlorothiazide is also forbidden.
Considered relative contra-indications for treatment with hydrochlorothiazide are low blood pressure, cerebral blood flow disorder, coronary artery reduction, diabetes, mild renal impairment, and a liver functional constraint. In these cases, the doctor will decide individually on a therapy.
What must you consider when pregnancy and breast-feeding?
The use of the combination Quinapril + hydrochlorothiazide is strictly prohibited during pregnancy and lactation. Both ingredients have proven to have negative effects on the unborn or breastfed child.
Becoming aware of pregnancy during treatment with this combination must them promptly from the attending physician deposed and replaced by an other blood pressure lowering. Also when planning a pregnancy, the treatment should be converted at an early stage. The doctor decides individually about an alternative treatment.
Breastfeeding beyond the combination into breast milk. Treatment is an urgent need during breastfeeding off must cater for the patient.
What is taken into account in children?
The combination should not be used in children. No sufficient experience exist in this age group.
What side effects can Quinapril + hydrochlorothiazide have?
Below, you will learn the most important thing possible, well-known side effects of Quinapril + hydrochlorothiazide. These side effects should not occur, but can. Because everyone reacts differently to medications. Please also note that the side effects in type and frequency can vary depending on the pharmaceutical form of a drug (for example, Tablet, syringe, ointment).
Da Quinapril + hydrochlorothiazide is a combination of two individual drugs, the side effects of both individual substances must be respected.
Common side effects of Quinapril: dizziness, weakness, visual disturbances (rarely with loss of consciousness without apparent cause), renal impairment (rarely up to renal failure), dry tickly, inflammation of the bronchial mucous membrane (bronchitis), nausea, upper abdomen pains, indigestion, headache, fatigue, drowsiness, reduced concentration of Red hemoglobin.
Uncommon side effects of Quinapril: excessive lowering of blood pressure, waste of the share of the cellular shares in blood, waste of white blood cells, platelets reduction, extending the transition period and reconciliation failures of Atrium and ventricle (AV block II. and III. degree), drop in blood pressure, protein excreted in the urine (partly with situations weaken kidney function), shortness of breath, sinus infection, runny nose, vomiting, diarrhea, constipation, loss of appetite, pancreatitis, allergic reaction with Exantheme, redness and itching.
Rare side effects of Quinapril: loss of consciousness, swoon without apparent cause deterioration in kidney function, Nasenschleimhautentzündung, swelling of the vessel with the participation of the lips, face, larynx or arms and legs; Drowsiness, depression, sleep disorders, impotence, abnormal sensations of the skin, loss of balance, confusion, ringing in the ears, visual disturbances, alteration in flavor, temporary loss of taste, anaemia, platelets waste, waste of polymorphonuclear and Eosinophilic granulocytes (special cells of the body defense), blood urea increased, blood creatinine elevations climbing, blood potassium increase, blood sodium waste, shock heart-related conditions, blistering of the skin, beginning jaundice (bile accumulation) increased up to the Leberzelluntergang possibly with fatal outcome (unclear relation to taking Quinapril), hives, skin rash with severe disorder of Allgemeinbefindens.
Very rare side effects and individual cases of Quinapril: heart palpitations, medical…, chest pain, cardiac arrhythmia, angina, heart attack, body feeling of the heart, precursors of stroke, stroke, acute renal failure, spasm of the respiratory tract muscles, conditional allergic lung disease and pneumonia, inflammation of the tongue, dry mouth, inflammation of the liver, hepatic, intestinal obstruction, serious drug-related lesions, fever, muscle pain, joint pain, arthritis, possibility, increase of white blood cells, high ANA titre (antibodies to components of the cell nucleus), psoriasis-like lesions, bubble-like skin lesions, skin reactions, rash with skin separation, Light sensitivity, hair loss, nail separation by Gefäßkrämpfe conditional attacks reduced supply of the fingers (Raynaud’s syndrome), blood bilirubin level increases, liver enzyme increase, liver dysfunction, inflammation of the liver, waste of all granulocytes (special cells of the body defense), waste of all blood cells (especially in patients with impaired renal function, binding tissue remodeling diseases or concurrent therapy with the uric acid-lowering drug allopurinol, procainamide heartbeat-regulating active substance or certain medicines that suppress the immune reactions), potassium increase in destruction of red blood cells with anaemia, diabetes, breast enlargement, increased sweating, increased erythrocyte sedimentation rate, resolution/breakdown of red blood cells.
Special features of Quinapril: in patients with cardiac insufficiency of blood pressure can fall off during treatment massively. This would have a reduced urine output, a blood from acidifying, a kidney failure and possibly the death. Therefore, these patients must be monitored very closely by the attending physician.
In particular for pre bestehendem gallstone, an acute inflammation of the gallbladder can occur.
In patients with renal impairment, the concentrations of blood urea, creatinine and potassium can rise and fall off the blood concentration of sodium. Blood values must be controlled by the doctor that is why prior to treatment and periodically during treatment.
On the suspicion of a serious reaction the attending physician must be sought immediately. The therapy is possibly to cancel and switch.
On occurrence of jaundice, or a significant increase in liver enzymes, the treatment is to end. Patients need to be monitored by doctors.
Dizziness, nausea and weakness should the patient temporarily lying down and the legs Highland.
Common side effects of hydrochlorothiazide: increased concentration of uric acid (hyperuricemia), potassium deficiency, blood sugar rise, urine sugar output, deterioration, or creation of a diabetes, increase of the blood lipid disturbances in the fluid balance, changes in blood salt budget, lack of potassium, sodium deficiency, lack of chlorine, calcium excess, lack of blood volume, magnesium excretion increased in the urine.
Uncommon side effects of hydrochlorothiazide: magnesium deficiency, urine urea increase, urine creatinine elevations climbing, increase in certain digestive enzymes (proteins) in the blood, pancreatitis, loss of appetite, nausea, vomiting, diarrhea, pain, stomach cramps, dry mouth, thirst, weakness, dizziness, muscle pain, muscle spasms, leg cramps, headaches, nervousness, medical…, drop in blood pressure, errors in district history regulation, increase in the share of cellular components in the blood.
Rare effects of hydrochlorothiazide: itching, rash, light sensitivity deflection, skin bleeding, hives, drug fever, jaundice, nephritis, possibility, platelets waste, potency disorders, vision problems, blurred vision, yellow marriages, limited formation of lacrimal, pneumonia, water accumulation in the lungs, shock (allergic cause suspected), convulsions, drowsiness, confusional, circulatory collapse, renal failure, partial or complete occlusions.
Very rare side effects and individual cases of hydrochlorothiazide: Syndrome of verbrühten skin to the skin setting with serious general manifestations, waste of white blood cells, connective tissue conversion disorder, litter of all granulocytes (special cells of the body defense), anaemia.
Adverse effects without specifying the frequency of hydrochlorothiazide: ECG changes, increased sensitivity to Herzglykosidse, gout anfälle, inflammation of the gall bladder (in the case of the pre-existing gallstones), deterioration of short-sightedness, potassium deficiency, fatigue, drowsiness, muscle weakness, abnormal sensations of the skin, paralysis, apathy, constipation, bloating, cardiac rhythm disorders, intestinal obstruction, impairment of consciousness, coma, increase the pH of the body.