Accuzide 20 Tablets / Film-coated
Hydrochlorothiazide + Quinapril
"20mg, 12.5mg"
PARKE DAVIS & CO.
Pack size | 30's (10's Blister x 3) |
---|---|
Dispensing mode | POM |
Source | GERMANY |
Agent | NEW MEDICAL CENTRE |
Retail Price | 66.00 AED |
Indications
Accuzide 20 Tablets / Film-coated is used for:
Hypertension
Adult Dose
Hypertension
Initial: 10 mg/12.5 mg or 20 mg/12.5 mg PO qDay
Increase either or both components based on clinical response
Do not increase hydrochlorothiazide component more often than q 2-3 weeks
To minimize dose-independent side effects, it is usually appropriate to initiate combination therapy only after inadequate response to quinapril monotherapy or significant potassium loss resulting from hydrochlorothiazide monotherapy
Child Dose
Renal Dose
Renal Impairment
CrCl >30 mL/min: No dosage adjustment
CrCl <30 mL/min/1.73 m² or serum creatinine ?3 mg/dL: Not recommended
Administration
Contra Indications
Hypersensitivity to either component or sulfonamides
History of hereditary or angioedema associated with previous ACE inhibitor treatment
Coadministration of neprilysin inhibitors (eg, sacubitril) with ACE inhibitors may increase angioedema risk; do not administer ACE inhibitors within 36 hr of switching to or from sacubitril/valsartan
Do not coadminister with aliskiren in patients with diabetes mellitus or with renal impairment (ie, GFR <60 mL/min/1.73 m²)
Precautions
Dual blockade of the renin angiotensin system with ARBs, ACE inhibitors, or aliskiren associated with increased risk for hypotension, hyperkalemia, and renal function changes (including acute renal failure) compared to monotherapy
May aggravate digitalis toxicity
Sensitivity reactions may occur with or without history of allergy or asthma
Risk of male sexual dysfunction
Renal impairment may occur
Acute transient myopia and acute angle-closure glaucoma has been reported, particularly with history of sulfonamide or penicillin allergy (hydrochlorothiazide is a sulfonamide)
Angioedema of the face, extremities, lips, tongue, glottis, and larynx has been reported in patients treated with angiotensin-converting enzyme inhibitors
If laryngeal stridor or angioedema of the face, tongue, or glottis occurs discontinue therapy and institute appropriate therapy immediately
Patients receiving coadministration of ACE inhibitor and mTOR (mammalian target of rapamycin) inhibitor (eg, temsirolimus, sirolimus, everolimus) therapy or a neprilysin inhibitor may be at increased risk for angioedema
Intestinal angioedema has been reported in patients treated with ACE inhibitors
Cholestatic jaundice may occur, which may progress to fulminant hepatic necrosis; discontinue
Dry hacking nonproductive cough may occur within few months of treatment; consider other causes of cough prior to discontinuation
Hyperkalemia may occur with ACE inhibitors; risk factors include renal dysfunction, diabetes mellitus, and concomitant use of potassium sparing diuretics and potassium supplements; use cautiously if at all with these agents
Thiazide diuretics may cause hypokalemia, hypochloremic alkalosis, hypomagnesemia, and hyponatremia
Hydrochlorothiazide may precipitate gout in patients with familial predisposition to gout or chronic renal failure
Symptomatic hypotension with or without syncope can occur with ACE inhibitors; mostly observed in volume depleted patients, correct volume depletion prior to initiation; monitor closely when initiating and increasing dosing
Agranulocytosis, neutropenia, or leukopenia with myeloid hypoplasia reported with other ACE inhibitor; patients with renal impairment are at high risk; monitor CBC with differential in these patients
Photosensitization may occur
Hydrochlorothiazide may cause acute transient myopia and acute angle-closure glaucoma that may occur within hours of initiating therapy; discontinue therapy immediately in patients with acute decreases in visual acuity or ocular pain; additional treatment may be needed if uncontrolled intraocular pressure persists
Use caution in patients with severe aortic stenosis; may reduce coronary perfusion resulting in ischemia
Use hydrochlorothiazide with caution in patients with diabetes or at risk of diabetes; may see increase in glucose
Use caution in patients collagen vascular disease, especially in patients with concomitant renal impairment
Thiazide diuretics may decrease renal calcium excretion; consider avoiding use in patients with hypercalcemia
Pregnancy-Lactation
Pregnancy Category: C (1st trimester); D (2nd & 3rd trimester)
Lactation: Excreted in breast milk, use caution
Interactions
Adverse Effects
Side effects of Hydrochlorothiazide + Quinapril :
No adverse effects specific to the combination have been observed; adverse effects limited to those previously reported with quinapril and hydrochlorothiazide
Quinapril
1-10%
Dizziness (4-8%)
Headache (2-6%)
Cough (2-4%)
Hyoptension (3%)
Fatigue (3%)
Hyperkalemia (2%)
Chest pain (2%)
Nausea/vomiting (1-2%)
Rash (1%)
Hyperkalemia (2%)
Myalagia (2-5%)
Back pain (1%)
Frequency Not Defined
Angioedema
Acute renal failure
Alopecia
Angina
Pancreatitis
Hyperkalemia
Hydrochlorothiazide
Frequency Not Defined
Anorexia
Epigastric distress
Hypotension
Orthostatic hypotension
Photosensitivity
Anaphylaxis
Anemia
Confusion
Erythema multiforme
Stevens-Johnson syndrome
Exfoliative dermatitis including toxic epidermal necrolysis
Hypomagnesemia
Dizziness
Headache
Hyperuricemia
Mechanism of Action
Accuretic is a fixed-combination tablet that combines an angiotensin-converting enzyme (ACE) inhibitor, quinapril hydrochloride, and a thiazide diuretic, hydrochlorothiazide
Quinapril competitively inhibits angiotensin-converting enzymes resulting in decreased plasma angiotensin II concentrations and consequently, blood pressure may be reduced in part through decreased vasoconstriction, increase renin activity, and decrease aldosterone secretion
Hydrochlorothiazide is a thiazide diuretic that inhibits Na reabsorption in distal renal tubules resulting in increased excretion of Na+ and water, also K+ and H+ ions
Note
Accuzide 20 "20mg, 12.5mg" Tablets / Film-coated manufactured by PARKE DAVIS & CO.. Its generic name is Hydrochlorothiazide + Quinapril. Accuzide 20 is availble in United Arab Emirates.
Farmaco UAE drug index information on Accuzide 20 Tablets / Film-coated is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.