Dual RAS blockade increases risks of hypotension, hyperkalemia, and acute renal failure. Contraindicated in diabetes; avoid in renal impairment (GFR <60).
Source: NLP:quinapril hydrochloride/hydrochlorothiazide
Quinapril Hydrochloride/Hydrochlorothiazide Interactions
Brand names: Quinapril Hydrochloride/Hydrochlorothiazide
Thiazide Diuretic
Route: Oral
FDA Black Box Warning
WARNING: FETAL TOXICITY When pregnancy is detected, discontinue quinapril and hydrochlorothiazide as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus. See WARNINGS: Fetal Toxicity
Contraindications
CONTRAINDICATIONS Quinapril and hydrochlorothiazide tablets are contraindicated in patients who are hypersensitive to quinapril or hydrochlorothiazide and in patients with a history of angioedema related to previous treatment with an ACE inhibitor. Quinapril and hydrochlorothiazide tablets are contraindicated in combination with a neprilysin inhibitor (e.g., sacubitril). Do not administer quinapril and hydrochlorothiazide tablets within 36 hours of switching to or from sacubitril/valsartan, a neprilysin inhibitor (see WARNINGS and PRECAUTIONS ). Because of the hydrochlorothiazide components, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. Do not co-administer quinapril and hydrochlorothiazide tablets with aliskiren: in patients with diabetes.
7 interactions on record
Increased serum lithium levels and symptoms of lithium toxicity reported with ACE inhibitors; thiazides further reduce lithium renal clearance, increasing toxicity risk.
Source: NLP:quinapril hydrochloride/hydrochlorothiazide
Nitritoid reactions (facial flushing, nausea, vomiting, hypotension) reported rarely with injectable gold and concomitant ACE inhibitor therapy.
Source: NLP:quinapril hydrochloride/hydrochlorothiazide
Drug Interactions Agents Increasing Serum Potassium Coadministration of quinapril and hydrochlorothiazide with other drugs that raise serum potassium levels may result in hyperkalemia. Because renal clearance of lithium is reduced by thiazides, the risk of lithium toxicity is presumably raised further when, as in therapy with quinapril and hydrochlorothiazide, a thiazide diuretic is coadministered with the ACE inhibitor. Quinapril and hydrochlorothiazide and lithium should be coadministered with caution, and frequent monitoring of serum lithium levels is recommended.
Source: FDA drug label - quinapril hydrochloride/hydrochlorothiazide
Drug Interactions Agents Increasing Serum Potassium Coadministration of quinapril and hydrochlorothiazide with other drugs that raise serum potassium levels may result in hyperkalemia. Because renal clearance of lithium is reduced by thiazides, the risk of lithium toxicity is presumably raised further when, as in therapy with quinapril and hydrochlorothiazide, a thiazide diuretic is coadministered with the ACE inhibitor. Quinapril and hydrochlorothiazide and lithium should be coadministered with caution, and frequent monitoring of serum lithium levels is recommended.
Source: FDA drug label - quinapril hydrochloride/hydrochlorothiazide
Simultaneous administration reduces tetracycline absorption by 28-37%, possibly due to high magnesium content in quinapril tablets.
Source: NLP:quinapril hydrochloride/hydrochlorothiazide
Other Agents Drug interaction studies of quinapril and other agents showed: Multiple dose therapy with propranolol or cimetidine has no effect on the pharmacokinetics of single doses of quinapril.
Source: FDA drug label - quinapril hydrochloride/hydrochlorothiazide