Accupril Precautions and Warnings (Cont.)

• There are a number of medicines that Accupril can interact with (see Accupril Drug Interactions).
   
• ACE inhibitors are more likely than other drugs to cause allergic reactions. For example, there have been reports of severe allergic reactions occurring in people on Accupril during dialysis. There have also been reports of severe reactions in people getting bee or wasp venom to protect against stings.
   

Make sure to discuss these risks with your healthcare provider. Also, seek emergency medical attention immediately if you notice things such as hives, an unexplained rash, difficulty breathing, or swelling of the face or throat.

• ACE inhibitors may cause swelling (angioedema) of the head and neck, including the tongue, lips, eyes, or throat. This occurs more frequently in African Americans. Seek emergency medical care immediately if you notice swelling in the head or neck area, or if you have wheezing or difficulty breathing or swallowing.
   
• In addition to head and neck angioedema, ACE inhibitors have been known to cause swelling in the intestines. This is known as intestinal angioedema. Symptoms may include but are not limited to stomach pain with or without vomiting. Seek medical attention immediately if you develop any of these symptoms.
   
• Accupril may cause extreme low blood pressure in some people. Extreme low blood pressure is more likely to happen in people who are taking a diuretic, who are on dialysis, who have diarrhea or vomiting, or who sweat a lot. This is why it is important to drink fluids regularly while taking Accupril. If you have any possible symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting, contact your healthcare provider and stop taking the medicine.
   

Also, make sure not to drive, operate any heavy machinery, or perform any other tasks that require alertness before you know how Accupril affects you.

• Accupril is a pregnancy Category C medicine for the first trimester and a pregnancy Category D medicine for the second and third trimesters, meaning that Accupril has health risks to your unborn child. Let your healthcare provider know if you are pregnant or thinking of becoming pregnant. If you become pregnant while taking Accupril, contact your healthcare provider immediately (see Accupril and Pregnancy for more information).
   
• ACE inhibitors, including Accupril, are known to cause a cough. If a cough becomes bothersome, talk with your healthcare provider about alternate treatment options for your condition (see Accupril Cough).
   
• While taking Accupril, do not use potassium supplements or salt substitutes with potassium unless you have discussed this with your doctor. This is because in some people taking Accupril, potassium in the blood can increase to dangerous levels.
   
• People on Accupril can be at increased risk of infections. Talk with your healthcare provider if you develop any infections, such as a sore throat or fever.
   
• If you are over 65 years old, your healthcare provider may choose to make any necessary dosing adjustments with caution.
   
• ACE inhibitors, including Accupril, have been known to cause a decrease in kidney function, especially in certain groups such as those with severe congestive heart failure. Let your healthcare provider know if you have symptoms such as a decrease in urine output, drowsiness, headache, or back pain. Your healthcare provider will also regularly check your kidney function with a blood test.
   
• If you have kidney disease or kidney failure, your body may metabolize the Accupril differently than intended. Therefore, your healthcare provider will monitor your situation more closely.
   
• In clinical studies, ACE inhibitors, including Accupril, have rarely been known to cause liver failure. Contact your healthcare provider immediately if you notice things such as nausea, tiredness, lethargy, itchy or yellowing skin, abdominal pain, or flu-like symptoms.
   
• It is not known whether or not Accupril passes through breastmilk. Therefore, if you are nursing, talk with your healthcare provider about whether you should stop Accupril or stop breastfeeding.