Warnings and Precautions With Quinaretic

• There are a number of medicines that may interact with Quinaretic (see Drug Interactions With Quinaretic).
   
• Quinaretic is more likely than other drugs to cause allergic reactions. For example, there have been reports of severe allergic reactions occurring in people who were taking Quinaretic during dialysis. There have also been reports of severe reactions in people getting bee or wasp venom to protect against stings. Finally, people with a history of asthma or allergies are more likely to have an allergic reaction to Quinaretic. 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.

• Medicines like Quinaretic that contain an ACE inhibitor may cause swelling (angioedema) of the head and neck, including the tongue, lips, eyes, or throat. This occurs more frequently in African Americans than in Caucasians. Seek emergency medical care immediately if you notice swelling in the head or neck area, experience wheezing, or have difficulty breathing or swallowing.
   
• In addition to head and neck angioedema, medicines like Quinaretic have also been known to cause swelling in the intestines. This is known as intestinal angioedema. Symptoms may include, but are not limited to, abdominal pain (or stomach pain) with or without vomiting. Seek medical attention immediately if you develop any of these symptoms.
   
• Quinaretic may cause extreme low blood pressure in some people. Extreme low blood pressure is more likely to occur when people first start taking Quinaretic or when the dosage is changed. It is also more likely to happen in people who are taking a diuretic, are on dialysis, have congestive heart failure, have diarrhea or vomiting, or sweat a lot. This is why it is important to drink fluids regularly while taking Quinaretic. If you have any possible symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting, contact your healthcare provider. If you have fainted, stop taking Quinaretic until you have talked to your healthcare provider.

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

• People on Quinaretic can be at increased risk of infections. Talk to your healthcare provider if you develop any infections, such as a sore throat or fever.
   
• Quinaretic is a pregnancy Category C medicine for the first trimester and a pregnancy Category D medicine for the second and third trimesters, meaning that it 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 Quinaretic, contact your healthcare provider immediately (see Accuretic and Pregnancy for more information).
   
• Medicines like Quinaretic that contain an ACE inhibitor are known to cause a cough. If a cough becomes bothersome, talk to your healthcare provider about alternate options for your condition (see Accupril Cough).
   
• While taking Quinaretic, do not use potassium supplements or salt substitutes with potassium unless you have discussed this with your doctor. In some people taking Quinaretic, potassium in the blood can increase or decrease to dangerous levels.

• Drugs that contain hydrochlorothiazide, including this medication, can sometimes cause a potentially dangerous eye reaction (a particularly dangerous type of glaucoma). This reaction usually occurs within days to weeks of starting the drug. Because this reaction can permanently damage vision, let your healthcare provider know right away if you develop vision changes and/or eye pain. The main treatment for this reaction is to stop taking this medication, although other treatment, including surgery, may sometimes be necessary. 

• This medication may cause a decrease in kidney function, especially in people who:
 
• Are elderly
• Have kidney disease
• Have severe congestive heart failure (CHF)
• Are taking nonsteroidal anti-inflammatory drugs (NSAIDs) or diuretics (water pills). 

Your healthcare provider may choose to monitor your kidney function with a blood test while you are taking it. Contact your healthcare provider if you notice a decrease in urination or swelling in your hands, legs, ankles, or feet, which can be signs of kidney problems.

• In clinical studies, medicines that contain an ACE inhibitor, including Quinaretic, 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 stomach pain), or flu-like symptoms.
   
• Quinaretic may affect electrolytes in the blood (including sodium, potassium, magnesium, and chloride). Therefore, your healthcare provider will regularly check these levels. If you notice any symptoms of a possible electrolyte imbalance, contact your healthcare provider. These symptoms may include: a dry mouth, increased thirst, weakness, tiredness, restlessness, seizures, confusion, muscle pain or cramps, decrease in urine output, weak or irregular heartbeat, nausea, or vomiting.
   
• Because of the hydrochlorothiazide it contains, Quinaretic is more likely to worsen systemic lupus erythematosus or, in some cases, even cause the condition.
   
• Because of the hydrochlorothiazide in Quinaretic, the medication is also known to worsen gout.
   
• Quinaretic may cause high blood sugar (hyperglycemia) in people with diabetes or, in some cases, even cause diabetes in people without a history of the condition.
   
• Quinaretic may increase levels of cholesterol and triglycerides in the blood.
   
• Quinaretic passes through breast milk. If you are nursing, talk with your healthcare provider about whether you should discontinue Quinaretic or stop breastfeeding.