Angiotensin-converting Enzyme - ACE Inhibitors and Hydrochlorothiazide : Before Using

Angiotensin-converting Enzyme - ACE Inhibitors and Hydrochlorothiazide - Systemic

Angiotensin-converting Enzyme - ACE Inhibitors and Hydrochlorothiazide *** Before Using *** How to Use *** Fore Safe Use *** Side Effects *** Additional Information

Before Using

In deciding to using a medication, the chance of taking the drug must be weighed against the good it will do. This is a decision you will make. For the angiotensin-converting enzyme - ACE inhibitors and hydrochlorothiazide, the following must be considered

Allergic reaction

Tell your family doctor if you have any unusual or allergy to benazepril, enalapril, captopril, lisinopril, moexipril, quinapril, sulfonamides - sulfa drugs, bumetanide, furosemide, acetazolamide, dichlorphenamide, or methazolamide or to hydrochlorothiazide or any of the other thiazide diuretics - water pills. Also tell your health care professional if you are allergic to any other substances, such as foods, sulfites or other preservatives, or dyes.

Pregnancy care

Studies with this combination drug have not been done in pregnant women. However, use of any of the ACE inhibitors during pregnancy, especially in the second and third trimesters - after the first three months, can cause low blood pressure, kidney failure, too much potassium, or even death in newborns Therefore, it is important that you check with your family doctor immediately if you think that you may be pregnant . Be sure that you have discussed this with your family doctor before taking this drug. In addition, if your drug contains:

Benazepril Studies in rats, mice and rabbits at doses up to 300 times the recommended human dose showed no evidence of birth defects.
Captopril Studies in rabbits and rats at doses up to 400 times the recommended human dose have shown that captopril causes an increase in death of the fetus and newborn. Always captopril has causing deformed skulls in the offspring of rabbits given doses 2 to 70 times the recommended human dose.
Enalapril Studies in rats at doses many times the recommended human dose have shown that use of enalapril causes the fetus to be smaller than normal. Studies in rabbits have shown that enalapril causes an increase in fetal death. Enalapril has not been shown to cause birth defects in rats or rabbits.
Lisinopril Studies in mice and rats at doses many times the recommended human dose have shown that use of lisinopril causes a decrease in successful pregnancies, a decrease in the weight of infants, and an increase in infant deaths. It has also causing a decrease in successful pregnancies and abnormal bone growth in rabbits. Lisinopril has not been shown to cause birth defects in mice, rats, or rabbits.
Moexipril Studies in rats and rabbits did not show moexipril to cause birth defects.
Quinapril Studies in rats showed quinapril causing reduced body weights but did not show it to cause birth defects in either rats or rabbits.
Hydrochlorothiazide Hydrochlorothiazide has not been shown to cause birth defects or other problems in animal studies. However, when hydrochlorothiazide is using during pregnancy, it may cause side effects including jaundice, blood problems and low potassium in the newborn baby.

Breast-feeding problem

Benazepril Passes into breast milk. However, this drug has not been reported to cause problems in nursing babies.
Captopril Passes into breast milk. However, this drug has not been reported to cause problems in nursing babies.
Enalapril Passes into breast milk. However, this drug has not been reported to cause problems in nursing babies.
Lisinopril It is not known whether lisinopril passes into breast milk. However, this drug has not been reported to cause problems in nursing babies.
Moexipril It is not known whether moexipril passes into breast milk. However, this drug has not been reported to cause problems in nursing babies.
Quinapril Passes into breast milk. However, this drug has not been reported to cause problems in nursing babies.
Hydrochlorothiazide Passes into breast milk. However, this drug has not been reported to cause problems in nursing babies.

Use for Children

Children may be especially sensitive to the blood pressure-lowering effect of ACE inhibitors. This may increase the risk of side effects or other problems during treat. Extra caution may be necessary when using hydrochlorothiazide in infants with jaundice because it can make this condition worse. Therefore, it is especially important that you discuss with the child's family doctor the good that this drug may do as well as the chance of using it.

Elderly care

Dizziness or lightheadedness and symptoms of too much potassium loss may be more likely to occur in the elderly, who may be more sensitive to the effects of this drug.

Drug interactions

Although certain medication must not be using together at all, in other cases two various medication may be using together even if an interaction might occur. In these cases, your family doctor may want to change the dose, or other precautions may be necessary. When taking ACE inhibitors and hydrochlorothiazide it is especially important that your health care professional know if you are taking any of the following:

Cholestyramine
Colestipol Use with thiazide diuretics may prevent the diuretic from help you; the diuretic must be taken at least 1 hour before or 4 hours after cholestyramine or colestipol

Diabetes medication - insulin or tablets Blood sugar levels may change; extra care in self monitoring is necessary

Digitalis glycosides - heart drug If potassium levels in the body are decreased, symptoms of digitalis toxicity may occur

Diuretics - water pills Effects on blood pressure may be increased

Lithium - Lithane chance of lithium overdose, even at low doses, may be increased

Potassium-containing medication or supplements
Salt substitutes
Low-salt milk Use of these substances with ACE inhibitors may result in an unusually high potassium level in the blood, which can lead to heart rhythm and other problems

Tetracycline Use with quinapril will decrease the effects of tetracycline

Other Information for using

The presence of other medical problems may effect the use of the ACE inhibitors. Make sure you tell your family doctor if you have any other medical problems, especially:

Diabetes mellitus - sugar diabetes Increased risk of potassium levels in the body becoming too high

Gout - or history of Hydrochlorothiazide may increase the amount of uric acid in the body, which can lead to gout

Heart or blood vessel disease
Heart attack or stroke - recent Lowering blood pressure may make problems resulting from these conditions worse

Kidney disease
Liver disease Effects may be increased because of slower removal from the body

Kidney transplant Increased risk of kidney disease causing by ACE inhibitors

Pancreatitis - inflammation of the pancreas Hydrochlorothiazide can make this condition worse

Systemic lupus erythematosus - SLE - or history of Hydrochlorothiazide may worsen the condition and there is an increased risk of blood problems causing by ACE inhibitors

Previous reaction to benazepril, captopril, enalapril, lisinopril, moexipril, or quinapril involving hoarseness; swelling of face, mouth, hands, or feet; or sudden trouble in breathing Reaction is more likely to occur again