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Accuretic 10/12.5mg

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PACKAGE LEAFLET: INFORMATION FOR THE USER


Accuretic™ 10/12.5mg Tablets

quinapril hydrochloride and hydrochlorothiazide

Important things that you SHOULD know about your medicine:

•    Accuretic is a treatment for high blood pressure.

•    Read all of this leaflet carefully before you start taking this medicine.

•    Keep this leaflet. You may need to read it again.

•    This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.

•    You should take Accuretic regularly to get the maximum benefit, even if you are feeling well.

•    Most people do not have serious problems when taking Accuretic but side effects can occur - see Section 4 for details. If you experience swelling of the face, tongue or throat, see your doctor immediately. If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

•    Taking other medicines may sometimes cause problems. Check with your doctor or pharmacist before taking this or any other medicines.

•    If you are pregnant, trying to become pregnant or are of child bearing potential and not using adequate contraception, do not take Accuretic and tell your doctor.

Please read the rest of this leaflet. It includes other important information on the safe and effective use of this medicine

that might be especially important to you. If you have any further questions, ask your doctor or pharmacist.



In this leaflet:

1.    What Accuretic is and what it is used for

2.    Before you take Accuretic

3.    How to take Accuretic

4.    Possible side effects

5.    How to store Accuretic

6.    Further information

i.What Accuretic is and what it is used for

Accuretic is used to treat high blood pressure.

Accuretic contains the active ingredients quinapril and hydrochlorothiazide. Quinapril belongs to a group of medicines called angiotensin converting enzyme (ACE) inhibitors. ACE inhibitors work by widening blood vessels in the body, which can help to reduce the pressure in the vessels. Hydrochlorothiazide belongs to a group of medicines called diuretics. Diuretics help the body to get rid of extra fluid and are used in patients with high blood pressure. Because they get rid of fluid diuretics are sometimes called ‘water tablets’.

2. Before you take Accuretic

•    Do not take Accuretic

•    If you ever had a reaction to Accuretic, any of its ingredients, similar drugs or to a group of antibiotics called sulphonamides.

•    If you are pregnant, trying to become pregnant, or are of child bearing potential and are not using adequate contraception.

•    If you have kidney disease or are experiencing problems passing water (anuria).

•    If you have an obstruction in your heart that slows blood in the heart.

•    If you have hereditary (inherited)/idiopathic (unknown cause) angioneurotic oedema (a swelling of the face, tongue or throat which causes difficulty breathing).

•    If you have a history of angiooedema relating to previous treatment with an ACE inhibitor.

•    If you have diabetes or impaired kidney function and you are treated with a blood pressure lowering medicine containing aliskiren.

   Warnings and precautions

Talk to your doctor or pharmacist before taking Accuretic.

If any of the following statements applies to you, and you

have not already discussed the matter with your doctor,

you must contact your doctor before taking Accuretic, as

this medicine may not be suitable for you:

•    You have aortic stenosis (narrowing of the main blood vessel from the heart)

•    You have kidney disease or use a haemodialysis machine (an artificial kidney)

•    You have liver disease

•    You have heart disease

•    You are elderly

•    You have collagen vascular disease (deposits of collagen in your blood vessels)

•    You are having, or about to have, low density lipoprotein apheresis treatment (removal of cholesterol from your blood by machine).

•    You suffer from allergies or asthma

•    You are having, or about to have desensitisation treatment, i.e. to reduce the effects of an allergy to a bee or wasp sting.

•    You are of child bearing potential, talk to your doctor about adequate contraception.

•    You are breast-feeding or about to start breast-feeding

•    You have diabetes or gout

•    You have systemic lupus erythematosus (SLE) an allergic condition which causes joint pain, skin rashes and fever.

•    The active ingredient hydrochlorothiazide can cause an

unusual reaction resulting in visual disturbances and increased pressure in the eye. Symptoms of increased pressure in the eye are intense pain, redness of the eye, headaches, tender eye area, misty vision and loss of vision.

If this is not treated, it can lead to permanent loss of vision. If you experience any such symptoms, you should seek immediate medical attention.

•    You are taking any of the following medicines used to treat high blood pressure:

-    an angiotensin II receptor blocker (ARBs) (also known as sartans - for example valsartan, telmisartan, irbesartan), in particular if you have diabetes-related kidney problems.

-    aliskiren

•    You are also taking other medicines.

Your doctor may check your kidney function, blood pressure and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.

See also information under the heading ‘Do not take Accuretic’.

Other medicines and Accuretic

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. There are some medicines that may interact with Accuretic. Your doctor may need to change your dose and/or to take other precautions:

•    Angiotensin II receptor blocker (ARB) or aliskiren (see also information under the headings ‘Do not take Accuretic’ and ‘Warnings and precautions’).

•    Other blood pressure treatments and diuretics (water tablets).

•    Medicines to treat infections called tetracyclines.

•    Potassium supplements (this includes salt substitutes which often contain potassium).

•    Anaesthetics.

•    Lithium (used to treat depression).

•    Non-steroidal anti-inflammatory pain killers (for example aspirin or ibuprofen).

•    Corticosteroids (for example hydrocortisone, dexamethasone or prednisolone) and ACTH (tetracosactide).

•    Procainamide (used to correct irregular heartbeats), cytostatic drugs (cancer therapy), immunosuppressants (for the treatment of autoimmune diseases such as Crohn’s disease and rheumatoid arthritis), allopurinol (for the treatment of chronic gout).

•    Indigestion and heartburn medicines (antacids).

•    Drugs that have a sedative effect. This includes alcoholic drinks and sleeping pills.

•    Drugs to treat diabetes.

•    Digitalis glyocsides (for the treatment of heart problems).

You should always tell your doctor if you are taking or have recently taken any other medicine, even those not prescribed, because they might interact with Accuretic.

Surgery

Remember to tell any medical staff that you are taking Accuretic. This is important if you go into hospital for an operation as your anaesthetist will want to know.

Laboratory Tests

Accuretic may affect the results of some laboratory tests. Tell your doctor or hospital you are taking Accuretic if you need to have any tests carried out by your doctor or in hospital.

•    Taking Accuretic with food and drink

Accuretic can be taken with or without food.

•    Pregnancy

Do not take Accuretic if you are pregnant or trying to become pregnant. Ask your doctor for advice before taking any medicine.

•    Breast-feeding

Tell your doctor if you are breast-feeding or about to start breast-feeding. Your doctor will advise you on the benefits and risks of taking Accuretic whilst breast-feeding and

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YOU WILL FIND MORE ABOUT ACCURETIC ON THE BACK OF THIS LEAFLET


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decide whether or not you should continue taking Accuretic.

♦ Driving and using machinery:

Your tablets may affect your ability to drive or operate machinery safely. They may make you feel dizzy or weary. If affected, do not drive or operate machinery and contact your doctor immediately.

Important information about some of the ingredients in Accuretic

Accuretic contains lactose (a type of sugar), if you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

3. How to take Accuretic

The usual dose of Accuretic is one tablet each day. Your doctor may increase the dose to two tablets which may be taken together once a day or may be taken separately, one tablet in the morning and one in the evening.

Accuretic should not be used in children and adolescents under 18 years of age.

Swallow the tablets whole with water. Do not chew, divide or crush the tablets.

If you are still not sure, ask your doctor or pharmacist.

It is important to keep taking your tablets. They help to control your blood pressure.

Don‘t wait until your tablets are finished before seeing your doctor.

If you take more Accuretic than you should

Taking too many tablets at once may make you unwell. If you take too many Accuretic tablets, tell your doctor or go to your nearest hospital casualty department immediately.

If you miss a dose of Accuretic:

Do not worry. If you forget to take a dose, miss out the forgotten dose completely and take the next dose at the normal time. Do not take a double dose to make up for a missed dose.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, Accuretic can cause side effects although not everybody gets them.

STOP taking Accuretic and seek immediate medical attention if you experience any of the following symptoms. Although they are very rare, they can be serious.

•    Severe allergic (anaphylactoid) reaction to this medicine such as swelling of the face, tongue and throat which cause great difficulty breathing (angioedema).

•    Severe abdominal pain causing you to be sick (intestinal angioedema).

•    Heart attack (symptoms may include chest pain, tightness of the chest, shortness of breath or trouble breathing), speeding up of the heart rate

•    Weakness of arms, legs or problems speaking which may be symptoms of a possible stroke

•    Intense skin rash including hives, severe itching, blistering, peeling and swelling of the skin, inflammation of mucous membranes (Stevens Johnson Syndrome).

Tell your doctor immediately if you experience any of the following symptoms after taking Accuretic. Although they are very rare, these symptoms can be serious.

•    Feeling faint, particularly when standing; this may mean your blood pressure is too low (hypotension). This is more likely to occur if you have been taking diuretics (water tablets), other blood pressure medication in addition to Accuretic, alcohol, or if you are dehydrated or are on dialysis. If you feel light headed or faint, lie down until this feeling passes.

•    Severe sore throat or severe mouth ulcers, particularly if you suffer from kidney problems or collagen vascular disease.You may not have enough of certain white blood cells (neutropenia/agranulocytosis) which may lead to increased risk of infection or fever.

•    Chest pain (angina), tightness of the chest, shortness of breath, wheezing or trouble breathing, irregular or strong heartbeat (palpitations).

•    Severe abdominal and back pain accompanied with feeling very unwell (pancreatitis)

•    Yellowing of the skin or the eyes (jaundice)

The following side effects have also been reported in patients with high blood pressure being treated with Accuretic. If any of these side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor.

Common side effects

These can affect up to 1 in every 10 people:

•    diarrhoea, indigestion, mild stomach pain, feeling or being sick

•    dizziness, headache, tiredness, feeling weak, sleepiness or sleeplessness

•    painful muscles, muscle weakness, back pain,

•    high levels of uric acid in your blood causing swollen, painful joints (gout)

•    coughing, bronchitis

•    nose or throat infections, nasal stuffiness and/or runny nose (rhinitis)

•    widening of blood vessels

Uncommon side effects:

These can affect up to 1 in every 100 people:

•    kidney and urinary problems, urinary tract infection

•    numbness or tingling sensation in your limbs, aching joints

•    depression, nervousness, confusion

•    ringing or noise in the ears

•    wind

•    lazy eye

•    feeling of spinning or rotation of surroundings (vertigo)

•    fainting, low blood pressure

•    dry mouth, or throat, taste disturbances

•    fluid retention in the body

•    inflammation of your sinuses (sinusitis)

•    increased sweating, feeling hot (fever)

•    hair loss, itching, sensitivity of skin to light

•    failure/inability to achieve penile erection

•    viral infection

Rare side effects

These can affect up to 1 in every 1000 people:

•    problems with balance

•    inflammation of the lungs which can cause breathlessness, cough and raised temperature

•    constipation

•    inflammation of the tongue

•    inflammation of blood vessels

Very Rare side effects

These can affect up to 1 in every 10,000 people:

•    obstruction of the digestive system (bowel)

•    blurred vision

Other side effects (how often they happen is not known):

•    skin discolouration

•    decreased numbers of white blood cells or decrease in blood platelets which may result in bruising or easy bleeding, low numbers of red blood cells (anaemia)

•    bleeding from blood vessels in the brain

•    narrowing of the airways in the lungs (bronchospasm)

•    liver inflammation (hepatitis).

Accuretic may cause certain changes in your blood and your doctor may do blood tests to monitor this. If you notice bruising, feeling very tired or if you are diabetic and notice your sugar levels rising let your doctor know so blood tests can be arranged if necessary.

If any of these side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor.

5. How to store Accuretic

Keep your tablets out of the reach and sight of children.

Do not use Accuretic after the expiry date which is stated on carton. The expiry date refers to the last day of that month.

Do not store above 25°C.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help protect the environment.

6. Further information

What Accuretic contains and its package

The active substances in Accuretic are quinapril and hydrochlorothiazide. Each tablet contains 10 mg of quinapril (present as 10.85 mg quinapril hydrochloride) and 12.5 mg of hydrochlorothiazide.

The tablets also contain the inactive ingredients: magnesium carbonate, lactose, povidone, crospovidone and magnesium stearate.

The coating of the tablets contains candelilla wax and opadry pink OY-S-6937 which contains iron oxide (EI72), titanium dioxide (EI7I), hydroxypropyl methyl cellulose, hydroxypropyl cellulose and polyethylene glycol.

Each Accuretic tablet is pink film coated and oval in shape. The tablets are available in blister packs of 28 tablets.

Marketing Authorisation Holder

Pfizer Limited, Sandwich, Kent, CTI3 9NJ, United Kingdom.

Manufacturer

Pfizer Manufacturing Deutschland GmbH Betriebsstatte Freiburg Mooswaldallee I 79090 Freiburg Germany

Date last revised: 08/2014

Ref: AH I6_0 UK

PAA052849

Pfizer Limited Sandwich, England


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