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Hydrochlorothiazide / quinapril Disease Interactions

There are 19 disease interactions with hydrochlorothiazide / quinapril:

Major

Ace Inhibitors (Includes Hydrochlorothiazide/quinapril) ↔ Angioedema

Severe Potential Hazard, Moderate plausibility

Applies to: Angioedema

Patients with a history of angioedema unrelated to ACE inhibitors may be at increased risk of angioedema while receiving an ACE inhibitor. Patients should be advised to immediately report any signs or symptoms suggestive of angioedema (swelling of face, extremities, eyes, lips, or tongue, or difficulty swallowing or breathing) and to stop taking the medication until otherwise directed by their physician. Emergency therapy and/or measures to prevent airway obstruction are required for angioedema involving the tongue, glottis, or larynx. The use of these agents is contraindicated in patients with hereditary angioedema or a history of idiopathic angioedema. Treatment with ACE inhibitors should be discontinued permanently if angioedema develops in association with therapy.

References

  1. Seidman MD, Lewandowski CA, Sarpa JR, et al "Angioedema related to angiotensin-converting enzyme inhibitors." Otolaryngol Head Neck Surg 102 (1990): 727-31
  2. Gonzalo FE, Montagut LB, Vecina ST "Angioedema caused by ramipril." Ann Pharmacother 29 (1995): 431-2
  3. Gianos ME, Klaustermeyer WB, Kurohara M, et al "Enalapril induced angioedema." Am J Emerg Med 8 (1990): 124-6
  4. Roberts JR, Wuerz RC "Clinical characteristics of angiotensin-converting enzyme inhibitor-induced angioedema." Ann Emerg Med 20 (1991): 555-8
  5. Chin HL, Buchan DA "Severe angioedema after long-term use of an angiotensin-converting enzyme inhibitor ." Ann Intern Med 112 (1990): 312-3
  6. Gannon TH, Eby TL "Angioedema from angiotensin converting enzyme inhibitors: a cause of upper airway obstruction." Laryngoscope 100 (1990): 1156-60
  7. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
  8. Hedner T, Samuelsson O, Lunde H, et al "Angio-oedema in relation to treatment with angiotensin converting enzyme inhibitors." Br Med J 304 (1992): 941-6
  9. Soo Hoo GW, Dao HT, Klaustermeyer WB "Severe angioedema and respiratory distress associated with lisinopril use." West J Med 158 (1993): 412-7
  10. Gimenez JC "Angioneurotic edema produced by enalapril." Ann Pharmacother 29 (1995): 317
  11. "Product Information. Capoten (captopril)." Bristol-Myers Squibb, Princeton, NJ.
  12. Orfan N, Patterson R, Dykewicz MS "Severe angioedema related to ACE inhibitors in patients with a history of idiopathic angioedema." JAMA 264 (1990): 1287-9
  13. Werber JL, Pincus RL "Oropharyngeal angioedema associated with the use of angiotensin-converting enzyme inhibitors." Otolaryngol Head Neck Surg 101 (1989): 96-8
  14. Kaplan NM "The CARE study: a postmarketing evaluation of ramipril in 11,100 patients." Clin Ther 18 (1996): 658-70
  15. Abidin MR, Eisele DW "Angioedema after long-term use of angiotensin-converting enzyme inhibitor ." Arch Otolaryngol Head Neck Surg 117 (1991): 1059
  16. Frontera Y, Piecuch JF "Multiple episodes of angioedema associated with lisinopril, an ACE inhibitor." J Am Dent Assoc 126 (1995): 217-20
  17. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  18. Jett GK "Captopril-induced angioedema ." Ann Emerg Med 13 (1984): 489-90
  19. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
  20. Suarez M, Ho PW, Johnson ES, Perez G "Angioneurotic edema, agranulocytosis, and fatal septicemia following captopril therapy." Am J Med 81 (1986): 336-8
  21. "Product Information. Aceon (perindopril)." Solvay Pharmaceuticals Inc, Marietta, GA.
  22. Alderman CP "Adverse effects of the angiotensin-converting enzyme inhibitors." Ann Pharmacother 30 (1996): 55-61
  23. Jason DR "Fatal angioedema associated with captopril." J Forensic Sci 37 (1992): 1418-21
  24. O'Mara NB, O'Mara EM Jr "Delayed onset of andioedema with angiotensin-converting enzyme inhibitors: case report and review of the literature." Pharmacotherapy 16 (1996): 675-9
  25. "Product Information. Accupril (quinapril)." Parke-Davis, Morris Plains, NJ.
  26. "Product Information. Monopril (fosinopril)." Bristol-Myers Squibb, Princeton, NJ.
  27. Gonnering RS, Hirsch SR "Delayed drug-induced periorbital angioedema ." Am J Ophthalmol 110 (1990): 566-8
  28. "Product Information. Univasc (moexipril)." Schwarz Pharma, Mequon, WI.
  29. "Product Information. Prinivil (lisinopril)." Merck & Co, Inc, West Point, PA.
  30. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  31. Forslund T, Tohmo H, Weckstrom G, Stenborg M, Jarvinen S "Angio-oedema induced by enalapril." J Intern Med 238 (1995): 179-81
  32. Gunkel AR, Thurner KH, Kanonier G, Sprinzl GM, Thumfart WF "Angioneurotic edema as a reaction to angiotensin-converting enzyme inhibitors." Am J Otolaryngol 17 (1996): 87-91
  33. Wood SM, Mann RD, Rawlins MD "Angio-oedema and urticaria associated with angiotensin converting enzyme inhibitors." Br Med J 294 (1987): 91-2
  34. McElligott S, Perlroth M, Raish L "Angioedema after substituting lisinopril for captopril ." Ann Intern Med 116 (1992): 426-7
View all 34 references
Major

Ace Inhibitors (Includes Hydrochlorothiazide/quinapril) ↔ Bone Marrow Suppression

Severe Potential Hazard, Moderate plausibility

Applies to: Collagen Vascular Disease, Renal Dysfunction, Bone Marrow Depression/Low Blood Counts

ACE inhibitors may cause bone marrow suppression, rarely in uncomplicated individuals but more frequently in patients with renal impairment, especially if they also have a collagen-vascular disease such as systemic lupus erythematosus or scleroderma. Neutropenia, agranulocytosis, aplastic anemia, hemolytic anemia, eosinophilia and thrombocytopenia have been reported, mostly with captopril. Therapy with ACE inhibitors should be administered cautiously in patients with preexisting blood dyscrasias or complications that may increase the risk of bone marrow depression during ACE inhibitor therapy. Monitoring of blood counts, particularly white blood cells, should be considered.

References

  1. Davies RO, Irvin JD, Kramsch PK, Walker JF, Moncloa F "Enalapril worldwide experience." Am J Med 77 (1984): 23-35
  2. Knapp LE, Frank GJ, McLain R, Rieger MM, Posvar E, Singer R "The safety and tolerability of quinapril." J Cardiovasc Pharmacol 15 (1990): s47-55
  3. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
  4. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  5. Edwards IR, Coulter DM, Beasley DM, MacIntosh D "Captopril: 4 years of post marketing surveillance of all patients in New Zealand." Br J Clin Pharmacol 23 (1987): 529-36
  6. Gavras I, Graff LG, Rose BD, et al "Fatal pancytopenia associated with the use of captopril." Ann Intern Med 94 (1981): 58-9
  7. Shindo K, Matsuya F, Ura T, et al "Captopril-associated granulocytopenia in hypertension after renal transplantation." Clin Nephrol 22 (1984): 314-6
  8. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  9. "Product Information. Capoten (captopril)." Bristol-Myers Squibb, Princeton, NJ.
  10. Strair RK, Mitch WE, Faller DV, Skorecki KL "Reversible captopril-associated bone marrow aplasia ." Can Med Assoc J 132 (1985): 320-2
  11. Beroniade V "Severe side-effects of captopril in advanced chronic kidney insufficiency." Proc Eur Dial Transplant Assoc 20 (1983): 530-7
  12. Grosbois B, Milton D, Beneton C, Jacomy D "Thrombocytopenia induced by angiotensin converting enzyme inhibitors." Br Med J 298 (1989): 189-90
  13. Hirakata H, Onoyama K, Iseki K, et al "Worsening of anemia induced by long-term use of captopril in hemodialysis patients." Am J Nephrol 4 (1984): 355-60
  14. Elijovisch F, Krakoff LR "Captopril associated granulocytopenia in hypertension after renal transplantation ." Lancet 1 (1980): 927-8
  15. Loftus WK, Ierino F, Mathew TH "Enalapril and anaemia ." Med J Aust 148 (1988): 209-10
  16. Suarez M, Ho PW, Johnson ES, Perez G "Angioneurotic edema, agranulocytosis, and fatal septicemia following captopril therapy." Am J Med 81 (1986): 336-8
  17. Forslund T, Borgmastars H, Fyrquist F "Captopril-associated leucopenia confirmed by rechallenge in patient with renal failure ." Lancet 1 (1981): 166
  18. Torello J, Duran JA, Abadin JA "Captopril-associated aplastic anemia ." Drug Intell Clin Pharm 24 (1990): 543-4
  19. "Product Information. Univasc (moexipril)." Schwarz Pharma, Mequon, WI.
  20. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
  21. Materson BJ "Adverse effects of angiotensin-converting enzyme inhibitors in antihypertensive therapy with focus on quinapril." Am J Cardiol 69 (1992): c46-53
  22. Onoyama K, Sanai T, Motomura K, Fujishima M "Worsening of anemia by angiotensin converting enzyme inhibitors and its prevention by antiestrogenic steroid in chronic hemodialysis patients." J Cardiovasc Pharmacol 13 (1989): s27-30
  23. Elis A, Lishner M, Lang R, Ravid M "Agranulocytosis associated with enalapril." Drug Intell Clin Pharm 25 (1991): 461-2
  24. Kim CR, Maley MB, Mohler ER "Captopril and aplastic anemia." Ann Intern Med 111 (1989): 187-8
  25. Chalmers D, Whitehead A, Lawson DH "Postmarketing surveillance of captopril for hypertension." Br J Clin Pharmacol 34 (1992): 215-23
  26. Waeber B, Gavras I, Brunner HR, Gavras H "Safety and efficacy of chronic therapy with captopril in hypertensive patients: an update." J Clin Pharmacol 21 (1981): 508-16
  27. "Product Information. Aceon (perindopril)." Solvay Pharmaceuticals Inc, Marietta, GA.
  28. Harrison BD, Laidlaw ST, Reilly JT "Fatal aplastic anaemia associated with lisinopril." Lancet 346 (1995): 247-8
  29. Elijovisch F, Krakoff LR "Captopril associated granulocytopenia in hypertension after renal transplantation." Lancet 1 (1980): 927-8
  30. Vlahakos DV, Canzanello VJ, Madaio MP, Madias NE "Enalapril-associated anemia in renal transplant recipients treated for hypertension." Am J Kidney Dis 17 (1991): 199-205
  31. Vidt DG, Bravo EL, Fouad FM "Captopril." N Engl J Med 306 (1982): 214-9
  32. "Product Information. Accupril (quinapril)." Parke-Davis, Morris Plains, NJ.
  33. Alderman CP "Adverse effects of the angiotensin-converting enzyme inhibitors." Ann Pharmacother 30 (1996): 55-61
  34. "Product Information. Monopril (fosinopril)." Bristol-Myers Squibb, Princeton, NJ.
  35. Israeli A, Or R, Leitersdorf E "Captopril-associated transient aplastic anemia." Acta Haematol 73 (1985): 106-7
  36. Pillans PI, Koopowitz A "Captopril-associated agranulocytosis: a report of 3 cases." S Afr Med J 79 (1991): 399-400
  37. el-Makri A, Larabi MS, Kechrid C, et al "Fatal bone-marrow suppression associated with captopril." Br Med J 283 (1981): 277-8
  38. "Product Information. Prinivil (lisinopril)." Merck & Co, Inc, West Point, PA.
View all 38 references
Major

Ace Inhibitors (Includes Hydrochlorothiazide/quinapril) ↔ Chf

Severe Potential Hazard, Moderate plausibility

Applies to: Congestive Heart Failure

ACE inhibitors can cause marked renal impairment in patients whose renal function depends on the activity of the renin-angiotensin-aldosterone system. In addition, symptomatic and sometimes excessive hypotension can occur in susceptible individuals, particularly during the initiation of treatment, which may compromise renal and myocardial perfusion. In patients with severe congestive heart failure (CHF), treatment with ACE inhibitors may be associated with oliguria and/or progressive azotemia and, rarely, renal failure, myocardial ischemia and death. Therapy with ACE inhibitors should be initiated under very close medical supervision in patients with severe CHF, especially when accompanied by volume and/or sodium depletion. Patients should be monitored closely for several hours after an initial dose until blood pressure has stabilized, and followed closely for the first 2 weeks of treatment and whenever the dosage of ACE inhibitor or diuretic is increased. If feasible, the risk of severe hypotension may be minimized by reducing or temporarily withholding the dosing of diuretics and/or liberalizing dietary sodium intake for 2 to 3 days prior to starting ACE inhibitor therapy. In patients who experience a worsening of renal function, discontinuation of ACE inhibitor therapy is usually not required provided there is symptomatic improvement of the heart failure and renal deterioration is well-tolerated. Transient hypotension is also not a contraindication to further treatment with ACE inhibitors. After blood pressure stabilizes, therapy can usually be reinstated with caution, although a lower dosage of the ACE inhibitor and/or dosage reduction or discontinuation of concomitantly administered diuretics may be necessary.

References

  1. Moyses C, Higgins TJ "Safety of long-term use of lisinopril for congestive heart failure." Am J Cardiol 70 (1992): c91-7
  2. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  3. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
  4. Heintz B, Verho M, Brockmeier D, Kirsten R, Nelson K, Maigatter S, Lefevre G, Kierdorf H, Sieberth HG "Influence of ramipril on renal function in patients with chronic congestive heart failure." J Cardiovasc Pharmacol 18 (1991): s174-9
  5. Moyses C, Higgins TJ "Safety of long-term use of lisinopril for congestive heart failure." Am J Cardiol 70 (1992): c91-7
  6. "Product Information. Capoten (captopril)." Bristol-Myers Squibb, Princeton, NJ.
  7. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  8. Kober L, Torp-Pedersen C, Carlsen JE, Bagger H, Eliasen P, Lyngborg K, Videbaek J, Cole DS, Auclert L, Pauly NC, et al "A clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. Trandolapril Cardiac Evaluation (TRACE) Study Group." N Engl J Med 333 (1995): 1670-6
  9. Antonios TFT, Macgregor GA "Angiotensin converting enzyme inhibitors in hypertension: potential problems." J Hypertens 13 Suppl (1995): s11-6
  10. Kostis JB, Shelton BJ, Yusuf S, Weiss MB, Capone RJ, Pepine CJ, Gosselin G, Delahaye F, Probstfield JL, Cahill L, Dutton D "Tolerability of enalapril initiation by patients with left ventricular dysfunction: results of the medication challenge phase of the studies of left ventricular dysfunction." Am Heart J 128 (1994): 358-64
  11. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
  12. Dietz R, Nagel F, Osterziel KJ "Angiotensin-converting enzyme inhibitors and renal function in heart failure." Am J Cardiol 70 (1992): c119-25
  13. "Product Information. Monopril (fosinopril)." Bristol-Myers Squibb, Princeton, NJ.
  14. Ljungman S, Kjekshus J, Swedberg K "Renal function in severe congestive heart failure during treatment with enalapril." Am J Cardiol 70 (1992): 479-87
  15. "Product Information. Prinivil (lisinopril)." Merck & Co, Inc, West Point, PA.
  16. "Product Information. Accupril (quinapril)." Parke-Davis, Morris Plains, NJ.
  17. "Product Information. Aceon (perindopril)." Solvay Pharmaceuticals Inc, Marietta, GA.
  18. Schwartz D, Averbuch M, Pines A, et al "Renal toxicity of enalapril in very elderly patients with progressive, severe congestive heart failure." Chest 100 (1991): 1558-61
  19. "Product Information. Univasc (moexipril)." Schwarz Pharma, Mequon, WI.
  20. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  21. Kostis JB, Shelton B, Gosselin G, Goulet C, Hood WB, Kohn RM, Kubo SH, Schron E, Weiss MB, Willis PW, Young JB, Probstfie "Adverse effects of enalapril in the studies of left ventricular dysfunction (SOLVD)." Am Heart J 131 (1996): 350-5
View all 21 references
Major

Ace Inhibitors (Includes Hydrochlorothiazide/quinapril) ↔ Hemodialysis

Severe Potential Hazard, Moderate plausibility

Applies to: hemodialysis

Anaphylactoid reactions have been reported in patients undergoing hemodialysis with high-flux polyacrylonitrile membranes and treated concomitantly with an ACE inhibitor. The frequency and mechanism of this interaction have not been established, and it is not known whether the interaction occurs with other membrane types. Therapy with ACE inhibitors should be administered cautiously in patients requiring hemodialysis.

References

  1. "Product Information. Capoten (captopril)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
  3. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  4. "Product Information. Accupril (quinapril)." Parke-Davis, Morris Plains, NJ.
  5. "Product Information. Prinivil (lisinopril)." Merck & Co, Inc, West Point, PA.
  6. "Product Information. Monopril (fosinopril)." Bristol-Myers Squibb, Princeton, NJ.
  7. "Product Information. Aceon (perindopril)." Solvay Pharmaceuticals Inc, Marietta, GA.
  8. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  9. "Product Information. Univasc (moexipril)." Schwarz Pharma, Mequon, WI.
  10. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
View all 10 references
Major

Ace Inhibitors (Includes Hydrochlorothiazide/quinapril) ↔ Hyperkalemia

Severe Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction, Hyperkalemia, Diabetes Mellitus

In patients with hyperkalemia, especially those associated with impaired renal function or congestive heart failure, ACE inhibitors may further raise serum potassium levels. Therapy with ACE inhibitors should be administered cautiously in patients with or predisposed to hyperkalemia, and serum potassium levels should be carefully monitored. Risk factors for the development of hyperkalemia during ACE inhibitor therapy include renal insufficiency, diabetes mellitus, and the concomitant use of potassium-sparing diuretics, potassium supplements, and/or potassium-containing salt substitutes.

References

  1. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  2. Alderman CP "Adverse effects of the angiotensin-converting enzyme inhibitors." Ann Pharmacother 30 (1996): 55-61
  3. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
  4. Kostis JB, Shelton BJ, Yusuf S, Weiss MB, Capone RJ, Pepine CJ, Gosselin G, Delahaye F, Probstfield JL, Cahill L, Dutton D "Tolerability of enalapril initiation by patients with left ventricular dysfunction: results of the medication challenge phase of the studies of left ventricular dysfunction." Am Heart J 128 (1994): 358-64
  5. "Product Information. Accupril (quinapril)." Parke-Davis, Morris Plains, NJ.
  6. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  7. "Product Information. Aceon (perindopril)." Solvay Pharmaceuticals Inc, Marietta, GA.
  8. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  9. "Product Information. Univasc (moexipril)." Schwarz Pharma, Mequon, WI.
  10. Kostis JB, Shelton B, Gosselin G, Goulet C, Hood WB, Kohn RM, Kubo SH, Schron E, Weiss MB, Willis PW, Young JB, Probstfie "Adverse effects of enalapril in the studies of left ventricular dysfunction (SOLVD)." Am Heart J 131 (1996): 350-5
  11. "Product Information. Monopril (fosinopril)." Bristol-Myers Squibb, Princeton, NJ.
  12. Tramonti G, Donadio C, Confessore N, Bianchi C "Antihypertensive activity and renal effects of benazepril in humans." Kidney Int (suppl 5) (1996): s107-8
  13. Moyses C, Higgins TJ "Safety of long-term use of lisinopril for congestive heart failure." Am J Cardiol 70 (1992): c91-7
  14. "Product Information. Capoten (captopril)." Bristol-Myers Squibb, Princeton, NJ.
  15. Kindler J, Schunkert H, Gassmann M, Lahn W, Irmisch R, Debusmann ER, Ocon-Pujadas J, Ritz E, Sieberth HG "Therapeutic efficacy and tolerance of ramipril in hypertensive patients with renal failure." J Cardiovasc Pharmacol 13 (1989): s55-8
  16. "Product Information. Prinivil (lisinopril)." Merck & Co, Inc, West Point, PA.
  17. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
  18. Antonios TFT, Macgregor GA "Angiotensin converting enzyme inhibitors in hypertension: potential problems." J Hypertens 13 Suppl (1995): s11-6
View all 18 references
Major

Ace Inhibitors (Includes Hydrochlorothiazide/quinapril) ↔ Hypotension

Severe Potential Hazard, Moderate plausibility

Applies to: Diarrhea, Vomiting, hemodialysis, Hyponatremia, Dehydration, Cerebrovascular Insufficiency, Ischemic Heart Disease

ACE inhibitors can cause symptomatic hypotension, most often during the initiation of therapy and in patients who are volume- and/or sodium-depleted or treated for congestive heart failure (CHF). Therapy with ACE inhibitors should be administered cautiously in such patients and in those predisposed to hypovolemic or hyponatremic states (e.g., patients on diuretic therapy, especially if it was recently instituted; those on dietary salt restriction; those with severe or prolonged diarrhea or vomiting; and renal dialysis patients). Volume and/or sodium depletion should be corrected prior to initiating therapy with ACE inhibitors, and the patient should be hemodynamically stable. If concomitant diuretics and/or dietary sodium restriction are employed, reducing or temporarily withholding the dosing of diuretics and/or liberalizing dietary sodium intake for 2 to 3 days in advance can help minimize the risk of severe hypotension in patients who are able to tolerate such adjustments. ACE inhibitors should also be used cautiously in patients in whom excessive hypotension may have serious consequences, such as patients with coronary or cerebrovascular insufficiency. Patients at risk for excessive hypotension should initiate ACE inhibitor therapy under very close medical supervision, and followed closely for the first 2 weeks of treatment and whenever the dosage of ACE inhibitor or diuretic is increased.

References

  1. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
  2. Chalmers D, Whitehead A, Lawson DH "Postmarketing surveillance of captopril for hypertension." Br J Clin Pharmacol 34 (1992): 215-23
  3. Kostis JB, Shelton BJ, Yusuf S, Weiss MB, Capone RJ, Pepine CJ, Gosselin G, Delahaye F, Probstfield JL, Cahill L, Dutton D "Tolerability of enalapril initiation by patients with left ventricular dysfunction: results of the medication challenge phase of the studies of left ventricular dysfunction." Am Heart J 128 (1994): 358-64
  4. Alderman CP "Adverse effects of the angiotensin-converting enzyme inhibitors." Ann Pharmacother 30 (1996): 55-61
  5. Kaplan NM "The CARE study: a postmarketing evaluation of ramipril in 11,100 patients." Clin Ther 18 (1996): 658-70
  6. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  7. Balfour J, Goa K "Benazepril: A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in hypertension and congestive heart failure." Drugs 42 (1991): 511-39
  8. "Product Information. Monopril (fosinopril)." Bristol-Myers Squibb, Princeton, NJ.
  9. Schnaper HW "Comparison of the efficacy and safety of quinapril vs. captopril in treatment of moderate to severe hypertension." Angiology 40 (1989): 389-95
  10. Schoenberger JA, Testa M, Ross AD, et al "Efficacy, safety, and quality-of-life assessment of captopril antihypertensive therapy in clinical practice." Arch Intern Med 150 (1990): 301-6
  11. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  12. "Product Information. Aceon (perindopril)." Solvay Pharmaceuticals Inc, Marietta, GA.
  13. Forette B, Koen R, Vivaut E "Efficacy and safety of quinapril in the elderly hypertensive patient." Am Heart J 123 (1992): 1426-32
  14. Young BA "ACE inhibitor first dose effect." Med J Aust 158 (1993): 577
  15. "Product Information. Accupril (quinapril)." Parke-Davis, Morris Plains, NJ.
  16. Edwards IR, Coulter DM, Beasley DM, MacIntosh D "Captopril: 4 years of post marketing surveillance of all patients in New Zealand." Br J Clin Pharmacol 23 (1987): 529-36
  17. Osterziel KJ, Karr M, Busch C, Dietz R "Comparison of the first-dose effect of captopril and lisinopril in heart failure." Am J Cardiol 70 (1992): c137-9
  18. "Product Information. Prinivil (lisinopril)." Merck & Co, Inc, West Point, PA.
  19. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  20. Cooper WD, Sheldon D, Brown D, et al "Post-marketing surveillance of enalapril: experience in 11,710 hypertensive patients in general practice." J R Coll Gen Pract 37 (1987): 346-9
  21. Black J, Hunt TL, Godley PJ "Initiation of captopril therapy: the first-dose effect." J Clin Pharmacol 26 (1986): 539-40
  22. Inman WH, Rawson NS, Wilton LV, et al "Postmarketing surveillance of enalapril. I: results of prescription-event monitoring." Br Med J 297 (1988): 826-9
  23. Lang RM, Dibianco R, Broderick GT, Gottlieb SS, Kostis J, Lyle PA, Makris L, Rajfer SI, Rucinska EJ "First-dose effects of enalapril 2.5 mg and captopril 6.25 mg in patients with heart failure: a double-blind, randomized, multicenter study." Am Heart J 128 (1994): 551-6
  24. Russell RM, Jones RM "Postoperative hypotension associated with enalapril." Anaesthesia 44 (1989): 837-8
  25. Schmitt JK, Koch KS, Midha M "Profound hypotension in a tetraplegic patient following angiotensin-converting enzyme inhibitor lisinopril. case report." Paraplegia 32 (1994): 871-4
  26. Howes LG, Nguyen T, Jackson B "Safety and efficacy of quinapril in hypertensive geriatric patients." J Am Geriatr Soc 44 (1996): 1135
  27. "Product Information. Capoten (captopril)." Bristol-Myers Squibb, Princeton, NJ.
  28. MacNab M, Mallows S "Safety profile of benazepril in essential hypertension." Clin Cardiol 14 Suppl I (1991): iv33-7
  29. "Product Information. Univasc (moexipril)." Schwarz Pharma, Mequon, WI.
  30. Larochelle P, Haynes B, Maron N, Dugas S "A postmarketing surveillance evaluation of quinapril in 3742 canadian hypertensive patients - the ACCEPT study." Clin Ther 16 (1994): 838-53
  31. Antonios TFT, Macgregor GA "Angiotensin converting enzyme inhibitors in hypertension: potential problems." J Hypertens 13 Suppl (1995): s11-6
  32. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
View all 32 references
Major

Thiazides (Includes Hydrochlorothiazide/quinapril) ↔ Anuria

Severe Potential Hazard, High plausibility

Applies to: Anuria

The use of thiazide diuretics is contraindicated in patients with anuria.

References

  1. "Product Information. Diuril (chlorothiazide)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Thalitone (chlorthalidone)." Monarch Pharmaceuticals Inc, Bristol, TN.
  3. "Product Information. Renese-R (reserpine-polythiazide)." Pfizer US Pharmaceuticals, New York, NY.
  4. "Product Information. Zaroxolyn (metolazone)." Rhone-Poulenc Rorer, Collegeville, PA.
  5. "Product Information. Enduron (methyclothiazide)." Abbott Pharmaceutical, Abbott Park, IL.
  6. "Product Information. Metahydrin (trichlormethiazide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  7. "Product Information. Lozol (indapamide)." Rhone-Poulenc Rorer, Collegeville, PA.
  8. "Product Information. Diucardin (hydroflumethiazide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  9. "Product Information. HydroDIURIL (hydrochlorothiazide)." Merck & Co, Inc, West Point, PA.
View all 9 references
Major

Thiazides (Includes Hydrochlorothiazide/quinapril) ↔ Electrolyte Losses

Severe Potential Hazard, High plausibility

Applies to: Hypokalemia, Diarrhea, Electrolyte Abnormalities, Hyperaldosteronism, Hyponatremia, Magnesium Imbalance, Malnourished, Vomiting, Ventricular Arrhythmia, Dehydration

The use of thiazide diuretics is commonly associated with loss of electrolytes, most significantly potassium but also sodium, chloride, bicarbonate, and magnesium. The loss of other electrolytes such as phosphate, bromide and iodide is usually slight. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. Other electrolyte-related complications include metabolic alkalosis and hyponatremia, which are rarely life-threatening. Therapy with thiazide diuretics should be administered cautiously in patients with or predisposed to fluid and electrolyte depletion, including patients with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; and those with poor nutritional status. Fluid and electrolyte abnormalities should be corrected prior to initiating therapy, and blood pressure as well as serum electrolyte concentrations monitored periodically and maintained at normal ranges during therapy. Patients should be advised to immediately report signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Digitalized patients and patients with a history of ventricular arrhythmias should be monitored carefully, since development of hypokalemia may be particularly dangerous in these patients. The risk of hypokalemia may be minimized by slow diuresis, a lower thiazide dosage, potassium supplementation, or combined use with a potassium-sparing diuretic.

References

  1. Bain PG, Egner W, Walker PR "Thiazide-induced dilutional hyponatraemia masquerading as subarachnoid haemorrhage ." Lancet 2 (1986): 634
  2. Medical Research Council Working Party on Mild to Moderate Hypertension. "Ventricular extrasystoles during thiazide treatment: substudy of MRC mild hypertension trial." Br Med J (Clin Res Ed) 287 (1983): 1249-53
  3. Peters RW, Hamilton J, Hamilton BP "Incidence of cardiac arrhythmias associated with mild hypokalemia induced by low-dose diuretic therapy for hypertension." South Med J 82 (1989): 966-9,
  4. Jorgensen FS, Brunner S "The long-term effect of bendroflumethiazide on renal calcium and magnesium excretion and stone formation in patients with recurring renal stones." Scand J Urol Nephrol 8 (1974): 128-31
  5. Hollifield JW, Slaton PE "Thiazide diuretics, hypokalemia and cardiac arrhythmias." Acta Med Scand Suppl 647 (1981): 67-73
  6. "Product Information. Metahydrin (trichlormethiazide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  7. Mroczek WJ "Indapamide: clinical pharmacology, therapeutic efficacy in hypertension, and adverse effects." Pharmacotherapy 3 (1983): 61-7
  8. Brors O, Jacobsen S, Foss OP, Aakvaag A "Effect of repeated doses of hydroflumethiazide on renal excretion of electrolytes and uric acid in healthy subjects." Acta Pharmacol Toxicol (Copenh) 48 (1981): 145-50
  9. Starr JM, Whalley LJ "Hypertensive Old People in Edinburgh (HOPE) Study: electrocardiographic changes after captopril or bendrofluazide treatment." Age Ageing 22 (1993): 343-8
  10. "Product Information. Diucardin (hydroflumethiazide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  11. Landmann-Suter R, Struyvenberg A "Initial potassium loss and hypokalaemia during chlorthalidone administration in patients with essential hypertension: the influence of dietary sodium restriction." Eur J Clin Invest 8 (1978): 155-64
  12. Pinnock CA "Hyponatraemia associated with hydrochlorothiazide treatment ." Br Med J 1 (1978): 48
  13. Husby S, Marthedal NJ "Hyponatraemia due to a thiazide diuretic. A case report." Acta Med Scand 210 (1981): 523-4
  14. Gudbrandsson T, Hansson L "Combination therapy with saluretics and atenolol in essential hypertension. Effects on blood pressure, electrolytes and uric acid." Acta Med Scand Suppl 625 (1979): 86-91
  15. Gould L, Reddy CV, Zen B, Singh BK "Life-threatening reaction to thiazides." N Y State J Med 80 (1980): 1975-6
  16. Ljunghall S, Backman U, Danielson BG, Fellstrom B, Johansson G, Wikstrom B "Calcium and magnesium metabolism during long-term treatment with thiazides." Scand J Urol Nephrol 15 (1981): 257-62
  17. Brater DC "Drug therapy: Diuretic therapy." N Engl J Med 339 (1998): 387-95
  18. Oh SJ, Douglas JE, Brown RA "Hypokalemic vacuolar myopathy associated with chlorthalidone treatment." JAMA 216 (1971): 1858-9
  19. "Product Information. Zaroxolyn (metolazone)." Rhone-Poulenc Rorer, Collegeville, PA.
  20. Fichman MP, Vorherr H, Kleeman CR, Telfer N "Diuretic-induced hyponatremia." Ann Intern Med 75 (1971): 853-63
  21. Sumiye L, Vivian AS, Frisof KB, Podany EC "Potassium loss associated with hydrochlorothiazide versus chlorthalidone." Clin Ther 4 (1981): 308-20
  22. Navarro RP, O'Brien DK, Nuffort P, Spencer DL "Diuretic induced hypokalemia in the elderly." J Fam Pract 14 (1982): 685-9
  23. el-Meheiry MM, Nabih AE, Soliman MD "A clinical study of a new diuretic, Trichlormethiazide." J Trop Med Hyg 69 (1966): 209-14
  24. Kuller LH, Hulley SB, Cohen JD, Neaton J "Unexpected effects of treating hypertension in men with electrocardiographic abnormalities: a critical analysis." Circulation 73 (1986): 114-23
  25. Lee MR, Morgan DB "Familial hyperkalaemia responsive to benzothiadiazine diuretic." Lancet 1 (1980): 879
  26. Chan TY "Indapamide-induced severe hyponatremia and hypokalemia." Ann Pharmacother 29 (1995): 1124-8
  27. Kuller L, Farrier N, Caggiula A, Borhani N, Dunkle S "Relationship of diuretic therapy and serum magnesium levels among participants in the Multiple Risk Factor Intervention Trial." Am J Epidemiol 122 (1985): 1045-59
  28. Berglund G, Andersson O, Larsson O, Wilhelmsen L "Antihypertensive effect and side-effects of bendroflumethiazide and propranolol." Acta Med Scand 199 (1976): 499-506
  29. Elmfeldt D, Berglund G, Wedel H, Wilhelmsen L "Incidence and importance of metabolic side-effects during antihypertensive therapy." Acta Med Scand Suppl 672 (1983): 79-83
  30. Seelig CB "Magnesium deficiency in two hypertensive patient groups." South Med J 83 (1990): 739-42
  31. Black W, Shiner P, Roman J "Severe electrolyte disturbances associated with metolazone and furosemide." South Med J 71 (1978): 381
  32. Holland OB, Kuhnert L, Pollard J, Padia M, Anderson RJ, Blomqvist G "Ventricular ectopic activity with diuretic therapy." Am J Hypertens 1 (1988): 380-5
  33. Struthers AD, Whitesmith R, Reid JL "Prior thiazide diuretic treatment increases adrenaline-induced hypokalaemia." Lancet 1 (1983): 1358-61
  34. Itescu S, Haskell LP, Tannenberg AM "Thiazide-induced clinically significant hypophosphatemia ." Clin Nephrol 27 (1987): 161-2
  35. "Product Information. HydroDIURIL (hydrochlorothiazide)." Merck & Co, Inc, West Point, PA.
  36. Lindy S, Tarssanen L "Serum calcium and phosphorus in patients treated with thiazides and furosemide." Acta Med Scand 194 (1973): 319-22
  37. "Product Information. Lozol (indapamide)." Rhone-Poulenc Rorer, Collegeville, PA.
  38. Winchester JF, Kellett RJ, Boddy K, Boyle P, Dargie HJ, Mahaffey ME, Ward DM, Kennedy AC "Metolazone and bendroflumethiazide in hypertension: physiologic and metabolic observations." Clin Pharmacol Ther 28 (1980): 611-8
  39. Condon JR, Nassim R "Hypophosphataemia and hypokalaemia." Br Med J 1 (1970): 110
  40. Freis ED "The efficacy and safety of diuretics in treating hypertension." Ann Intern Med 122 (1995): 223-6
  41. Chowdhury FR, Bleicher SJ "Chlorthalidone--induced hypokalemia and abnormal carbohydrate metabolism." Horm Metab Res 2 (1970): 13-6
  42. Polanska AI, Baron DN "Hyponatraemia associated with hydrochlorothiazide treatment ." Br Med J 1 (1978): 175-6
  43. Slotkoff L "Clinical efficacy and safety of indapamide in the treatment of edema." Am Heart J 106 (1983): 233-7
  44. Cembrowski GS, Huntington RW, 3d "Probable fatal cardiac dysrhythmia secondary to diuretic-induced hypokalemia." Am J Forensic Med Pathol 2 (1981): 243-8
  45. Mouallem M, Friedman E, Shemesh Y, Mayan H, Pauzner R, Farfel Z "Cardiac conduction defects associated with hyponatremia." Clin Cardiol 14 (1991): 165-8
  46. "Product Information. Enduron (methyclothiazide)." Abbott Pharmaceutical, Abbott Park, IL.
  47. Hesp R, Wilkinson PR "Potassium supplementation of thiazide therapy." Lancet 2 (1976): 1144
  48. Benfield GF, Haffner C, Harris P, Stableforth DE "Dilutional hyponatraemia masquerading as subarachnoid haemorrhage in patient on hydrochlorothiazide/amiloride/timolol combined drug ." Lancet 2 (1986): 341
  49. Byatt CM, Millard PH, Levin GE "Diuretics and electrolyte disturbances in 1000 consecutive geriatric admissions." J R Soc Med 83 (1990): 704-8
  50. Mozes B, Pines A, Werner D, Olchovsky D, Lieberman P, Frankl O "Thiazide-induced hyponatremia: an unusual neurologic course." South Med J 79 (1986): 629-31
  51. Stern A "Metolazone, a diuretic agent." Am Heart J 91 (1976): 262-3
  52. Berg KJ, Gisholt K, Wideroe TE "Potassium deficiency in hypertensives treated with diuretics. Analysis of three alternative treatments by an oral test for potassium deficiency." Eur J Clin Pharmacol 7 (1974): 401-5
  53. Jensen OB, Mosdal C, Reske-Nielsen E "Hypokalemic myopathy during treatment with diuretics." Acta Neurol Scand 55 (1977): 465-82
  54. Ragnarsson J, Hardarson T, Snorrason SP "Ventricular dysrhythmias in middle-aged hypertensive men treated either with a diuretic agent or a beta-blocker." Acta Med Scand 221 (1987): 143-8
  55. Moore TD, Bechtel TP "Hyponatremia secondary to tolbutamide and chlorothiazide." Am J Hosp Pharm 36 (1979): 1107-10
  56. Krishna GG, Narins RG "Hemodynamic consequences of diuretic-induced hypokalemia." Am J Kidney Dis 12 (1988): 329-31
  57. Stewart DE, Ikram H, Espiner EA, Nicholls MG "Arrhythmogenic potential of diuretic induced hypokalaemia in patients with mild hypertension and ischaemic heart disease." Br Heart J 54 (1985): 290-7
  58. Ghose RR "Letter: Hyponatraemia and diuretics." Lancet 1 (1975): 578-9
  59. Papademetriou V, Fletcher R, Khatri IM, Freis ED "Diuretic-induced hypokalemia in uncomplicated systemic hypertension: effect of plasma potassium correction on cardiac arrhythmias." Am J Cardiol 52 (1983): 1017-22
  60. Read SJ, Trenerry HM, Whiting GF "Hyponatraemia and raised creatine kinase level associated with indapamide." Med J Aust 161 (1994): 607-8
  61. Kone B, Gimenez L, Watson AJ "Thiazide-induced hyponatremia." South Med J 79 (1986): 1456-7
  62. "Product Information. Renese-R (reserpine-polythiazide)." Pfizer US Pharmaceuticals, New York, NY.
  63. Petri M, Cumber P, Grimes L, Treby D, Bryant R, Rawlins D, Ising H "The metabolic effects of thiazide therapy in the elderly: a population study." Age Ageing 15 (1986): 151-5
  64. Simunic M, Rumboldt Z, Ljutic D, Sardelic S "Ramipril decreases chlorthalidone-induced loss of magnesium and potassium in hypertensive patients." J Clin Pharmacol 35 (1995): 1150-5
  65. Katz FH, Eckert RC, Gebott MD "Hypokalemia caused by surreptitious self-administration of diuretics." Ann Intern Med 76 (1972): 85-90
  66. Beling S, Vukovich RA, Neiss ES, Zisblatt M, Webb E, Losi M "Long-term experience with indapamide." Am Heart J 106 (1983): 258-62
  67. Kaur J, Wahi PL "Polythiazide as a diuretic. A clinical trial." J Indian Med Assoc 48 (1967): 13-7
  68. Papademetriou V, Fletcher R, Khatri IM, Freis ED "Diuretic-induced hypokalemia in uncomplicated systemic hypertension: effect of plasma potassium correction on cardiac arrhythmias." Am J Cardiol 52 (1983): 1017-22
  69. Brors O, Enger E, Jacobsen S, Aakvaag A, Foss OP "Effects of hydroflumethiazide in congestive heart failure: renal electrolyte excretion related to urinary thiazide excretion and aldosterone." Acta Pharmacol Toxicol (Copenh) 49 (1981): 399-406
  70. "Product Information. Thalitone (chlorthalidone)." Monarch Pharmaceuticals Inc, Bristol, TN.
  71. Carney SL, Morgan TO "Diuretic-induced hypokalemia and altered renal function." Int J Clin Pharmacol Ther Toxicol 24 (1986): 665-7
  72. Papademetriou V, Price M, Notargiacomo A, Gottdiener J, Fletcher RD, Freis ED "Effect of diuretic therapy on ventricular arrhythmias in hypertensive patients with or without left ventricular hypertrophy." Am Heart J 110 (1985): 595-9
  73. Falch DK, Schreiner AM "Changes in urinary electrolytes versus serum electrolytes during treatment of primary hypertension with chlorthalidone alone and in combination with spironolactone." Acta Med Scand 209 (1981): 111-4
  74. "Product Information. Diuril (chlorothiazide)." Merck & Co, Inc, West Point, PA.
  75. Toner JM, Ramsay LE "Thiazide-induced hypokalaemia; prevalence higher in women." Br J Clin Pharmacol 18 (1984): 449-52
  76. Remenchik AP, Johnston LC "Potassium depletion produced by administration of chlorthalidone to nonedematous patients with arterial hypertensin." Am J Med Sci 252 (1966): 171-6
  77. Leigh H "Letter: Factitious hypokalemia." Ann Intern Med 80 (1974): 111-2
View all 77 references
Major

Thiazides (Includes Hydrochlorothiazide/quinapril) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Patients with severe liver disease or cirrhosis are very susceptible to thiazide-induced hypokalemic hypochloremic alkalosis. Blood ammonia concentrations may be further increased in patients with previously elevated concentrations. Hepatic encephalopathy and death have occurred secondary to the electrolyte alterations accompanying diuretic use. Therapy with thiazide diuretics should be administered cautiously in patients with impaired hepatic function or progressive liver disease, and discontinued promptly if signs of impending hepatic coma appear (e.g., tremors, confusion, and increased jaundice).

References

  1. Sherlock S, Senewiratne B, Scott A, Walker JG "Complications of diuretic therapy in hepatic cirrhosis." Lancet 1 (1966): 1049-52
  2. "Product Information. Zaroxolyn (metolazone)." Rhone-Poulenc Rorer, Collegeville, PA.
  3. "Product Information. Diucardin (hydroflumethiazide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Metahydrin (trichlormethiazide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  5. "Product Information. HydroDIURIL (hydrochlorothiazide)." Merck & Co, Inc, West Point, PA.
  6. Sherlock S, Walker JG, Senewiratne B, Scott A "The complications of diuretic therapy in patients with cirrhosis." Ann N Y Acad Sci 139 (1966): 497-505
  7. "Product Information. Enduron (methyclothiazide)." Abbott Pharmaceutical, Abbott Park, IL.
  8. "Product Information. Lozol (indapamide)." Rhone-Poulenc Rorer, Collegeville, PA.
  9. Aneckstein AG, Weingold AB "Chlorothiazide-induced hepatic coma in pregnancy." Am J Obstet Gynecol 95 (1966): 136-7
  10. "Product Information. Diuril (chlorothiazide)." Merck & Co, Inc, West Point, PA.
  11. "Product Information. Renese-R (reserpine-polythiazide)." Pfizer US Pharmaceuticals, New York, NY.
  12. "Product Information. Thalitone (chlorthalidone)." Monarch Pharmaceuticals Inc, Bristol, TN.
View all 12 references
Major

Thiazides (Includes Hydrochlorothiazide/quinapril) ↔ Lupus Erythematosus

Severe Potential Hazard, Moderate plausibility

Applies to: Lupus Erythematosus

The use of thiazide diuretics has been reported to possibly exacerbate or activate systemic lupus erythematosus. Reported cases have generally been associated with chlorothiazide and hydrochlorothiazide. Therapy with thiazide diuretics should be administered cautiously in patients with a history or risk of SLE.

References

  1. "Product Information. Zaroxolyn (metolazone)." Rhone-Poulenc Rorer, Collegeville, PA.
  2. "Product Information. Renese-R (reserpine-polythiazide)." Pfizer US Pharmaceuticals, New York, NY.
  3. "Product Information. HydroDIURIL (hydrochlorothiazide)." Merck & Co, Inc, West Point, PA.
  4. "Product Information. Lozol (indapamide)." Rhone-Poulenc Rorer, Collegeville, PA.
  5. "Product Information. Diucardin (hydroflumethiazide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. "Product Information. Metahydrin (trichlormethiazide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  7. Rich MW, Eckman JM "Can hydrochlorothiazide cause lupus?" J Rheumatol 22 (1995): 1001
  8. Parodi A, Romagnoli M, Rebora A "Subacute cutaneous lupus erythematosus-like eruption caused by hydrochlorothiazide." Photodermatol 6 (1989): 100-2
  9. Reed BR, Huff JC, Jones SK, Orton PW, Lee LA, Norris DA "Subacute cutaneous lupus erythematosus associated with hydrochlorothiazide therapy." Ann Intern Med 103 (1985): 49-51
  10. "Product Information. Diuril (chlorothiazide)." Merck & Co, Inc, West Point, PA.
  11. Goodrich AL, Kohn SR "Hydrochlorothiazide-induced lupus erythematosus: a new variant?" J Am Acad Dermatol 28 (1993): 1001-2
  12. Brown CW, Deng JS "Thiazide diuretics induce cutaneous lupus-like adverse reaction." J Toxicol Clin Toxicol 33 (1995): 729-33
  13. "Product Information. Enduron (methyclothiazide)." Abbott Pharmaceutical, Abbott Park, IL.
  14. "Product Information. Thalitone (chlorthalidone)." Monarch Pharmaceuticals Inc, Bristol, TN.
View all 14 references
Major

Thiazides (Includes Hydrochlorothiazide/quinapril) ↔ Renal Function Disorders

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Thiazide diuretics may be ineffective when the glomerular filtration rate is low (GFR < 25 mL/min) because they are not expected to be filtered into the renal tubule, their site of action. In addition, thiazide diuretics decrease the GFR and may precipitate azotemia in renal disease. Cumulative effects may also develop because most of these drugs are excreted unchanged in the urine by glomerular filtration and active tubular secretion. Therapy with thiazide diuretics should be administered cautiously at reduced dosages in patients with renal impairment. If renal function becomes progressively worse, as indicated by rising BUN or serum creatinine levels, an interruption or discontinuation of thiazide therapy should be considered.

References

  1. Riess W, Dubach UC, Burckhardt D, Theobald W, Vuillard P, Zimmerli M "Pharmacokinetic studies with chlorthalidone (Hygroton) in man." Eur J Clin Pharmacol 12 (1977): 375-82
  2. Klunk LJ, Ringel S, Neiss ES "The disposition of 14C-indapamide in man." J Clin Pharmacol 23 (1983): 377-84
  3. el-Meheiry MM, Nabih AE, Soliman MD "A clinical study of a new diuretic, Trichlormethiazide." J Trop Med Hyg 69 (1966): 209-14
  4. Brennan L, Wu MJ, Laquer UJ "A multicenter study of indapamide in hypertensive patients with impaired renal function." Clin Ther 5 (1982): 121-8
  5. Craswell PW, Ezzat E, Kopstein J, Varghese Z, Moorhead JF "Use of metolazone, a new diuretic, in patients with renal disease." Nephron 12 (1974): 63-73
  6. Gehr TW, Sica DA, Brater DC, et al "Metolazone pharmacokinetics and pharmacodynamics in renal transplantation." Int J Clin Pharmacol Ther Toxicol 29 (1991): 116-23
  7. Sketris IS, Skoutakis VA, Acchiardo SR, Meyer MC "The pharmacokinetics of trichlormethiazide in hypertensive patients with normal and compromised renal function." Eur J Clin Pharmacol 20 (1981): 453-7
  8. Magil AB "Drug-induced acute interstitial nephritis with granulomas." Hum Pathol 14 (1983): 36-41
  9. Magil AB, Ballon HS, Cameron EC, Rae A "Acute interstitial nephritis associated with thiazide diuretics. Clinical and pathologic observations in three cases." Am J Med 69 (1980): 939-43
  10. Beermann B, Groschinsky-Grind M, Lindstrom B, Wikland B "Pharmacokinetics of bendroflumenthiazide in hypertensive patients." Eur J Clin Pharmacol 13 (1978): 119-24
  11. Fleuren HLJ, Verwey-van Wissen C, van Rossum JM "Dose-dependent urinary excretion of chlorthalidone." Clin Pharmacol Ther 25 (1979): 806-12
  12. Hobbs DC, Twomey TM "Kinetics of polythiazide." Clin Pharmacol Ther 23 (1978): 241-6
  13. "Product Information. Lozol (indapamide)." Rhone-Poulenc Rorer, Collegeville, PA.
  14. "Product Information. Enduron (methyclothiazide)." Abbott Pharmaceutical, Abbott Park, IL.
  15. Larsson GB, Langer L, Nassberger L "Thiazide-induced kidney damage with circulating antibodies against myeloperoxidase and cardiolipin." J Intern Med 233 (1993): 493-4
  16. Madkour H, Gadallah M, Plante GE, Massry SG "Comparison between the effects of indapamide and hydrochlorothiazide on creatinine clearance in patients with impaired renal function and hypertension." Am J Nephrol 15 (1995): 251-5
  17. Lant AF, Baba WI, Wilson GM "Localization of the site of action of oral diuretics in the human kidney." Clin Sci 33 (1967): 11-27
  18. Acchiardo SR, Skoutakis VA "Clinical efficacy, safety, and pharmacokinetics of indapamide in renal impairment." Am Heart J 106 (1983): 237-44
  19. Delevett AF, Recalde M "Diuretic-induced renal colic." JAMA 225 (1973): 992
  20. Read SJ, Trenerry HM, Whiting GF "Hyponatraemia and raised creatine kinase level associated with indapamide." Med J Aust 161 (1994): 607-8
  21. "Product Information. Renese-R (reserpine-polythiazide)." Pfizer US Pharmaceuticals, New York, NY.
  22. Beermann B, Groschinsky-Grind M, Rosen A "Absorption, metabolism, and excretion of hydrochlorothiazide." Clin Pharmacol Ther 19 (1975): 531-7
  23. Niemeyer C, Hasenfub G, Wais U, et al "Pharmacokinetics of hydrochlorothiazide in relation to renal function." Eur J Clin Pharmacol 24 (1983): 661-5
  24. Beermann B, Groschinsky-Grind M, Lindstrom B "Pharmacokinetics of bendroflumethiazide." Clin Pharmacol Ther 22 (1977): 385-8
  25. Yakatan GJ, Smith RB, Frome EL, Doluisio JT "Pharmacokinetics of orally administered hydroflumethiazide in man." J Clin Pharmacol 17 (1977): 37-47
  26. Brors O, Jacobsen S "Distribution of elimination of hydroflumethiazide in man." Eur J Clin Pharmacol 16 (1979): 125-31
  27. Brors O, Haffner JF, Jacobsen S "Excretion of hydroflumethiazide in bile and urine of man." Eur J Clin Pharmacol 15 (1979): 287-9
  28. "Product Information. Diuril (chlorothiazide)." Merck & Co, Inc, West Point, PA.
  29. Carney SL, Morgan TO "Diuretic-induced hypokalemia and altered renal function." Int J Clin Pharmacol Ther Toxicol 24 (1986): 665-7
  30. "Product Information. HydroDIURIL (hydrochlorothiazide)." Merck & Co, Inc, West Point, PA.
  31. "Product Information. Thalitone (chlorthalidone)." Monarch Pharmaceuticals Inc, Bristol, TN.
  32. Jones B, Nanra RS "Double-blind trial of antihypertensive effect of chlorothiazide in severe renal failure." Lancet 2 (1979): 1258-60
  33. "Product Information. Metahydrin (trichlormethiazide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  34. "Product Information. Diucardin (hydroflumethiazide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  35. Gilman AG, Rall TW, Nies AS, Taylor P, eds. "Goodman and Gilman's the Pharmacological Basis of Therapeutics. 8th ed." New York, NY: Pergamon Press Inc. (1990):
  36. "Product Information. Zaroxolyn (metolazone)." Rhone-Poulenc Rorer, Collegeville, PA.
  37. Brater DC "Drug therapy: Diuretic therapy." N Engl J Med 339 (1998): 387-95
  38. Tilstone WJ, Dargie H, Dargie EN, Morgan HG, Kennedy AC "Pharmacokinetics of metolazone in normal subjects and in patients with cardiac or renal failure." Clin Pharmacol Ther 16 (1974): 322-9
  39. Seyffart, G "Drug Dosage in Renal Insufficiency." Dordrecht, The Netherlands: Kluwer Academic Publishers 1 (1991): 227-8
  40. Newstead CG, Moore RH, Barnes AJ "Interstitial nephritis associated with indapamide." BMJ 300 (1990): 1344
  41. Bennett WM, Porter GA "Efficacy and safety of metolazone in renal failure and the nephrotic syndrome." J Clin Pharmacol 13 (1973): 357-64
View all 41 references
Moderate

Ace Inhibitors (Includes Hydrochlorothiazide/quinapril) ↔ Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Rarely, elevations of liver enzymes and/or serum bilirubin have occurred with the use of ACE inhibitors. Patients receiving ACE inhibitors who develop jaundice or marked elevations of hepatic enzymes should discontinue the ACE inhibitor and receive appropriate medical follow-up.

Moderate

Ace Inhibitors (Includes Hydrochlorothiazide/quinapril) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

With the exception of fosinopril, ACE inhibitors (and/or their active metabolites in some cases) are primarily eliminated by the kidney and may accumulate in patients with renal impairment. ACE inhibitors can also worsen renal function in some patients by blocking the effect of angiotensin II-mediated efferent arteriolar vasoconstriction, thereby decreasing glomerular filtration. Therapy with ACE inhibitors should be administered cautiously in patients with preexisting renal dysfunction, particularly those with renovascular disease. Patients with moderate to severe renal impairment usually require lower or less frequent doses and smaller increments in dose. In addition, a dosage reduction or discontinuation of any concomitantly administered diuretics may be helpful. Fosinopril probably does not require dosage adjustments unless hepatic function is also significantly impaired.

In patients with bilateral renal artery stenosis or renal artery stenosis in a solitary kidney, ACE inhibitors may reduce renal perfusion to a critically low level. Renal function should be monitored closely for the first few weeks of therapy.

References

  1. Dietz R, Nagel F, Osterziel KJ "Angiotensin-converting enzyme inhibitors and renal function in heart failure." Am J Cardiol 70 (1992): c119-25
  2. Frank GJ, Knapp LE, Olson SC, Phelps MC, Quade MM, Rieger MM, Sedman AJ "Overview of quinapril, a new ACE inhibitor." J Cardiovasc Pharmacol 15 (1990): s14-23
  3. Champ JD "Case report: azotemia secondary to enalapril and diuretic use and the diagnosis of renovascular hypertension." Am J Med Sci 305 (1993): 25-7
  4. "Moexipril: another ace inhibitor for hypertension." Med Lett Drugs Ther 37 (1995): 75-6
  5. Forette B, Koen R, Vivaut E "Efficacy and safety of quinapril in the elderly hypertensive patient." Am Heart J 123 (1992): 1426-32
  6. "Product Information. Accupril (quinapril)." Parke-Davis, Morris Plains, NJ.
  7. Ljungman S, Kjekshus J, Swedberg K "Renal function in severe congestive heart failure during treatment with enalapril." Am J Cardiol 70 (1992): 479-87
  8. Inman WH, Rawson NS, Wilton LV, et al "Postmarketing surveillance of enalapril. I: results of prescription-event monitoring." Br Med J 297 (1988): 826-9
  9. Olivier PB, German ML, Carette BD, Millart HG, Trenque TC "Elevation of serum creatinine following fosinopril therapy." Ann Pharmacother 33 (1999): 382-3
  10. "Product Information. Monopril (fosinopril)." Bristol-Myers Squibb, Princeton, NJ.
  11. "Product Information. Univasc (moexipril)." Schwarz Pharma, Mequon, WI.
  12. Thind GS "Renal insufficiency during angiotensin-converting enzyme inhibitor therapy in hypertensive patients with no renal artery stenosis." J Clin Hypertens 1 (1985): 337-43
  13. O'Donnell D "Renal failure due to enalapril and captopril in bilateral renal artery stenosis: greater awareness needed." Med J Aust 148 (1988): 525-7
  14. "Product Information. Aceon (perindopril)." Solvay Pharmaceuticals Inc, Marietta, GA.
  15. "Product Information. Prinivil (lisinopril)." Merck & Co, Inc, West Point, PA.
  16. Knapp LE, Frank GJ, McLain R, Rieger MM, Posvar E, Singer R "The safety and tolerability of quinapril." J Cardiovasc Pharmacol 15 (1990): s47-55
  17. Frank GJ, Knapp LE, McLain RW "Overall tolerance and safety of quinapril in clinical trials." Angiology 40 (1989): 405-15
  18. Howes LG, Nguyen T, Jackson B "Safety and efficacy of quinapril in hypertensive geriatric patients." J Am Geriatr Soc 44 (1996): 1135
  19. Heintz B, Verho M, Brockmeier D, Kirsten R, Nelson K, Maigatter S, Lefevre G, Kierdorf H, Sieberth HG "Influence of ramipril on renal function in patients with chronic congestive heart failure." J Cardiovasc Pharmacol 18 (1991): s174-9
  20. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  21. Persson B, Stimpel M "Evaluation of the antihypertensive efficacy and tolerability of moexipril, a new ACE inhibitor, compared to hydrochlorothiazide in elderly patients." Eur J Clin Pharmacol 50 (1996): 259-64
  22. Cetnarowski-Cropp AB "Quinapril: a new second-generation ACE inhibitor." DICP 25 (1991): 499-504
  23. Thomson AH, Kelly JG, Whiting B "Lisinopril population pharmacokinetics in elderly and renal disease patients with hypertension." Br J Clin Pharmacol 27 (1989): 57-65
  24. Heeg JE, de Jong PE, de Zeeuw D "Lisinopril and renal failure ." Lancet 1 (1989): 846
  25. Alderman CP "Adverse effects of the angiotensin-converting enzyme inhibitors." Ann Pharmacother 30 (1996): 55-61
  26. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
  27. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  28. Sica DA, Cutler RE, Parmer RJ, Ford NF "Comparison of the steady-state pharmacokinetics of fosinopril, lisinopril and enalapril in patients with chronic renal insufficiency." Clin Pharmacokinet 20 (1991): 420-7
  29. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
  30. Schwartz D, Averbuch M, Pines A, et al "Renal toxicity of enalapril in very elderly patients with progressive, severe congestive heart failure." Chest 100 (1991): 1558-61
  31. Antonios TFT, Macgregor GA "Angiotensin converting enzyme inhibitors in hypertension: potential problems." J Hypertens 13 Suppl (1995): s11-6
  32. Murray BM, Venuto RC, Kohli R, Cunningham EE "Enalapril-associated acute renal failure in renal transplants: possible role of cyclosporine." Am J Kidney Dis 16 (1990): 66-9
View all 32 references
Moderate

Thiazides (Includes Hydrochlorothiazide/quinapril) ↔ Asthma

Moderate Potential Hazard, Moderate plausibility

Applies to: Asthma

Thiazide diuretics should be used with caution in patients with history of bronchial asthma as sensitivity reactions may occur.

Moderate

Thiazides (Includes Hydrochlorothiazide/quinapril) ↔ Diabetes

Moderate Potential Hazard, Moderate plausibility

Applies to: Diabetes Mellitus, Abnormal Glucose Tolerance

Thiazide diuretics may cause hyperglycemia and glycosuria in patients with diabetes. They may also precipitate diabetes in prediabetic patients. These effects are usually reversible following discontinuation of the drugs. Therapy with thiazide diuretics should be administered cautiously in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Patients with diabetes mellitus should be monitored more closely during thiazide therapy, and their antidiabetic regimen adjusted accordingly.

References

  1. Nielsen S, Schmitz A, Knudsen RE, Dollerup J, Mogensen CE "Enalapril versus bendroflumethiazide in type 2 diabetes complicated by hypertension." Q J Med 87 (1994): 747-54
  2. "Product Information. Diuril (chlorothiazide)." Merck & Co, Inc, West Point, PA.
  3. Jones IG, Pickens PT "Diabetes mellitus following oral diuretics." Practitioner 199 (1967): 209-10
  4. Diamond MT "Hyperglycemic hyperosmolar coma associated with hydrochlorothiazide and pancreatitis." N Y State J Med 72 (1972): 1741-2
  5. Blayac JP, Ribes G, Buys D, Puech R, Loubatieres-Mariani MM "Effects of a new benzothiadiazine derivative, LN 5330, on insulin secretion." Arch Int Pharmacodyn Ther 253 (1981): 154-63
  6. Petri M, Cumber P, Grimes L, Treby D, Bryant R, Rawlins D, Ising H "The metabolic effects of thiazide therapy in the elderly: a population study." Age Ageing 15 (1986): 151-5
  7. "Product Information. Renese-R (reserpine-polythiazide)." Pfizer US Pharmaceuticals, New York, NY.
  8. Elmfeldt D, Berglund G, Wedel H, Wilhelmsen L "Incidence and importance of metabolic side-effects during antihypertensive therapy." Acta Med Scand Suppl 672 (1983): 79-83
  9. "Product Information. Thalitone (chlorthalidone)." Monarch Pharmaceuticals Inc, Bristol, TN.
  10. Pickkers P, Schachter M, Hughes AD, Feher MD, Sever PS "Thiazide-induced hyperglycaemia: a role for calcium-activated potassium channels?" Diabetologia 39 (1996): 861-4
  11. Berglund G, Andersson O, Widgren B "Low-dose antihypertensive treatment with a thiazide diuretic is not diabetogenic. A 10-year controlled trial with bendroflumethiazide." Acta Med Scand 220 (1986): 419-24
  12. "Product Information. Enduron (methyclothiazide)." Abbott Pharmaceutical, Abbott Park, IL.
  13. Andersen OO, Persson I "Carbohydrate metabolism during treatment with chlorthalidone and ethacrynic acid." Br Med J 2 (1968): 798-801
  14. Berlin I "Prazosin, diuretics, and glucose intolerance." Ann Intern Med 119 (1993): 860
  15. Seltzer HS, Allen EW "Hyperglycemia and inhibition of insulin secretion during administration of diazoxide and trichlormethiazide in man." Diabetes 18 (1969): 19-28
  16. Pollare T, Lithell H, Berne C "A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension." N Engl J Med 321 (1989): 868-73
  17. Bell DS "Insulin resistance. An often unrecognized problem accompanying chronic medical disorders." Postgrad Med 93 (1993): 99-103,
  18. "Product Information. Zaroxolyn (metolazone)." Rhone-Poulenc Rorer, Collegeville, PA.
  19. Goldman JA, Neri A, Ovadia J, Eckerling B, Vries A, de "Effect of chlorothiazide on intravenous glucose tolerance in pregnancy." Am J Obstet Gynecol 105 (1969): 556-60
  20. Freis ED "The efficacy and safety of diuretics in treating hypertension." Ann Intern Med 122 (1995): 223-6
  21. Schmitz O, Hermansen K, Nielsen OH, Christensen CK, Arnfred J, Hansen HE, Mogensen CE, Orskov H, Beck-Nielsen H "Insulin action in insulin-dependent diabetics after short-term thiazide therapy." Diabetes Care 9 (1986): 631-6
  22. Rowe P, Mather H "Hyperosmolar non-ketotic diabetes mellitus associated with metolazone." Br Med J 291 (1985): 25-6
  23. Winchester JF, Kellett RJ, Boddy K, Boyle P, Dargie HJ, Mahaffey ME, Ward DM, Kennedy AC "Metolazone and bendroflumethiazide in hypertension: physiologic and metabolic observations." Clin Pharmacol Ther 28 (1980): 611-8
  24. "Product Information. Diucardin (hydroflumethiazide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  25. Chowdhury FR, Bleicher SJ "Chlorthalidone--induced hypokalemia and abnormal carbohydrate metabolism." Horm Metab Res 2 (1970): 13-6
  26. Miller NR, Moses H "Transient oculomotor nerve palsy. Association with thiazide-induced glucose intolerance." JAMA 240 (1978): 1887-8
  27. Murphy MB, Kohner E, Lewis PJ, Schumer B, Dollery CT "Glucose intolerance in hypertensive patients treated with diuretics: a fourteen-year follow-up." Lancet 2 (1982): 1293-5
  28. Slotkoff L "Clinical efficacy and safety of indapamide in the treatment of edema." Am Heart J 106 (1983): 233-7
  29. "Product Information. Lozol (indapamide)." Rhone-Poulenc Rorer, Collegeville, PA.
  30. Domenet JG "Diabetogenic effect of oral diuretics." Br Med J 3 (1968): 188
  31. "Product Information. Metahydrin (trichlormethiazide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  32. Harper R, Ennis CN, Heaney AP, Sheridan B, Gormley M, Atkinson AB, Johnston GD, Bell PM "A comparison of the effects of low- and conventional-dose thiazide diuretic on insulin action in hypertensive patients with NIDDM." Diabetologia 38 (1995): 853-9
  33. Beling S, Vukovich RA, Neiss ES, Zisblatt M, Webb E, Losi M "Long-term experience with indapamide." Am Heart J 106 (1983): 258-62
  34. Curtis J, Horrigan F, Ahearn D, Varney R, Sandler SG "Chlorthalidone-induced hyperosmolar hyperglycemic nonketotic coma." JAMA 220 (1972): 1592-3
  35. Kansal PC, Buse J, Buse MG "Thiazide diuretics and control of diabetes mellitus." South Med J 62 (1969): 1372-9
  36. "Product Information. HydroDIURIL (hydrochlorothiazide)." Merck & Co, Inc, West Point, PA.
View all 36 references
Moderate

Thiazides (Includes Hydrochlorothiazide/quinapril) ↔ Hyperlipidemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperlipidemia

Thiazide diuretics may increase serum triglyceride and cholesterol levels, primarily LDL and VLDL. Whether these effects are dose-related and sustained during chronic therapy are unknown. Patients with preexisting hyperlipidemia may require closer monitoring during thiazide therapy, and adjustments made accordingly in their lipid-lowering regimen

References

  1. Ames RP "A comparison of blood lipid and blood pressure responses during the treatment of systemic hypertension with indapamide and with thiazides." Am J Cardiol 77 (1996): b12-6
  2. Slotkoff L "Clinical efficacy and safety of indapamide in the treatment of edema." Am Heart J 106 (1983): 233-7
  3. Freis ED "The efficacy and safety of diuretics in treating hypertension." Ann Intern Med 122 (1995): 223-6
  4. "Product Information. Lozol (indapamide)." Rhone-Poulenc Rorer, Collegeville, PA.
  5. Winchester JF, Kellett RJ, Boddy K, Boyle P, Dargie HJ, Mahaffey ME, Ward DM, Kennedy AC "Metolazone and bendroflumethiazide in hypertension: physiologic and metabolic observations." Clin Pharmacol Ther 28 (1980): 611-8
  6. Ames RP, Hill P "Increase in serum-lipids during treatment of hypertension with chlorthalidone." Lancet 1 (1976): 721-3
  7. Elmfeldt D, Berglund G, Wedel H, Wilhelmsen L "Incidence and importance of metabolic side-effects during antihypertensive therapy." Acta Med Scand Suppl 672 (1983): 79-83
  8. Smith WM "Diuretics and cholesterol elevation." JAMA 242 (1979): 1612
  9. "Product Information. Diuril (chlorothiazide)." Merck & Co, Inc, West Point, PA.
  10. "Product Information. Enduron (methyclothiazide)." Abbott Pharmaceutical, Abbott Park, IL.
  11. Pollare T, Lithell H, Berne C "A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension." N Engl J Med 321 (1989): 868-73
  12. Petri M, Cumber P, Grimes L, Treby D, Bryant R, Rawlins D, Ising H "The metabolic effects of thiazide therapy in the elderly: a population study." Age Ageing 15 (1986): 151-5
  13. "Product Information. Thalitone (chlorthalidone)." Monarch Pharmaceuticals Inc, Bristol, TN.
  14. Luther RR, Glassman HN, Estep CB, Maurath CJ, Jordan DC "The effects of terazosin and methyclothiazide on blood pressure and serum lipids." Am Heart J 117 (1989): 842-7
  15. Kasiske BL, Ma JZ, Kalil RS, Louis TA "Effects of antihypertensive therapy on serum lipids." Ann Intern Med 122 (1995): 133-41
  16. "Product Information. Renese-R (reserpine-polythiazide)." Pfizer US Pharmaceuticals, New York, NY.
  17. Beling S, Vukovich RA, Neiss ES, Zisblatt M, Webb E, Losi M "Long-term experience with indapamide." Am Heart J 106 (1983): 258-62
  18. "Product Information. Diucardin (hydroflumethiazide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  19. Pollare T, Lithell H, Berne C "A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension." N Engl J Med 321 (1989): 868-73
  20. "Product Information. Zaroxolyn (metolazone)." Rhone-Poulenc Rorer, Collegeville, PA.
  21. "Product Information. HydroDIURIL (hydrochlorothiazide)." Merck & Co, Inc, West Point, PA.
  22. Fager G, Berglund G, Bondjers G, Elmfeldt D, Lager I, Olofsson SO, Smith U, Wiklund O "Effects of anti-hypertensive therapy on serum lipoproteins. Treatment with metoprolol, propranolol and hydrochlorothiazide." Artery 11 (1983): 283-96
  23. "Product Information. Metahydrin (trichlormethiazide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
View all 23 references
Moderate

Thiazides (Includes Hydrochlorothiazide/quinapril) ↔ Hyperparathyroidism

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperparathyroidism

Urinary calcium excretion is decreased by thiazide diuretics during chronic administration. Pathologic changes in the parathyroid gland with hypercalcemia and hypophosphatemia have been reported during prolonged therapy. However, the common complications of hyperparathyroidism such as renal lithiasis, bone resorption, and peptic ulceration have not been seen. Clinicians should be cognizant of these effects when prescribing or administering thiazide therapy to patients with hyperparathyroidism. These drugs should be discontinued before carrying out tests for parathyroid function.

References

  1. Lindy S, Tarssanen L "Serum calcium and phosphorus in patients treated with thiazides and furosemide." Acta Med Scand 194 (1973): 319-22
  2. "Product Information. Lozol (indapamide)." Rhone-Poulenc Rorer, Collegeville, PA.
  3. Jorgensen FS, Brunner S "The long-term effect of bendroflumethiazide on renal calcium and magnesium excretion and stone formation in patients with recurring renal stones." Scand J Urol Nephrol 8 (1974): 128-31
  4. Paloyan E, Farland M, Pickleman JR "Hyperparathyroidism coexisting with hypertension and prolonged thiazide administration." JAMA 210 (1969): 1243-5
  5. "Product Information. Zaroxolyn (metolazone)." Rhone-Poulenc Rorer, Collegeville, PA.
  6. Gammon GD, Docherty JP "Thiazide-induced hypercalcemia in a manic-depressive patient." Am J Psychiatry 137 (1980): 1453-5
  7. Itescu S, Haskell LP, Tannenberg AM "Thiazide-induced clinically significant hypophosphatemia ." Clin Nephrol 27 (1987): 161-2
  8. Duarte CG, Winnacker JL, Becker KL, Pace A "Thiazide-induced hypercalcemia." N Engl J Med 284 (1971): 828-30
  9. "Product Information. Metahydrin (trichlormethiazide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  10. "Product Information. HydroDIURIL (hydrochlorothiazide)." Merck & Co, Inc, West Point, PA.
  11. Klimiuk PS, Davies M, Adams PH "Primary hyperparathyroidism and thiazide diuretics." Postgrad Med J 57 (1981): 80-3
  12. Parfitt AM "Thiazide-induced hypercalcemia in vitamin D-treated hypoparathyroidism." Ann Intern Med 77 (1972): 557-63
  13. "Product Information. Diucardin (hydroflumethiazide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  14. Anderson PE, Ellis GG, Austin SM "Case report: metolazone-associated hypercalcemia and acute pancreatitis." Am J Med Sci 302 (1991): 235-7
  15. Palmer FJ "Letter: Chlorthalidone-induced hypercalcemia." JAMA 229 (1974): 267
  16. "Product Information. Thalitone (chlorthalidone)." Monarch Pharmaceuticals Inc, Bristol, TN.
  17. Paloyan E, Farland M, Pickleman JR "Hyperparathyroidism coexisting with hypertension and prolonged thiazide administration." JAMA 210 (1969): 1243-5
  18. "Product Information. Renese-R (reserpine-polythiazide)." Pfizer US Pharmaceuticals, New York, NY.
  19. Ljunghall S, Backman U, Danielson BG, Fellstrom B, Johansson G, Wikstrom B "Calcium and magnesium metabolism during long-term treatment with thiazides." Scand J Urol Nephrol 15 (1981): 257-62
  20. Balizet L "Recurrent parathyroid adenoma. Association with prolonged thiazide administration." JAMA 225 (1973): 1238-9
  21. Popovtzer MM, Subryan VL, Alfrey AC, Reeve EB, Schrier RW "The acute effect of chlorothiazide on serum-ionized calcium. Evidence for a parathyroid hormone-dependent mechanism." J Clin Invest 55 (1975): 1295-302
  22. "Product Information. Enduron (methyclothiazide)." Abbott Pharmaceutical, Abbott Park, IL.
  23. Hakim R, Tolis G, Goltzman D, Meltzer S, Friedman R "Severe hypercalcemia associated with hydrochlorothiazide and calcium carbonate therapy." Can Med Assoc J 121 (1979): 591-4
  24. "Product Information. Diuril (chlorothiazide)." Merck & Co, Inc, West Point, PA.
  25. Parfitt AM "Chlorothiazide-induced hypercalcemia in juvenile osteoporosis and hyperparathyroidism." N Engl J Med 281 (1969): 55-9
  26. Byatt CM, Millard PH, Levin GE "Diuretics and electrolyte disturbances in 1000 consecutive geriatric admissions." J R Soc Med 83 (1990): 704-8
  27. Hilker RR "Reversible hypercalcemia associated with prolonged thiazide administration to control hypertension." J Occup Med 12 (1970): 444-5
View all 27 references
Moderate

Thiazides (Includes Hydrochlorothiazide/quinapril) ↔ Hyperuricemia

Moderate Potential Hazard, High plausibility

Applies to: Gout

Thiazide diuretics decrease the rate of uric acid excretion. Hyperuricemia occurs frequently but is usually asymptomatic and rarely leads to clinical gout except in patients with a history of gout or chronic renal failure. Therapy with thiazide diuretics should be administered cautiously in such patients.

References

  1. "Product Information. Thalitone (chlorthalidone)." Monarch Pharmaceuticals Inc, Bristol, TN.
  2. "Product Information. Diuril (chlorothiazide)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Enduron (methyclothiazide)." Abbott Pharmaceutical, Abbott Park, IL.
  4. "Product Information. Zaroxolyn (metolazone)." Rhone-Poulenc Rorer, Collegeville, PA.
  5. Beling S, Vukovich RA, Neiss ES, Zisblatt M, Webb E, Losi M "Long-term experience with indapamide." Am Heart J 106 (1983): 258-62
  6. Labeeuw M, Pozet N, Aissa AH, Zech PY, Sassard J, Laville M "Uric acid renal handling: spontaneous changes and influence of a thiazide alone or associated with triamterene." Int J Clin Pharmacol Ther Toxicol 26 (1988): 79-83
  7. "Product Information. Lozol (indapamide)." Rhone-Poulenc Rorer, Collegeville, PA.
  8. "Product Information. HydroDIURIL (hydrochlorothiazide)." Merck & Co, Inc, West Point, PA.
  9. "Product Information. Renese-R (reserpine-polythiazide)." Pfizer US Pharmaceuticals, New York, NY.
  10. Petri M, Cumber P, Grimes L, Treby D, Bryant R, Rawlins D, Ising H "The metabolic effects of thiazide therapy in the elderly: a population study." Age Ageing 15 (1986): 151-5
  11. Freis ED "The efficacy and safety of diuretics in treating hypertension." Ann Intern Med 122 (1995): 223-6
  12. "Product Information. Diucardin (hydroflumethiazide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  13. Slotkoff L "Clinical efficacy and safety of indapamide in the treatment of edema." Am Heart J 106 (1983): 233-7
  14. Gudbrandsson T, Hansson L "Combination therapy with saluretics and atenolol in essential hypertension. Effects on blood pressure, electrolytes and uric acid." Acta Med Scand Suppl 625 (1979): 86-91
  15. Elmfeldt D, Berglund G, Wedel H, Wilhelmsen L "Incidence and importance of metabolic side-effects during antihypertensive therapy." Acta Med Scand Suppl 672 (1983): 79-83
  16. Brors O, Jacobsen S, Foss OP, Aakvaag A "Effect of repeated doses of hydroflumethiazide on renal excretion of electrolytes and uric acid in healthy subjects." Acta Pharmacol Toxicol (Copenh) 48 (1981): 145-50
  17. Lapidus PW, Guidotti FP "Gout in orthopaedic practice: review of 232 cases." Clin Orthop 28 (1963): 97-110
  18. "Product Information. Metahydrin (trichlormethiazide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  19. Winchester JF, Kellett RJ, Boddy K, Boyle P, Dargie HJ, Mahaffey ME, Ward DM, Kennedy AC "Metolazone and bendroflumethiazide in hypertension: physiologic and metabolic observations." Clin Pharmacol Ther 28 (1980): 611-8
  20. Ljunghall S, Backman U, Danielson BG, Fellstrom B, Johansson G, Odlind B, Wikstrom B "Effects of bendroflumethiazide on urate metabolism during treatment of patients with renal stones." J Urol 127 (1982): 1207-10
View all 20 references
Moderate

Thiazides (Includes Hydrochlorothiazide/quinapril) ↔ Thyroid Function Tests

Moderate Potential Hazard, Moderate plausibility

Applies to: Thyroid Disease

Thiazide diuretics may decrease serum PBI (protein-bound iodine) levels without associated thyroid disturbance. Clinicians should be cognizant of this effect when prescribing or administering thiazide therapy to patients with thyroid disorders.

References

  1. Bech K, Skovsted L, Siersbaek-Nielsen K, Hansen JM "Influence of thiazides on thyroid parameters in man." Acta Endocrinol (Copenh) 89 (1978): 673-8
  2. "Product Information. Thalitone (chlorthalidone)." Monarch Pharmaceuticals Inc, Bristol, TN.
  3. "Product Information. Zaroxolyn (metolazone)." Rhone-Poulenc Rorer, Collegeville, PA.
  4. "Product Information. Renese-R (reserpine-polythiazide)." Pfizer US Pharmaceuticals, New York, NY.
  5. "Product Information. Metahydrin (trichlormethiazide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  6. "Product Information. Lozol (indapamide)." Rhone-Poulenc Rorer, Collegeville, PA.
  7. "Product Information. HydroDIURIL (hydrochlorothiazide)." Merck & Co, Inc, West Point, PA.
  8. "Product Information. Diucardin (hydroflumethiazide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  9. "Product Information. Diuril (chlorothiazide)." Merck & Co, Inc, West Point, PA.
  10. "Product Information. Enduron (methyclothiazide)." Abbott Pharmaceutical, Abbott Park, IL.
View all 10 references

hydrochlorothiazide / quinapril drug Interactions

There are 1022 drug interactions with hydrochlorothiazide / quinapril

hydrochlorothiazide / quinapril alcohol/food Interactions

There are 3 alcohol/food interactions with hydrochlorothiazide / quinapril

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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