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Package leaflet: Information for the user

Accuretic® 10/12.5 mg
film-coated tablets
quinapril and hydrochlorothiazide
Read all of this leaflet carefully before you start taking this medicine because it contains important
information for you.
– Keep this leaflet. You may need to read it again.
– If you have any further questions, ask your doctor or pharmacist.
– This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness
are the same as yours.
– If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.
See section 4.
What is in this leaflet
1. What Accuretic is and what it is used for
2. What you need to know before you take Accuretic
3. How to take Accuretic
4. Possible side effects
5. How to store Accuretic
6. Contents of the pack and other information

1. What Accuretic is and what it
is used for
Accuretic contains the active substances 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’.
Accuretic is used to treat high blood pressure.
You must talk to a doctor if you do not feel better or if you
feel worse.

2. What you need to know
before you take Accuretic
Do not take Accuretic
• if you are in your second or third trimester of pregnancy.
It is also better to avoid Accuretic in early pregnancy. See
section 2 Pregnancy, breast-feeding and fertility
• if you are allergic to quinapril, hydrochlorothiazide, or any of
the other ingredients of this medicine (listed in section 6),
similar drugs or to a group of antibiotics called sulfonamides
• if you have a history of angioedema relating to previous
treatment with an ACE inhibitor
• 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 diabetes or impaired kidney function and you
are treated with a blood pressure lowering medicine
containing aliskiren
• if you are taking sacubitril/valsartan, a medicine for heart
Warnings and precautions
Talk to your doctor or pharmacist before taking Accuretic:
• if you have aortic stenosis (narrowing of the main blood
vessel from the heart)
• if you have kidney disease, a transplanted kidney, or use a
haemodialysis machine (an artificial kidney)
• if you have liver disease
• if you have heart disease or heart failure
• if you are elderly
• if you have low blood pressure (hypotension), likely to occur
if you are dehydrated (excessive loss of body water) or have
salt deficiency due to diuretic therapy (water tablets),
low-salt diet, diarrhoea, vomiting, or haemodialysis
• if you have a dry cough
• if you are of African-Caribbean ethnic origin
• if you have collagen vascular disease (deposits of collagen
in your blood vessels)
• if you are having, or about to have, low density
lipoprotein apheresis treatment (removal of cholesterol
from your blood by machine)
• if you have a history of severe allergic reactions, asthma
or angioedema (such as swelling of the eyes, face, lips,
tongue or throat)
• if you are having, or about to have desensitisation
treatment, i.e. to reduce the effects of an allergy to a bee
or wasp sting
• if you are planning to become pregnant, or you just
became aware of being pregnant (see section
2 Pregnancy, breast-feeding and fertility)
• if you are breast-feeding or about to start breast-feeding
(see section 2 Pregnancy, breast-feeding and
• if you are taking medicines containing lithium
• if you have diabetes or gout
• if you have systemic lupus erythematosus (SLE) an allergic
condition which causes joint pain, skin rashes and fever
• if you have a salt or electrolyte imbalance in your blood
(e.g. sodium or potassium), your doctor may want to
monitor you more closely
• if you experience 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 are about to have surgery or receive anaesthetics
(even at the dentist), remember to tell any medical staff
that you are taking Accuretic
• if you have a fever, sore throat, mouth ulcers, tiredness,
unexplained bruising or bleeding, or a blood problem
such as low or lack of white blood cells (neutropenia or


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• if 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
• if you are simultaneously receiving an mTOR (mammalian
target of Rapamycin) inhibitor (e.g. temsirolimus) or a
DPP-4 (dipeptidyl-peptidase-4) inhibitor (e.g. vildagliptin)
or a neutral endopeptidase inhibitor (e.g. racecadotril), may
have an increased risk for angioedema (swelling of the face,
eyes, tongue or throat). Special caution is advised if
treatment with an mTOR inhibitor or DPP-4 inhibitor or
a neutral endopeptidase inhibitor is initiated in patients
who are already receiving an ACE inhibitor.
Your doctor may check your kidney function, blood pressure
and the amount of electrolytes (e.g. potassium) in your blood
at regular intervals. See section 2 Do not take Accuretic.
Children and adolescents
Accuretic should not be used in children and adolescents
under 18 years of age.
Other medicines and Accuretic
Tell your doctor or pharmacist if you are taking, have recently
taken or might take any other medicines, including medicines
obtained without a prescription. There are some medicines
that may interact with Accuretic. Your doctor may need to
change your dose and/or to take other precautions if you are
• angiotensin II receptor blocker (ARB) or aliskiren
(see section 2 Do not take Accuretic and Warnings
and precautions)
• other blood pressure treatments and diuretics
(including aliskiren and water tablets)
• medicines called tetracyclines used to treat infections
• cholestyramine and colestipol (medicines used to treat
high levels of fats in the blood)
• medicines called ‘pressor amines’ such as norepinephrine
and epinephrine
• antibiotics like sulfamethoxazole and trimethoprim
• potassium supplements (this includes salt substitutes
which often contain potassium)
• anaesthetics
• lithium (used to treat depression)
• non-steroidal anti-inflammatory pain killers
(including aspirin or ibuprofen)
• corticosteroids (including hydrocortisone, dexamethasone
or prednisolone) and ACTH (tetracosactide) or drugs
known to reduce the amount of potassium in the blood
• 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, uricosurics and xanthine
oxidase inhibitors (for the treatment of chronic gout)
• indigestion and heartburn medicines (antacids)
• medicines that have a sedative effect. This includes alcoholic
drinks and sleeping pills
• digitalis glycosides (e.g. digoxin, for the treatment of heart
• mTOR inhibitors used to treat kidney cancer (including
temsirolimus), certain antidiabetic drugs (DPP-4 inhibitors
e.g. vildagliptin) or certain drugs against heart insufficiency
and high blood pressure (neutral endopeptidase inhibitor,
e.g. racecadotril): the risk of an angioedema (swelling of the
face, eyes, tongue or throat) can be elevated.
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.
Accuretic with food and drink
See section 3 How to take Accuretic.
Pregnancy, breast-feeding and fertility
Do not start taking Accuretic if you are pregnant or planning
to become pregnant.
If you are pregnant or breast-feeding, think you may be
pregnant or are planning to have a baby, ask your doctor for
advice before taking this medicine. Your doctor will normally
advise you to stop taking Accuretic before you become
pregnant or as soon as you know you are pregnant and will
advise you to take another medicine instead of Accuretic.
Accuretic is not recommended during pregnancy, and must
not be taken when more than 3 months pregnant, as it may
cause serious harm to your baby if used after the third month
of pregnancy.
Tell your doctor if you are breast-feeding or about to start
breast-feeding. Accuretic is not recommended for mothers
who are breast-feeding.
Driving and using machines
Your tablets may affect your ability to drive or operate
machines safely. They may make you feel dizzy or weary. If
affected, do not drive or operate machines and contact your
doctor immediately.
Accuretic contains lactose
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

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3. How to take Accuretic
Always take this medicine exactly as your doctor or pharmacist
has told you. Check with your doctor or pharmacist if you are
not sure.
Do not wait until your tablets are finished before seeing your
The recommended dose is one tablet each day. Try to take the
tablet at about the same time every day. Accuretic can be
taken with or without food.
Accuretic is not recommended for use in patients who suffer with
kidney disease with a creatinine clearance of less than 40 mL/min.
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.
Swallow the tablets whole with water. Do not chew, divide
or crush the tablets.
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 forget to take 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 forgotten dose.
If you stop taking Accuretic
Do not stop taking your tablets or alter the dose you are
currently taking without seeing your doctor first. It is
important to keep taking your tablets. They help to control
your blood pressure.
If you have any further questions on the use of this medicine,
ask your doctor or pharmacist.

4. Possible side effects
Like all medicines, this medicine 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 as
they can be serious:
Common: may affect up to 1 in 10 people
• severe chest pain, tightness of the chest, shortness of
breath, wheezing or trouble breathing, irregular or strong
heartbeat (palpitations). These symptoms may be due to
heart attack or angina
Uncommon: may affect up to 1 in 100 people
• ringing or noise in the ears
Very rare: may affect up to 1 in 10,000 people
• severe abdominal pain causing you to be sick (intestinal
Not known: frequency cannot be estimated from the
available data
• severe allergic (anaphylactoid) reaction to this medicine
such as swelling of the face, tongue and throat which
cause great difficulty breathing (angioedema)
• weakness of arms, legs or problems speaking which may
be symptoms of a possible stroke
• fever, cough, and other nonspecific symptoms, followed by
redness and sloughing of the skin and mucous membranes
(Toxic Epidermal Necrolysis). A skin rash with irregular red
spots or ‘target’ lesions (erythema multiforme). Intense
skin rash including hives, severe itching, blistering, peeling
and swelling of the skin, inflammation of mucous
membranes (Stevens Johnson Syndrome)
• 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
• neutropenia/agranulocytosis resulting in decreased
numbers of white blood cells or decrease in blood
platelets which may result in bruising or easy bleeding
• severe abdominal and back pain accompanied with feeling
very unwell (pancreatitis)
• liver inflammation (hepatitis), abdominal pain, nausea, dark
brown urine, yellowing of the skin or the eyes (jaundice)
• inflammation of the kidneys (tubulointerstitial nephritis)
symptoms include fever and a rash but occasionally
patients might notice blood in urine as well
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: may affect up to 1 in 10 people
• diarrhoea, indigestion, mild stomach pain, feeling or being
• dizziness, headache, tiredness, feeling weak, sleepiness or
• 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
• increased levels of creatinine in the blood
• increased levels of blood urea
• chest pain
• increased levels of Potassium in serum
• rapid heart rate
Uncommon: may affect up to 1 in 100 people
• kidney and urinary problems, urinary tract infection
• numbness or tingling sensation in your limbs, aching joints
• depression, nervousness, confusion
• 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
heart attack (myocardial infarction)
increased glucose levels in blood
painful joints
shortness of breath
swelling under the skin
protein in urine

Rare: may affect up to 1 in 1,000 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
• psoriasis
• swelling of the hands, face and tongue (angioedema)
• skin disorders
Very rare: may affect up to 1 in 10,000 people
• obstruction of the digestive system (bowel)
• blurred vision
• hives
Not known: frequency cannot be estimated from the
available data
• allergic condition which causes joint pain, skin rashes and
fever (systemic lupus erythematosus)
• inflammation of the lining of the lungs, heart or abdomen
• erythema and scaling of the skin (dermatitis exfoliative)
• bruising or a purple or red rash (purpura)
• small fluid-filled blisters on the skin (pemphigus)
• skin discolouration
• low numbers of red blood cells (anaemia)
• bleeding from blood vessels in the brain
• narrowing of the airways in the lungs (bronchospasm)
• short-sightedness
• acute closure glaucoma (increased pressure in the eyes)
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.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse.
This includes any possible side effects not listed in this leaflet. You
can also report side effects directly via the Yellow Card Scheme at: or search for MHRA Yellow Card in
the Google Play or Apple App Store. By reporting side effects you
can help provide more information on the safety of this medicine.

5. How to store Accuretic
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated
on the carton and blister strip after EXP. The expiry date
refers to the last day of that month.
Do not store above 25°C. Store in the original package in
order to protect from moisture.
Do not throw away any medicines via wastewater or household
waste. Ask your pharmacist how to throw away medicines you no
longer use. These measures will help protect the environment.

6. Contents of the pack
and other information
What Accuretic contains
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
The other ingredients (excipient(s)) are magnesium carbonate,
lactose (see section 2 Accuretic contains lactose),
povidone, crospovidone and magnesium stearate.
The coating of the tablets contains candelilla wax and Opadry
pink OY-S-6937 which contains iron oxide (E172), titanium
dioxide (E171), hydroxypropylmethyl cellulose, hydroxypropyl
cellulose and polyethylene glycol.
What Accuretic looks like and contents of the pack
Accuretic tablets are oval, pink, film-coated tablets scored on
both sides. The tablets are available in blister packs of 7, 28, 30,
100 and 156 tablets.
Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder:
Pfizer Limited
Ramsgate Road
CT13 9NJ
United Kingdom
Pfizer Manufacturing Deutschland GmbH
Betriebsstätte Freiburg
Mooswaldallee 1
79090 Freiburg
Company contact address
For further information on this medicine, please contact
Medical Information at:
Pfizer Limited, Walton Oaks, Tadworth, Surrey, UK
Tel: +44 1304 616161.
This leaflet was last revised in 02/2018.
Ref: AH 25_0

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Pfizer Limited
Sandwich, England

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