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ACQUIN

quinapril (as hydrochloride)


Consumer Medicine Information

What is in this leaflet

This leaflet answers some common questions about ACQUIN.

It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.

All medicines have benefits and risks. Your doctor has weighed the risks of you taking ACQUIN against the benefits they expect it will have for you.

Talk to your doctor or pharmacist if you have any concerns about taking this medicine.

Keep this leaflet with your medicine. You may need to read it again.

What ACQUIN is used for

ACQUIN is used to lower high blood pressure (hypertension). It is also used to treat heart failure. It contains the active ingredient quinapril hydrochloride.

Hypertension
ACQUIN is used to lower high blood pressure (hypertension). Everyone has blood pressure. This pressure helps get your blood all around your body. Your blood pressure may be different at different times of the day, depending on how busy or worried you are. You have hypertension (high blood pressure) when your blood pressure stays higher than is needed, even when you are calm and relaxed.

There are usually no symptoms of hypertension. The only way of knowing that you have hypertension is to have your blood pressure checked on a regular basis. If high blood pressure is not treated it can lead to serious health problems, including stroke, heart disease and kidney failure.

Heart Failure
Heart failure means that the heart muscle is weak and cannot pump blood strongly enough to supply all the blood needed throughout the body. Heart failure is not the same as heart attack and does not mean that the heart stops. Heart failure may start off with no symptoms, but as the condition progresses, patients may feel short of breath or may get tired easily after light physical activity such as walking. Some patients may wake up short of breath at night. Fluid may collect in different parts of the body, often first noticed as swollen ankles and feet.

How it works

ACQUIN works by widening your blood vessels, which reduces pressure in the vessels, making it easier for your heart to pump blood around your body. This helps increase the supply of oxygen to your heart, so that when you place extra demands on your heart, such as during exercise, your heart may cope better and you may not get short of breath as easily.

ACQUIN belongs to a group of medicines called angiotensin converting enzyme (ACE) inhibitors.

Your doctor may have prescribed ACQUIN for another reason. Ask your doctor if you have any questions about why it has been prescribed for you.

ACQUIN is not addictive.

This medicine is available only with a doctor's prescription.

Before you take it

When you must not take it

Do not take ACQUIN if:

  • you have an allergy to medicines containing quinapril or any of the ingredients listed at the end of this leaflet
  • you have taken any other 'ACE inhibitor' medicine before, which caused your face, lips, tongue, throat, hands or feet to swell up, or made it hard for you to breathe
  • you or your family have a history of swelling of the face, lips, tongue, throat, hands or feet for no apparent reason.

Symptoms of an allergic reaction may include skin rash, itchiness, shortness of breath, swelling of the face, lips or tongue, muscle pain or tenderness or joint pain.

If you have had an allergic reaction to an ACE inhibitor before, you may be allergic to ACQUIN.

Use of ACE inhibitors have been associated with Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH) and subsequent low blood sodium levels.

Your doctor may also wish to do a blood test to monitor your sodium levels to ensure they are within normal limits. In the elderly and other at risk patients, sodium levels may be monitored more frequently.

Do not take ACQUIN if:

  • you have kidney problems or a condition called renal artery stenosis
  • you have regular dialysis for blood filtration.

You may experience an allergic reaction.

Do not take ACQUIN if you are currently taking blood pressure lowering medicine containing aliskiren or with medicines known as angiotensin receptor blockers (ARB) or other ACE inhibitors and you have the following conditions:

  • diabetes
  • kidney problems
  • high levels or potassium in your blood
  • congestive heart failure.

You may experience severe side effects.

Do not take ACQUIN if you are pregnant or breastfeeding. ACQUIN may enter your womb or it may pass into the breast milk and there is the possibility that your baby may be affected.

Do not take it if the expiry date (Exp.) printed on the pack has passed. It may not work as well if you do.

Do not take it if the packaging shows signs of tampering or the tablets do not look quite right.

If you are not sure whether you should start taking ACQUIN, talk to your doctor.

Before you start to take it

Tell your doctor if you are allergic to any other medicines, foods, dyes or preservatives.

Tell your doctor if you have or have had any medical conditions, especially the following:

  • kidney problems, or are having dialysis
  • liver problems
  • heart problems
  • low blood pressure, which you may notice as dizziness or light-headedness
  • diabetes
  • high levels of potassium in your blood.

You must also tell your doctor if you:

  • are following a very low salt diet
  • are about to receive desensitisation therapy for an allergy
  • are about to undergo dialysis or lipoprotein apheresis
  • are about to have surgery or a general anaesthetic
  • plan to become pregnant or breastfeed.

If you have not told your doctor about any of the above, tell them before you start taking ACQUIN.

Taking other medicines

Tell your doctor if you are taking any other medicines, including any that you buy without a prescription from a pharmacy, supermarket or health food shop.

Some medicines may be affected by ACQUIN, or may affect how well it works. These include:

  • other medicines used to treat high blood pressure
  • other medicines that work in a similar fashion to ACE inhibitors, such as Angiotensin Receptor Blockers (these are used to treat high blood pressure and/or heart failure)
  • diuretics, also known as fluid or water tablets
  • non-steroidal anti-inflammatory drugs (NSAIDs) or Cox 2 inhibiting medicines used to relieve pain, swelling and other symptoms of inflammation, including arthritis
  • potassium supplements or potassium-containing salt substitutes
  • lithium, a medicine used to treat mood swings and some types of depression
  • tetracycline antibiotics
  • trimethoprim or trimethoprim/ sulfamethoxazole, medicines used to treat bacterial infections.

Tell your doctor if you are taking any of the following blood pressure lowering medicines:

  • angiotensin II receptor blocker (ARB)
  • aliskiren.

For some patients, ACQUIN should not be taken in combination with these medicines.

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

Tell your doctor if you are taking any of the following medicines:

  • mTOR inhibitors (e.g. temsirolimus), used in the treatment of kidney cancer
  • DPP-IV inhibitors (e.g. vildagliptin), used in the treatment of diabetes
  • NEP inhibitors (e.g. sacubitril/ valsartan), used in the treatment of congestive heart failure.

Taking ACQUIN in combination with these medicines may increase your risk of having an allergic reaction.

If you are not sure whether you are taking any of these medicines, check with your doctor or pharmacist.

Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking ACQUIN.

Use in children

The safety and effectiveness of ACQUIN in children have not been established.

How to take it

Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained in this leaflet.

Your doctor or pharmacist will tell you how many tablets you will need to take each day. This depends on your condition and whether or not you are taking any other medicines.

If you do not understand the instructions on the box, ask your doctor or pharmacist for help.

How much to take

For high blood pressure
For most patients, not on diuretics, the usual starting dose is 5 to 10 mg taken once a day. The dose may need to be increased depending on your blood pressure at an interval of 4 weeks. Most patients take between 10 and 40 mg each day.

This dose may be taken once a day or divided into two equal doses per day.

For heart failure
The usual starting dose is 5 mg taken once a day. In most patients, effective doses are between 10 and 20 mg a day. Your doctor will advise whether the dose is to be taken a single dose or as two separate doses.

How to take it

Swallow ACQUIN with a full glass of water.

Do not chew the tablets.

When to take it

Take ACQUIN at about the same time each day. Taking your tablets at the same time each day will have the best effect. It will also help you remember when to take the tablets.

Take ACQUIN before meals. Food with a high fat content may interfere with the absorption.

How long to take it

ACQUIN helps control your condition, but does not cure it. Therefore, you must take it every day. Continue taking your medicine for as long as your doctor tells you.

If you forget to take it

If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.

Otherwise, take the missed dose as soon as you remember, and then go back to taking your tablets as you would normally.

Do not take a double dose to make up for the dose that you missed. This may increase the chance of you getting an unwanted side effect.

If you are not sure what to do, ask your doctor or pharmacist.

If you have trouble remembering to take your medicine, ask your pharmacist for some hints.

If you take too much ACQUIN (overdose)

Immediately telephone your doctor, or the Poisons Information Centre (telephone 13 11 26), or go to Accident and Emergency at the nearest hospital, if you think you or anyone else may have taken too much ACQUIN. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.

If you take too much ACQUIN, you may feel light-headed, dizzy or you may faint.

While you are taking it

Things you must do

Before starting any new medicine, tell your doctor or pharmacist that you are taking ACQUIN.

Make sure you drink enough water during exercise and hot weather when you are taking it, especially if you sweat a lot. If you do not drink enough water while taking the medicine, you may feel faint, light-headed or sick. This is because your blood pressure is dropping suddenly. If you continue to feel unwell, tell your doctor.

If you have excess vomiting or diarrhoea while taking ACQUIN, tell your doctor. You may lose too much water and salt and your blood pressure may drop too much.

If you feel light-headed or dizzy after taking your first dose, or when your dose is increased, tell your doctor immediately. This is especially important if you are taking ACQUIN for heart failure.

If you plan to have surgery that needs a general anaesthetic, tell your doctor or dentist that you are taking ACQUIN. Your blood pressure may drop suddenly.

If you become pregnant while taking it, tell your doctor immediately.

If you are about to have any blood tests, tell your doctor that you are taking ACQUIN. It may interfere with the results of some tests.

Have your blood pressure checked when your doctor says, to make sure the medicine is working.

Go to your doctor regularly for a check-up. Your doctor may occasionally do a blood test to check your potassium levels and see how your kidneys are working.

Things you must not do

Do not give ACQUIN to anyone else, even if they have the same condition as you.

Do not take it to treat any other complaints unless your doctor or pharmacist tells you to.

Do not stop taking ACQUIN, or lower the dosage, without checking with your doctor.

Things to be careful of

If you feel light-headed, dizzy or faint when getting out of bed or standing up, get up slowly. Standing up slowly, especially when you get up from bed or chairs, will help your body get used to the change in position and blood pressure. If this problem continues or gets worse, talk to your doctor.

Be careful driving or operating machinery until you know how ACQUIN affects you. As with other ACE inhibitor medicines, it may cause dizziness, light-headedness or tiredness in some people. Make sure you know how you react to it before you drive a car, operate machinery, or do anything else that could be dangerous if you are dizzy or light-headed. If this occurs do not drive. If you drink alcohol, dizziness or light-headedness may be worse.

Things that would be helpful for your blood pressure or heart failure

Some self help measures suggested below may help your condition.

Talk to your doctor or pharmacist about these measures and for more information.

  • Alcohol - your doctor may advise you to limit your alcohol intake.
  • Weight - your doctor may suggest losing some weight to help lower your blood pressure and help lessen the amount of work your heart has to do. Some people may need a dietician's help to lose weight.
  • Diet - eat a healthy diet which includes plenty of fresh vegetables, fruit, bread (preferably wholegrain), cereals and fish. Also eat less sugar and fat (especially saturated fat) which includes sausages, fatty meats, full cream dairy products, biscuits, cakes, pastries, chocolates, chips and coconut. Monounsaturated and polyunsaturated fats from olive oil, canola oil, avocado and nuts are beneficial in small quantities.
  • Salt - your doctor may advise you to watch the amount of salt in your diet. To reduce your salt intake you should avoid using salt in cooking or at the table and avoid cooked or processed foods containing high sodium (salt) levels.
  • Exercise - regular exercise, maintained over the long term, helps to reduce blood pressure and helps get the heart fitter. Regular exercise also improves your blood cholesterol levels, helps reduce your weight and stress levels, and improves your sleep, mood and ability to concentrate. However, it is important not to overdo it. Walking is good exercise, but try to find a route that is reasonably flat. Before starting any exercise, ask your doctor about the best kind of programme for you.
  • Smoking - your doctor may advise you to stop smoking or at least cut down. There are enormous benefits to be gained from giving up smoking. There are many professionals, organisations and strategies to help you quit. Ask your doctor or pharmacist for further information and advice.

Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking ACQUIN.

ACQUIN helps most people with high blood pressure and heart failure, but it may have unwanted side effects in a few people.

All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.

It can be difficult to tell whether side effects are the result of taking ACQUIN, effects of your condition, or side effects of other medicines you may be taking. For this reason, it is important to tell your doctor of any change in your condition.

If you are over 65 years of age you may have an increased chance of getting side effects.

Do not be alarmed by this list of possible side effects. You may not experience any of them.

Ask your doctor or pharmacist to answer any questions you may have.

Tell your doctor or pharmacist if you notice any of the following and they worry you:

  • dry cough
  • feeling light-headed, dizzy or faint because your blood pressure is too low
  • headache
  • feeling sick (nausea) or vomiting
  • stomach pain
  • diarrhoea
  • constipation
  • unusual tiredness or weakness, fatigue
  • feeling drowsy or sleepy during the day
  • hair loss or thinning
  • dry mouth or throat
  • taste disturbances or loss of taste
  • confusion or nervousness
  • back pain
  • rash
  • difficulty in getting or maintaining an erection.

These side effects are usually mild. All side effects should be reported to a health professional.

Tell your doctor as soon as possible if you notice any of the following:

  • disturbed vision
  • symptoms of sunburn (such as redness, itching, swelling, blistering) which may occur more quickly than normal
  • itchy, raised or red skin rash
  • signs of worrying or frequent infections such as fever, severe chills, sore throat or mouth ulcers
  • aching, tender or weak muscles not caused by exercise
  • feeling of deep sadness and unworthiness (depression)
  • severe upper stomach pain, often with nausea and vomiting
  • passing little or no urine
  • bleeding or bruising more easily than normal.

These may be serious side effects. You may need medical attention. Serious side effects are rare.

If any of the following happen, stop taking ACQUIN and either tell your doctor immediately or go to Accident and Emergency at your nearest hospital:

  • fainting within a few hours of taking a dose
  • fast or irregular heart beat
  • shortness of breath or tightness in the chest
  • sudden onset of stomach pains or cramps with or without nausea or vomiting
  • severe flaking or peeling of the skin
  • severe blisters and bleeding in the lips, eyes, mouth, nose and genitals
  • chest pain.

These are very serious side effects. You may need urgent medical attention or hospitalisation. These side effects are very rare.

Stop taking ACQUIN and tell your doctor immediately or go to Accident and Emergency at your nearest hospital if you notice the following:

  • swelling of the face, lips, mouth, tongue or throat which may cause difficulty in swallowing or breathing

Tell your doctor or pharmacist if you notice anything that is making you feel unwell.

Other side effects not listed above may occur in some patients.

After using ACQUIN

Storage

Keep your tablets in the pack until it is time to take them. If you take the tablets out of the pack they will not keep well.

Keep ACQUIN where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Keep your tablets in a cool dry place where the temperature stays below 25°C.

Do not store ACQUIN or any other medicine in the bathroom or near a sink.

Do not leave it on a windowsill or in the car on hot days. Heat and dampness can destroy some medicines.

n Disposal

If your doctor or pharmacist tells you to stop taking ACQUIN, or your tablets have passed their expiry date, ask your pharmacist what to do with any that are left over.

Product description

What it looks like

ACQUIN comes in 3 strengths of tablets:

  • ACQUIN 5 - Yellow, oval, film-coated tablets debossed with “5” on one side and a breakline on the other
  • ACQUIN 10 – Yellow, oval shaped, film-coated tablets debossed with “10” on one side and a breakline on the other
  • ACQUIN 20 - Yellow, oval shaped, film-coated tablets debossed with “20” on one side and a breakline on the other.

Each blister pack contains 30 tablets.

Ingredients

The active ingredient in ACQUIN is quinapril (as hydrochloride):

  • each ACQUIN 5 tablet contains 5 mg of quinapril.
  • each ACQUIN 10 tablet contains 10 mg of quinapril.
  • each ACQUIN 20 tablet contains 20 mg of quinapril.

The tablets also contain:

  • magnesium carbonate hydrate
  • calcium sulphate dihydrate
  • colloidal anhydrous silica
  • crospovidone
  • povidone
  • magnesium stearate
  • polyvinyl alcohol
  • titanium dioxide
  • purified talc
  • lecithin
  • iron oxide yellow
  • xanthan gum

The tablets are gluten free.

Supplier

Arrow Pharma Pty Ltd
15 – 17 Chapel Street
Cremorne VIC 3121

Australian registration numbers:

ACQUIN 5 - AUST R 192146

ACQUIN 10 - AUST R 192147

ACQUIN 20 - AUST R 192148

Date of revision:
November 2018

Published by MIMS January 2019

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