Accuretic® (quinapril and hydrochlorothiazide 10/12.5 and 20/12.5 mg tablets) is being withdrawn and supplies will run out from August 2022. Patients will need to be switched to an alternative. Either:
- Switch to a separate ACE inhibitor and thiazide diuretic:
Our recommendation is to replace this with perindopril and bendroflumethiazide. Quinapril tablets remain available and can also be combined with bendroflumethiazide. The other diuretic options are chlortalidone or indapamide.
- If the patient does not wish to take two separate tablets:
Switch to a combination product containing an angiotensin-II receptor blocker (ARB) and thiazide diuretic. The only funded product is losartan and hydrochlorothiazide 50/12.5 mg tablets.
The new option can be started the day after stopping Accuretic®. When switching to the new ACE inhibitor or ARB our general advice is to look at the current dose (low, medium or maximum) and then use a dose at a similar point in the dose range for the new medicine. The doses can then be titrated based on patient response (e.g. blood pressure and adverse effects).
Further information can be found at:
- PHARMAC – Accuretic (quinapril and hydrochlorothiazide) tablets
- Medsafe – Accuretic found to contain nitrosamines
- BPAC – Prescribing ACE inhibitors
- Canterbury Community HealthPathways – Hypertension and Heart Failure
- Health professional are welcome to contact our service for advice on specific patients.