Risk of symptomatic hypotension in patients who are vol- &/or Na-depleted. Correct intravascular vol depletion prior to therapy. Increased risk of renovascular HTN in patients w/ bilateral renal artery stenosis or stenosis of the artery to a single functioning kidney. Monitor K & creatinine serum levels in patients w/ renal impairment. No experience in administration in patients w/ recent kidney transplantation. Dual blockade of renin-angiotensin-aldosterone system (RAAS) through combined use of ACE inhibitors, AIIAs or aliskiren. Close monitoring of serum K in patients at risk of hyperkalaemia. May induce hypoglycaemia in diabetic patient. Consider blood glucose monitoring in patients treated w/ insulin or antidiabetics. Caution in patients suffering from aortic or mitral valve stenosis, or obstructive hypertrophic cardiomyopathy; patients whose vascular tone & renal function depend primarily on RAAS. Not recommended in patients w/ primary aldosteronism. Not recommended in combination w/ lithium. Patients w/ rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine. No clinical experience in patients w/ severe hepatic impairment. Not recommended during the 1st trimester of pregnancy. Not recommended during breastfeeding. Safety & efficacy in childn 0-18 yr has not been established.
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