Adult Recommended starting dose: 10 mg once daily, may be increased to 20 mg once daily as the optimal dose. If additional BP reduction is required, dose may be increased to a max of 40 mg daily or hydrochlorothiazide therapy may be added. Mild to moderate renal impairment (CrCl 20-60 mL/min) Max: 20 mg once daily. Moderate hepatic impairment Initially 10 mg once daily. Max: 20 mg once daily.