Risk of symptomatic hypotension, especially in vol-depleted patients. Start therapy under close medical supervision in patients who are vol-depleted by diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting. Increased incidence of severe hypotension, renal failure & hyperkalemia w/ co-administration of other agents blocking the renin-angiotensin system (RAS) eg, ACE inhibitors or aliskiren. Not recommended to co-administer w/ lithium. May induce hypoglycemia, particularly in patients treated for diabetes. Caution in patients whose renal function may depend on the activity of the renin-angiotensin-aldosterone system. Assess renal function during treatment. May exacerbate psoriasis. May impair ability to drive or operate machinery.
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