HTNAdult 5 mg once daily. In combination w/ other antihypertensive agent 5 mg plus hydrochlorothiazide 12.5-25 mg. Elderly >65 yr & renal impairment Start at 2.5 mg daily. May be increased to 5 mg daily. Chronic heart failure Initially 1.25 mg once daily, increased at 1-2 wkly intervals based on patient tolerability to 2.5 mg once daily, then to 5 mg once daily & then to 10 mg once daily. Max: 10 mg once daily.
May increase sensitivity to allergens & severity of anaphylactic reactions. Not to be used in untreated CHF. Ischemic heart disease; peripheral circulatory disorders (Raynaud's disease or syndrome, intermittent claudication); 1st-degree heart block; Prinzmetal's angina. DM; hyperthyroidism. COPD. History of psoriasis. Avoid abrupt w/drawal. Not recommended in combination w/ Ca channel antagonists of verapamil & diltiazem type, class I antiarrhythmic drugs & centrally acting antihypertensive drugs. Concomitant use w/ certain anaesth causing myocardial depression. Not to be taken by patients w/ galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. May impair ability to drive or operate machinery. Not recommended in severe renal impairment. Pregnancy & lactation. Not recommended in childn & adolescent <18 yr. Elderly >75 yr.
Class I antiarrhythmic drugs may potentiate AV conduction time & increase negative inotropic effect. Ca channel antagonists of verapamil/diltiazem type has negative influence on contractility & AV conduction. Centrally-acting antihypertensives may worsen heart failure. Class III antiarrhythmic drugs may potentiate AV conduction time. Anaesth may attenuate reflex tachycardia & increase risk of hypotension. Insulin & oral antidiabetic drugs may mask certain symptoms of hypoglycaemia. Increased fall in BP w/ baclofen. Digitalis glycosides may increase AV conduction time. Ca channel antagonists of dihydropyridine type may increase risk of hypotension. Antipsychotics & antidepressants may enhance hypotensive effect. Sympathomimetic agents may counteract effect. CYP2D6 inhibitors may increase plasma levels.
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