HTN Adult Initially 10 mg once daily. Usual dosage range: 20-40 mg daily in a single dose.
Patients taking diuretics Initially 5 mg once daily.
Childn 6 ≥yr w/ GFR >30 mL/min/1.73 m2 Initially 0.07 mg/kg (up to 5 mg total) once daily.
Heart failure Initially 5 mg once daily when used w/ diuretics & (usually) digitalis as adjunctive therapy for systolic heart failure.
Patients w/ hyponatremia (serum Na <130 mEq/L) Initially 2.5 mg once daily. Max: 40 mg once daily as tolerated.
Reduction of mortality in acute MI 5 mg in hemodynamically stable patients w/in 24 hr of the onset of symptoms of MI, followed by 5 mg after 24 hr, 10 mg after 48 hr & then 10 mg once daily continued for at least 6 wk.
Patients w/ low systolic BP (≤120 mmHg & >100 mmHg) Initially 2.5 mg during the 1st 3 days after infarct. 5 mg daily maintenance dose may be given w/ temporary reductions to 2.5 mg as needed if hypotension occurs (systolic BP ≤100 mmHg).
Renal impairment CrCl ≥10 mL/min & ≤30 mL/min ½ the usual initial dose, up titrate as tolerated to max of 40 mg daily,
CrCl <10 mL/min or patients on hemodialysis Initially 2.5 mg once daily.
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