Essential HTN. Clinically stable patients w/ symptomatic heart failure or asymptomatic left ventricular systolic dysfunction after recent (12 hr-10 days) MI. Symptomatic heart failure when ACE inhibitors cannot be used or as add-on therapy to ACE inhibitors when β-blockers cannot be used.
HTN 80 mg once daily. Patient whose BP is not adequately controlled Dose can be increased to 160 mg, max: 320 mg. Recent MI Initially 20 mg bid. Target max dose: 160 mg bid. Heart failure 40 mg bid. Max: 320 mg in divided doses. Patient w/ mild to moderate hepatic impairment w/o cholestasis Dose should not exceed 80 mg.
Increased serum K & serum creatinine w/ K-sparing diuretics (eg, spironolactone, triamterene, amiloride), K supplements or K-containing salt substitutes. Attenuation of antihypertensive effect & increased risk of worsening of renal function w/ NSAIDs including selective COX-2 inhibitors. Increased systemic exposure w/ inhibitors of uptake transporter OATP1B1 (rifampin, ciclosporin) or hepatic efflux transporter MRP2 (ritonavir).
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