Initial & maintenance dose: 150 mg once daily. May be increased to 300 mg or other antihypertensive agents can be added. Vol &/or Na depletion should be corrected prior to administration. Haemodialysed patient & elderly >75 yr Initiation of therapy w/ 75 mg could be considered. Renal diseaseHypertensive type 2 diabetic patient Initially 150 mg once daily & titrated up to 300 mg once daily as maintenance dose.
Hypersensitivity. Do not co-administer w/ aliskiren-containing medicines in patients w/ diabetes or moderate to severe renal impairment (GFR <60 mL/min/1.73 m2); ACE inhibitors in patients w/ diabetic nephropathy. Pregnancy (2nd & 3rd trimesters) & lactation.
Dual blockade of renin-angiotensin-aldosterone system w/ ACE or aliskiren is not recommended. Symptomatic hypotension in vol &/or Na depleted patients. Increased risk of severe hypotension & renal insufficiency in patients w/ bilateral renal artery stenosis. Periodic monitoring of K & serum creatinine levels in patients w/ renal impairment & kidney transplantation. Close monitoring of serum K & creatinine levels in patients at risk of hyperkalaemia. Combination w/ lithium is not recommended. Aortic & mitral valve stenosis, obstructive hypertrophic cardiomyopathy, ischaemic cardiopathy or ischaemic CV disease. Not recommended in patients w/ primary aldosteronism. Galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption. Dizziness or weariness may affect ability to drive or operate machinery. Not recommended during 1st trimester of pregnancy. Childn.
Higher frequency of adverse events w/ ACE inhibitors, angiotensin II receptor blockers or aliskirin. May increase hypotensive effects w/ other antihypertensive agents. May increase serum K levels w/ K-sparing diuretics, supplements, salt substitutes containing K or other medicinal products that may increase serum K levels (eg, heparin). Monitor for possible increase in serum conc of lithium. Attenuation of antihypertensive effect & increased risk of renal impairment in concomitant w/ NSAIDs [ie, selective COX-2 inhibitors, acetylsalicylic acid (>3 g/day) & nonselective NSAIDs].
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