Adult HTN Recommended initial & maintenance dose: 150 mg once daily. May be titrated up to 300 mg once daily or add low dose diuretic eg, hydrochlorothiazide in case of uncontrolled HTN. Diabetic nephropathy Initially 150 mg once daily & titrated up to 300 mg daily as maintenance dose. Elderly >75 yr, patient undergoing hemodialysis & w/ vol- & Na-depletion Initially 75 mg once daily.
Discontinue treatment if face, tongue & lips edema or dyspnea occurred. Not recommended in patients w/ primary aldosteronism. Nausea & vomiting. May increase K levels; lead to renal artery stenosis resulting to severe HTN & renal insufficiency. Hypotension in patients w/ intravascular vol depletion, Na-restricted diet, diarrhea & treated w/ diuretics. Patients w/ aortic, mitral valve stenosis & obstructive hypertrophic cardiomyopathy. Black patient. Monitor K & creatinine level frequently in patients w/ renal impairment & kidney transplant. Concomitant use w/ K supplement or K-sparing diuretics. Severe hepatic impairment. Renal failure. Not to be used during pregnancy. Avoid during lactation. Childn.
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