HTN Adult Initially 50 mg once daily, can be increased to a max dose of 100 mg once daily. Patient w/ possible intravascular depletion (eg, on diuretic therapy) Initially 25 mg once daily. HTN w/ left ventricular hypertrophy Initially 50 mg once daily, may be increased to 100 mg once daily. Nephropathy in type 2 diabetic patients Initially 50 mg once daily, may be increased to 100 mg once daily.
Symptomatic hypotension upon treatment initiation in patients w/ activated renin-angiotensin system. Changes in renal function including acute renal failure. Hyperkalemia; monitor serum K periodically & treat appropriately. Dual blockade of renin-angiotensin-aldosterone system (RAAS) through combined use of ACE inhibitors, angiotensin II receptor blockers, or aliskiren. Renally impaired patients who are also vol-depleted. Patients w/ hepatic impairment. Fetal toxicity. Pregnancy & lactation.
Risk of hyperkalemia w/ agents increasing serum K. Increased serum conc & toxicity of lithium. Risk of renal function deterioration & attenuated effect w/ NSAIDs including selective COX-2 inhibitors. Higher frequency of adverse events through combined use of angiotensin II receptor blockers, ACE inhibitors, or aliskiren.
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