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The patient should talk to the doctor before taking Wamlox: if he/she has been sick (vomiting or diarrhoea); if he/she has liver or kidney problems; if he/she has had a kidney transplant or had been told that he/she has a narrowing of the kidney arteries; if he/she has a condition affecting the renal glands called "primary hyperaldosteronism"; if he/she has had heart failure or has experienced a heart attack [doctor's instructions for the starting dose should be followed carefully; kidney function may also be checked by the doctor]; if the doctor has told the patient that he/she has a narrowing of the valves in the heart (called "aortic or mitral stenosis") or that the thickness of the heart muscle is abnormally increased (called "obstructive hypertrophic cardiomyopathy"); if he/she has experienced swelling, particularly of the face and throat, while taking other medicines (including angiotensin converting enzyme inhibitors) [if these symptoms occur, the patient should stop taking Wamlox and should contact the doctor straight away; Wamlox should never be taken again]; if he/she is taking any of the following medicines used to treat high blood pressure: an ACE inhibitor (for example enalapril, lisinopril, ramipril), in particular if the patient has diabetes-related kidney problems; aliskiren.
The doctor may check the kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in the blood at regular intervals.
Dual blockade of the renin-angiotensin-aldosterone system (RAAS): There is evidence that the concomitant use of ACE inhibitors, angiotensin II receptor blockers or aliskiren increases the risk of hypotension, hyperkalaemia and decreased renal function (including acute renal failure). Dual blockade of RAAS through the combined use of ACE inhibitors, angiotensin II receptor blockers or aliskiren is therefore not recommended.
If dual blockade therapy is considered absolutely necessary, this should only occur under specialist supervision and subject to frequent close monitoring of renal function, electrolytes and blood pressure.
ACE inhibitors and angiotensin II receptor blockers should not be used concomitantly in patients with diabetic nephropathy.
See also information under Contraindications.
If any of these apply to the patient, he/she should tell the doctor before taking Wamlox.
Wamlox contains sodium: This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially 'sodium-free'.
Driving and using machines: This medicine may make the patient feel dizzy. This can affect how well the patient can concentrate. So, if the patient is unsure how this medicine will affect him/her, he/she should not drive, use machinery, or do other activities that he/she needs to concentrate on.
Use in Children: The use of Wamlox in children and adolescents is not recommended (aged below 18 years old).
