Dialysis patients. Patients with untreated decompensated heart failure. Severe renal impairment (Clcr < 30 mL/min). Moderate renal impairment (Clcr < 60 mL/min) for Triplixam 10 mg/2.5 mg/10 mg. Hypersensitivity to the active substances, to other sulfonamides, to dihydropyridine derivatives, any other ACE-inhibitor or to any of the excipients. History of angioedema (Quincke’s oedema) associated with previous ACE inhibitor therapy. Hereditary/idiopathic angioedema. Second and third trimesters of pregnancy. Hepatic encephalopathy. Severe hepatic impairment. Hypokalaemia. Severe hypotension. Shock, including cardiogenic shock. Obstruction of the outflow-tract of the left ventricle (e.g. high grade aortic stenosis). Haemodynamically unstable heart failure after acute myocardial infarction. Concomitant use of Triplixam with aliskiren-containing products in patients with diabetes mellitus or renal impairment (GFR < 60 mL/min/1.73 m2), concomitant use with sacubitril/valsartan therapy. Triplixam must not be initiated earlier than 36 hours after the last dose of sacubitril/valsartan, extracorporeal treatments leading to contact of blood with negatively charged surfaces, significant bilateral renal artery stenosis or stenosis of the artery to a single functioning kidney.
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