ANHIBIT

*Diabetic nephropathy in type 2 diabetes mellitus:* Adult: Initially 50 mg once daily for several weeks, then increased if necessary to 100 mg once daily. Elderly: Initially 25 mg once daily for several weeks, then increased if necessary to 100 mg once daily. *Chronic heart failure when ACE inhibitors are unsuitable or contraindicated:* Adult: Initially 12.5 mg once daily, increased if tolerated to up to 150 mg once daily, doses to be increased at weekly intervals. *Hypertension (including reduction of stroke risk in hypertension with left ventricular hypertrophy):* Adult: Initially 50 mg once daily for several weeks, then increased if necessary to 100 mg once daily. Elderly: Initially 25 mg once daily for several weeks, then increased if necessary to 100 mg once daily. Children 6-18 yrs: Body-weight less than 50 kg, initially 700 mcg/kg (max 25 mg) once daily (lower dose in intravascular volume depletion), adjusted according to response, max 50 mg once daily; Body-weight 50 kg and over, initially 50 mg once daily (initially 25 mg once daily in intravascular volume depletion), adjusted according to response, max 1.4 mg/kg (max 100 mg) once daily. *Hypertension with intravascular volume depletion:* Adult: Initially 25 mg once daily for several weeks, then increased if necessary up to 100 mg once daily.

Renal arteries stenosis.

Correct volume/salt depletion before starting ther-apy, anaesthesia, renal impairment; monitor serum potassium and creatinine, severe renal impairment, haemodialysis; carefully titrate dose and monitor BP thoroughly, renal artery stenosis, aortic or mitral stenosis, kidney transplant, obstructive hypertrophic cardiomyopathy, severe congestive heart failure, mild to moderate hepatic impairment, primary hyperaldosteronism.

K+ -sparing diuretics, K+ supplements, rifampicin, fluconazole, NSAIDs.

Hyperkalaemia, angioedema, symptomatic hypotension including dizziness particularly in patients with intravascular volume depletion, e.g. those taking high-dose diuretics,, arthralgia, rhinitis, flatulence, hypertriglyceridaemia, migraine, urticaria, pruritus, rash. Rare: Anaphylactic reactions, angioedema, vasculitis, hepatitis, cough, anaemia.