📋 Indications & Clinical Dosage
*Hypertension:*
Adult: Initially 150 mg once daily, increased if necessary to 300 mg once daily
Elderly: Initially 75-150 mg once daily, increased if necessary to 300 mg once daily.
*Hypertension in patients receiving haemodialysis:*
Adult: Initially 75-150 mg once daily, increased if necessary to 300 mg once daily.
*Renal disease in hypertensive type 2 diabetes mellitus:*
Adult: Initially 150 mg once daily, increased if tolerated to 300 mg once daily
Elderly: Initially 75-150 mg once daily, increased if tolerated to 300 mg once daily.
*Renal disease in hypertensive type 2 diabetes mellitus in patients receiving haemodialysis:*
Adult: Initially 75-150 mg once daily, increased if tolerated to 300 mg once daily
Children: Not recommended.
⚠️ Precautions & Warnings
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, primary aldosteronism, hypertensive patients with type 2 diabetes & renal disease, hyperkalaemia. May impair ability to drive or operate machinery.
🔄 Drug Interactions
Diuretics & other antihypertensive agents, K supplements & K-sparing diuretics, lithium, NSAIDs.
⚠️ Adverse Reactions / Side Effects
Hyperkalaemia, angioedema, symptomatic hypotension including dizziness particularly in patients with intravascular volume depletion, e.g. those taking high-dose diuretics,, arthralgia, rhinitis, flatulence, hypertriglyceridaemia, musculoskeletal trauma, nausea/vomiting, abnormal urination.
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated in pregnancy,
Lactation / Breastfeeding:
Not recommended.
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.