📋 Indications & Clinical Dosage
*Hypertension:*
Adults: 1 tab once daily, as per requirement, max 32/25 mg once daily.
Children: Not recommended.
⛔ Contraindications
Severe hepatic impairment, cholestasis.
⚠️ Precautions & Warnings
Correct volume/salt depletion before starting ther-apy, anaesthesia, renal impairment; monitor serum potassium and creatinine levels, haemodialysis; carefully titrate dose and monitor BP thoroughly, renal artery stenosis, electrolyte imbalance, aortic or mitral stenosis, kidney transplant, obstructive hy-pertrophic cardiomyopathy, severe congestive heart failure, mild to moderate hepatic impairment, primary
hyperaldosteronism
🔄 Drug Interactions
K+-sparing diuretics, K+-supplement, lithium, NSAIDs, skeletal muscle relaxants.
⚠️ Adverse Reactions / Side Effects
Hyperkalaemia, angioedema, symptomatic hypotension including dizziness particularly in patients with intravascular volume depletion, e.g. those taking high-dose diuretics, headache, back pain, electrolyte imbalance.,
📚 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.