🩺 ANGIOTENSIN-II ANTAGONISTS, COMBINATIONS 🏷️ Angiotensin II receptor antagonists
👨‍⚕️ Clinically Reviewed by: PakistaniBano Medical Editorial Board (Pharm.D Panel)
📅 Reviewed: November 2026 • 🔍 Authority: DRAP / WHO ATC
📦 Formulations, Pack Sizes & Retail Prices Currency: Rs.
Dosage Form Reg. No Pack Size Trade Price (TP) Maximum Retail Price (MRP)
Tab 50 mg 024065 2x10 Rs.76.50 Rs.90.00

📋 Indications & Clinical Dosage

*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.

⛔ Contraindications

Renal arteries stenosis.

⚠️ 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.

🔄 Drug Interactions

K+ -sparing diuretics, K+ supplements, rifampicin, fluconazole, 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, migraine, urticaria, pruritus, rash. Rare: Anaphylactic reactions, angioedema, vasculitis, hepatitis, cough, anaemia.

🤰 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.

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