👨‍⚕️ 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 160 mg 049213 14 Rs.467.87 Rs.550.43
Tab 80 mg 049212 14 Rs.280.39 Rs.329.87

📋 Indications & Clinical Dosage

*Hypertension:* Adult: Initially 80 mg once daily, increased if necessary up to 320 mg daily, increased at intervals of4 weeks Children 6-18 yrs: Body-weight less than 50 kg: initially 40 mg once daily, adjusted according to response, max 80 mg daily; Body-weight 50 kg and over, initially 80 mg once daily, adjusted according to response, up to 160 mg daily. *Hypertension with intravascular volume depletion:* Adult: Initially 40 mg once daily, increased if necessary up to 320 mg daily, doses to be increased at intervals of 4 weeks. *Heart failure when ACE inhibitors cannot be used, or in conjunction with an ACE inhibitor when a beta-blocker cannot be used:* Adult: Initially 40 mg twice daily, increased to up to 160 mg twice daily, doses to be increased at intervals of at least 2 weeks. *Myocardial infarction with left ventricular failure or left ventricular systolic dysfunction (adjunct):* Adult: Initially 20 mg twice daily, increased if necessary up to 160 mg twice daily, doses to be increased over several weeks if tolerated.

⛔ Contraindications

Severe hepatic impairment, cirrhosis, biliary obstruction, cholestasis

⚠️ Precautions & Warnings

Mild to moderate hepatic impairment, renal im-pairment, salt or volume depletion, renal artery stenosis, severe cardiac insufficiency. Monitor serum K+ in elderly and renal impaired if taking K+ supplement.

🔄 Drug Interactions

K+ sparing diuretics, K+ supplements, salt substitutes.

⚠️ Adverse Reactions / Side Effects

Renal impairment, cough, fatigue, GI disturbance, headache, syncope, hypersensitivity reactions, myalgia, neutropenia, pruritus, rash, serum sickness, thrombocytopenia, vasculitis

🤰 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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