📋 Indications & Clinical Dosage
*Hypertension:*
Adult: Initially 1.25-2.5 mg once daily, increased if necessary up to 10 mg once daily, increased at intervals of 2-4 weeks.
*Symptomatic heart failure (adjunct):*
Adult: Initially 1.25 mg once daily, increased if tolerated to 10 mg daily in 2 divided doses, increase dose gradually at intervals of 1-2 weeks.
*Prophylaxis after myocardial infarction in patients with clinical evidence of heart failure (started at least48 hours after infarction):*
Adult: Initially 2.5 mg twice daily for 3 days, then increased to 5 mg twice daily, if initial dose not tolerated then 1.25 mg twice daily for 2 days, then increased to 2.5 mg twice daily, then increased to 5 mg twice daily, withdraw treatment if dose cannot be increased to 2.5 mg twice daily.
*Prevention of cardiovascular events in patients with atherosclerotic cardiovascular disease or with diabetes mellitus and an additional risk factor for cardiovascular disease:*
Adult: Initially 2.5 mg once daily for 1-2 weeks, then increased to 5 mg once daily for a further 2-3 weeks, then increased to 10 mg once daily.
*Nephropathy:*
Adult: Initially 1.25 mg once daily for 2 weeks, then increased to 2.5 mg once daily for a further 2 weeks, then increased if tolerated to 5 mg once daily.
Children: Not recommended.
⛔ Contraindications
History of angioneurotic oedema, aortic stenosis, outflow obstruction.
⚠️ Precautions & Warnings
Congestive heart failure; initiate therapy in hos-pital. Hepatic impairment; initiate therapy under close medical supervision, haemodialysis, renal impairment; reduce dose and assess renal function prior to and during treatment.
🔄 Drug Interactions
Antihypertensive agents, K+ sparing diuretics or K+ supplements, lithium.
⚠️ Adverse Reactions / Side Effects
Bronchitis, dyspnea, muscle cramps, stomatitis, syncope, angina, anxiety, arrhythmias, chest pain, depression, dry mouth, flushing, myocardial infarction, nervousness, palpitations, peripheral oedema, sweating, tachycardia, visual disturbances. Rare: Confusion, conjunctivitis, impaired hearing, onycholysis, tinnitus, tremor
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated in pregnancy.
Lactation / Breastfeeding:
Not recommended.