VALCARD

*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.

Severe hepatic impairment, cirrhosis, biliary obstruction, cholestasis

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.

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

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