HTN Initially 80 mg once daily, may be increased to 160 mg once daily. Max: 320 mg once daily. Heart failure Initially 40 mg bid, may be increased to 160 mg bid.Post-MI patient Start as early as 12 hr after the infarction in clinically stable patient w/ an initial dose of 20 mg bid. Dose may be doubled at intervals over the next few wk up to 160 mg bid if tolerated.
Potential increased systemic exposure by inhibitors of hepatic uptake transporter OATP1B1 (eg, rifampin, cyclosporine) or hepatic efflux transporter MRP2 (eg, ritonavir). Increased serum K or creatinine (in heart failure patients) w/ K-sparing diuretics (eg, spironolactone, triamterene, amiloride), K supplements or salt substitutes containing K.
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