HTN. Heart failure (NYHA class II-IV) in patients receiving standard therapy eg, diuretics, digitalis & either ACE inhibitors or β-blockers but not both. Improves survival following MI in clinically stable patients w/ signs, symptoms or radiological evidence of left ventricular failure &/or w/ left ventricular dysfunction.
HTN 80 mg or 160 mg once daily. May be increased to 320 mg, or add a diuretic if BP is inadequately controlled. Heart failure 40 mg bid. May be up-titrated to 80 mg & 160 mg bid as tolerated. Max daily dose: 320 mg in divided doses. Post-MI Initially 20 mg bid as early as 12 hr after MI. Titrate to 40 mg, 80 mg, & 160 mg bid over next few wk, or until a dose level of 80 mg bid 2 wk after treatment initiation is achieved. Target max dose in 3 mth: 160 mg bid.
Discontinue if angioedema occurs. Patients w/ biliary obstructive disorders. Correct Na &/or vol depletion prior to starting treatment. Monitor BUN & serum creatinine in patients w/ bilateral or unilateral renal artery stenosis. Perform assessment of renal function in patients w/ heart failure or post-MI. Concomitant use w/ ACE inhibitors & β-blocker in patients w/ heart failure; drugs blocking renin-angiotensin system eg, ACE inhibitors or aliskiren. Avoid concomitant use w/ aliskiren in patients w/ severe renal impairment (GFR <30 mL/min). Women of childbearing potential. Not to be used during pregnancy. Lactation. Childn & adolescents <18 yr.
Sign Out
