Patients w/ bilateral renal artery stenosis or artery stenosis to single functioning kidney, severe CHF or underlying renal disease (including renal artery stenosis), primary aldosteronism, aortic or mitral stenosis, or obstructive hypertrophic cardiomyopathy, DM, ischaemic cardiopathy or CV disease.
Dual blockade of renin-angiotensin-aldosterone system. Dehydration, acute cardiac decompensation, metabolic acidosis, infectious diseases, cellular lysis eg, acute limb ischemia, rhabdomyolysis, extend trauma. Monitor K & serum creatinine levels periodically. Correct vol &/or Na depletion prior to administration. Concomitant use w/ K supplements, K-containing salt substitutes, K-sparing diuretics, ACE inhibitor, angiotensin II receptor antagonists, NSAIDs including selective COX-2 inhibitors, heparin, immunosuppressants, trimethoprim. Fructose & galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Black patients. May affect the ability to drive & use machines. Renal impairment; kidney transplantation. Not to be given in patients w/ cholestasis, biliary obstructive disorders or severe hepatic impairment. Mild to moderate hepatic impairment. Not recommended during 1st trimerster of pregnancy & lactation. Elderly >70 yr.