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Treatment of hypertension; treatment of heart failure


Hypersensitivity to any component, - From the second trimester of pregnancy: the use of antagonists of angiotensin II has shown in the 2nd and 3rd trimesters of pregnancy clinical fetal renal toxicity during the 2nd and / or 3rd quarter: anamnios sometimes even reversible oligohydramnios, stillbirth, neonatal transient renal perhaps forever. Some cases of delayed ossification of skull bones are reported. If a woman becomes pregnant during this period the regimen should be discontinued and monitoring of the fetal renal function should be considered. Due to the presence of lactose, the drug-cons is indicated for congenital galactosemia, malabsorption of glucose and galactose or lactase deficiency.

Adverse reactions:

The following adverse reactions have been reported very rarely (<1 / 10000) during post-marketing surveillance: . Blood and lymphatic: leukopenia, neutropenia, agranulocytosis; . Metabolism and nutrition disorders: hyperkalemia, hyponatremia; . Nervous system disorders: dizziness, headache; . Gastro-intestinal: nausea; . Hepatobiliary Disorders: elevated liver enzymes or hepatitis; . Skin and subcutaneous: angioedema, rash, urticaria, pruritus; . Musculoskeletal, connective tissue and bone disorders: back pain, arthralgia, myalgia; . Renal and urinary disorders: impaired renal function including renal failure in patients at risk. . An increase in creatinine, urea or potassium and a decrease in serum sodium were observed. . A slight decrease in hemoglobin was observed.


Lithium Plasma concentrations of lithium may be increased, resulting in an increase in pharmacologic and adverse reactions. Potassium-sparing diuretics (eg, amiloride, spironolactone, triamterene) Coadministration may cause elevated serum potassium concentrations in certain high-risk patients.


Pregnancy When used in pregnancy during the second and third trimesters, drugs that act directly on the renin-angiotensin system can cause injury and even death to the developing fetus. When pregnancy is detected, discontinue therapy as soon as possible. Monitor Monitor BP, serum potassium, and serum creatinine during therapy and periodically thereafter. Pregnancy Category D (second and third trimester); Category C (first trimester). Lactation Undetermined. Children Safety and efficacy not established. Renal Function Use caution in treating patients whose renal function may depend on the activity of the renin-angiotensin-aldosterone system (eg, patients with severe CHF). Heart failure Use with caution when initiating therapy; hypotension may occur. Hyperkalemia May occur, especially in heart failure patients. Hypotension/Volume-depleted patients Symptomatic hypotension may occur in patients who are intravascularly volume depleted (eg, those treated with diuretics). Correct these conditions prior to administration or use a lower starting dose.



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