Medically reviewed by Drugs.com. Last updated on Dec 25, 2020.
Applies to the following strengths: 4 mg; 8 mg; 16 mg; 32 mg
Usual Adult Dose for:
Usual Pediatric Dose for:
Additional dosage information:
Usual Adult Dose for Hypertension
Initial dose: 16 mg orally once a day
Maintenance dose: 8 to 32 mg/day orally in 1 to 2 divided doses
Maximum dose: 32 mg/day
-Consider administration of a lower initial dose in volume depleted patients.
-Most of the antihypertensive effect is present within 2 weeks; maximum blood pressure reduction at a given dose is generally observed within 4 to 6 weeks of starting that dose.
Usual Adult Dose for Congestive Heart Failure
Initial dose: 4 mg orally once a day; double dose every 2 weeks, as tolerated, to target dose of 32 mg orally once a day
Use: Treatment of New York Heart Association (NYHA) class II through IV heart failure
Usual Pediatric Dose for Hypertension
1 TO LESS THAN 6 YEARS:
Initial dose: 0.2 mg/kg/day orally in 1 to 2 divided doses
Maintenance dose: 0.05 to 0.4 mg/kg/day orally in 1 to 2 divided doses
6 TO LESS THAN 17 YEARS:
Less than 50 kg:
-Initial dose: 4 to 8 mg/day orally in 1 to 2 divided doses
-Maintenance dose: 2 to 16 mg/day orally in 1 to 2 divided doses
Greater than 50 kg:
-Initial dose: 8 to 16 mg/day orally in 1 to 2 divided doses
-Maintenance dose: 4 to 32 mg/day orally in 1 to 2 divided doses
-For patients with possible intravascular volume depletion (e.g., patients treated with diuretics, especially those with renal impairment), initiate this drug under close supervision and consider administration of a lower dose.
-Antihypertensive effect is present within 2 weeks; maximum blood pressure reduction at a given dose is generally observed within 4 weeks of starting that dose.
-For children unable to swallow tablets, an extemporaneous suspension may be used instead.
Renal Dose Adjustments
Adult: No adjustment recommended
-GFR 30 mL/min/1.73 m2 or greater: Data not available
-GFR less than 30 mL/min/1.73 m2: Not recommended
Liver Dose Adjustments
-Mild liver dysfunction (Child-Pugh A): No adjustment recommended
-Moderate liver dysfunction (Child-Pugh B): Initial dose: 8 mg orally once a day
-Severe liver dysfunction (Child-Pugh C): Data not available
Pediatric: Data not available
US BOXED WARNING:
-FETAL TOXICITY: If pregnancy is detected, discontinue this drug as soon as possible. Drugs that act directly on the renin angiotensin system (RAS) can cause injury and death to the developing fetus.
Safety and efficacy have not been established in patients younger than 1 year; the manufacturer makes no recommendation for patients 17 to less than 18 years old.
Consult WARNINGS section for additional precautions.
Data not available
-Extemporaneous suspension: Store at room temperature (30C or 86F); use within 30 days after first opening.
-Extemporaneous suspension: The manufacturer product information should be consulted.
-Monitor renal function and serum potassium periodically.
-Females of childbearing age should be informed of the consequences of exposure to this drug during pregnancy; ask these patients to report pregnancies as soon as possible.
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