10 to 20 : Initial dose 40 mg; titrate according to response
<10 : Initial dose 40 mg; titrate according to response
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD : Not dialysed. Dose as in GFR <10 mL/min
HD : Not dialysed. Dose as in GFR <10 mL/min
HDF/high flux : Unknown dialysability. Dose as in GFR <10 mL/min
CAV/VVHD : Unlikely to be dialysed. Dose as in GFR 10 to 20 mL/min
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs
Anaesthetics: enhanced hypotensive effect
Analgesics: antagonism of hypotensive effect and increased risk of renal impairment with NSAIDs; hyperkalaemia with ketorolac and other NSAIDs
Ciclosporin: increased risk of hyperkalaemia and nephrotoxicity
Diuretics: enhanced hypotensive effect; hyperkalaemia with potassium-sparing diuretics
Epoetin: increased risk of hyperkalaemia; antagonism of hypotensive effect
Lithium: reduced excretion (possibility of enhanced lithium toxicity)
Potassium salts: increased risk of hyperkalaemia
Tacrolimus: increased risk of hyperkalaemia and nephrotoxicity
ADMINISTRATION
Reconstition
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Route
Oral
Rate of Administration
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Comments
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OTHER INFORMATION
Side effects (e.g. hyperkalaemia, metabolic acidosis) are more common in patients with impaired renal function Close monitoring of renal function during therapy is necessary in those with renal insufficiency Renal failure has been reported in association with angiotensin-II antagonists in patients with renal artery stenosis, post renal transplant, and in those with severe congestive heart failure .
