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Indication & Dosage |
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| Oral |
| REFRACTORY HYPERTENSION, HTN WITH COEXISTING CONGESTIVE FAILURE |
| Adult:
Enalapril maleate-5mg + Amlodipine besylate-5mg (tablet) one tab to start with. Build up dose gradually according to response.
Elderly: ½ a tab to start with and built up gradually with caution. Diuretics should be withheld for 2-3 days before starting this combination.
Renal impairment: ½ a tab to start with and built up gradually with caution. Diuretics should be withheld for 2-3 days before starting this combination.
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| Precautions |
Lactation. Renal and hepatic disease, congestive heart failure; concomitant K supplements & potassium-conserving diuretics, hypovolaemic shock, diuretic therapy; periodic blood count monitoring to preclude neutropaenia or agranulocytosis. |
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Potentially Life-threatening
Adverse Drug Reactions |
Angioneurotic oedema, nausea, headache, cough, dizziness, fatigue, palpitations, chest pain, flushing, rash; increases in BUN, serum K & creatinine levels may occur; neutropaenia. |
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| Interactions |
Increases lithium levels & may cause lithium toxicity: Hyperkalaemia with K & K sparing diuretics. Risk of bone marrow suppression due to enalapril increased with concomitant use of immunosuppressives. Indometacin and other NSAIDs may blunt antihypertensive effect. Diuretics enhance antihypertensive effect. |
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