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Diuretic Treated Patients In hypertensive patients who are currently being treated with a diuretic, symptomatic hypotension may occur occasionally following the initial dose of PRINIVIL ® . The diuretic should be discontinued, if possible, for two to three days before beginning therapy with PRINIVIL ® to reduce the likelihood of hypotension (see WARNINGS). The dosage of PRINIVIL ® should be adjusted according to blood pressure response. If the patient's blood pressure is not controlled with PRINIVIL ® alone, diuretic therapy may be resumed as described above. If the diuretic cannot be discontinued, an initial dose of 5 mg should be used under medical supervision for at least two hours and until blood pressure has stabilized for at least an additional hour (see WARNINGS, Hypotension and PRECAUTIONS, Drug Interactions). Text Continues Below
A lower starting dose is required in the presence of renal impairment, in patients in whom diuretic therapy cannot be discontinued, patients who are volume-and/ or salt-depleted for any reason, and in patients with renovascular hypertension. Dosage Adjustment in Renal Impairment Dosage in patients with renal impairment should be based on creatinine clearance as outlined in the Table below: Creatinine Clearance Starting Dose
70 30 mL/ min ( 1.17 0.5 mL/ s) 5.0 -10.0 mg/ day
30 10 mL/ min ( 0.5 0.17 mL/ s) 2.5 -5.0 mg/ day
< 10 mL/ min (< 0.17 mL/ s) 2.5 mg/ day x (including patients on dialysis)
x Dosage and/ or frequency of administration should be adjusted depending on the blood pressure response. The dosage may be titrated upward until blood pressure is controlled or to a maximum of 40 mg daily. Anaphylactoid reactions have been reported in patients dialysed with high-flux membranes (e. g., polyacrylonitrile [PAN] and treated concomitantly with an ACE inhibitor) (see PRECAUTIONS, Anaphylactoid Reactions during Membrane Exposure). Page: << Prev | 1 | 2 | 3 | 4 | 5 | Next >>
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