Warnings for special population
Pregnancy
This medicine is not recommended for use in pregnant women except in life-threatening conditions. All the risks and benefits should be discussed with the doctor before taking this medicine. Your doctor may prescribe a safer alternative based on your clinical condition.
Breast-feeding
This medicine is not recommended for use in breastfeeding women unless absolutely necessary. All the risks and benefits should be discussed with the doctor before taking this medicine. Your doctor may advise you to discontinue breastfeeding or to discontinue the drug based on your clinical condition.
General warnings
Hypotension
This medicine should be used with caution in patients who are sodium depleted and/or volume depleted by diuretic use since it may increase the risk of hypotension. The volume depleted and/or sodium depleted state should be corrected before starting the therapy or the treatment should be started at a lower dose. Vital signs should be monitored closely during therapy with this medicine.
Hyperkalemia
Use of this medicine may increase the potassium levels in the blood (hyperkalemia). This may cause serious side effects such as fatal cardiac rhythm irregularities. It is advised to avoid potassium-rich foods (potatoes, bananas) and other medicines that may increase potassium levels (ACE inhibitors and potassium supplements) during treatment with this medicine.
Liver Disease
This medicine should be used with caution in patients with liver diseases due to the increased risk of severe adverse effects. Close monitoring of liver function tests, appropriate dose adjustments, or replacement with a suitable alternative may be required based on the clinical condition.
Kidney Disease
This medicine should be used with caution in patients with kidney diseases due to the increased risk of worsening of the patient's condition. Close monitoring of kidney function is recommended for such patients. Appropriate dose adjustments or replacement with a suitable alternative may be required based on the clinical condition.
Driving or operating machinery
Use of this medicine may cause blurred vision or dizziness in some patients. It is advised that you do not perform any activities such as driving a vehicle or operating machinery if you experience any of these symptoms during treatment with this medicine.
Major surgery
This medicine should be used with caution in patients who are scheduled to undergo major surgery. An anesthetic agent with little negative inotropic activity should be selected to minimize the effect on the heart.
Lung Diseases
This medicine should be used with caution in patients with lung diseases who do not respond to other antihypertensive medications. Start with the lowest possible dose and increase the dose based on the clinical condition. Replacement with a suitable alternative may be required in some cases.
Hyperlipidemia
This medicine should be used with caution in patients with hyperlipidemia since it may alter the serum lipid profiles. Appropriate dose adjustments or replacement with a suitable alternative should be considered under your doctor's supervision.
Sports
Athletes are advised not to indulge in certain sports while using this medicine. Archery, racing, shooting and other high-risk sports should be avoided. Sportspersons should refer to the list of medicines published by World Anti-Doping Agency (WADA) which are not to be taken while participating in specific sports events.
Hyperthyroidism
This medicine should be administered with caution in patients with increased thyroid levels. Abrupt withdrawal of this medicine may lead to a life-threatening condition called thyroid-storm. Frequent monitoring of thyroid hormone levels is recommended for such patients. Appropriate dose adjustments or replacement with a suitable alternative may be required based on the clinical condition.
Volume and electrolyte depletion
Use of this medicine may alter the blood volume levels and electrolyte levels. This may cause dizziness, dry mouth, and acid-base imbalance. Close monitoring of blood pressure and electrolyte levels is necessary while taking this medicine. Report any symptoms such as weakness, lethargy, muscle pain, drowsiness, dizziness, irregular heartbeat, etc. to the doctor immediately.