It is being used in moderate to severe essential hypertension, generally, in combination with a diuretic and/or beta blocker. It is considered safe in asthmatics & diabetics. It causes both arteriolar and vasodilatation which reduces after load & preload, Cardiac output is generally increased and heart rate is reduced.

INDICATIONS: All grades of hypertension. CHF Scleroderma crisis.

DOSAGE: Adults: 25 mg, 3 times increased gradually upto 100 mg 3 times. CHF or with diuretics: Start with 6.25 mg 3 times to avoid marked fall in BP with first dose.

CONTRA-INDICATIONS: Pregnancy, breast feeding, aortic stenosis, renal impairment, hypersensitivity.

SPECIAL PRACEUTIONS: Anaesthesia, correct sodium depletion, if any before initiating therapy. In case of concurrent use of immunosuppressant or leuko penic drugs, monitor W.B.C. counts and urinary protein before & during therapy. Bilateral renal artery stenosis-renal failure may be precipitated. Avoid concomitant use of k+ sparing diuretics.

SIDE-EFFECTS: Dry cough, precipitate hypotension, rashes, alteration of taste sensation, vertigo, fainting, headache, bowel upset, anaemia, granulocytopenia and proteinuria hyperkalaemia.

DRUG INTERACTIONS: With immuno suppersive drugs, risk of bone marrow depression increased. Hyperkalaemia if used with pot.sparing diuretics. Diuretics greatly enhance hypotensive action of ACE inhibitors.