Indications: hypertension including left ventricular hypertrophy; renal disease in hypertensive type 2 diabetes mellitus.

Cautions: renal artery stenosis; aortic or mitral valve stenosis and obstructive hypertrophic cardiomyopathy. Contra-indications: breastfeeding, intravascular volume depletion.

Side Effects: nausea, vomiting; fatigue; musculoskeletal pain; diarrhoea, dyspepsia, flushing, tachycardia, chest pain, cough and sexual dysfunction; dizziness; orthostatic effects; rash; angioedema.

Dose: hypertension and in renal disease in hypertensive type 2 diabetes mellitus: initially 150 mg once daily, increased if necessary to 300 mg once daily.

In haemodialysis or in elderly over 75 years, initial dose of 75 mg once daily may be used.