Indications
Treatment of essential hypertension.
Contraindications
- Hypersensitivity to any of the ingredients or Angiotensin-converting enzyme (ACE) inhibitors.
- History of angioneurotic oedema associated with previous ACE inhibitors therapy.
- Hereditary/idiopathic angioedema.
- Second and third trimesters of pregnancy.
- Severe renal failure with or without haemodialysis (Clcr < 10 m/min).
Dosage and administration
- Adults: Start with 5 mg daily; if control of blood pressure has not been achieved after at least 3 weeks, increased to 10 mg/day; maximum 20 mg/day; consider combination with a diuretic.
- Elderly (≥ 65 years old): Start with 2.5 mg once a day, titrate according to response, maximum 10 mg/day.
- Renal impairment: Clcr 30 – 80 ml/min: Initiate with 2.5 mg/day; Clcr 10 – 29 ml/min: Should not use.
- Hepatic impairment: Start with 2.5 mg/day.
- Patients at increased risk for first dose hypotension: Correction in salt and/or body fluids deficiencies and discontinuation of an existing diuretic therapy for 2 – 3 days before imidapril. If this is not possible, initial dose should be imidapril 2.5 mg/day, then careful dose titration.
- Cardiac failure: Start with 2.5 mg/day; should be closely monitored.
- Children: The safety and efficacy have not been established.
Precaution
- Ischaemic heart or cerebrovascular disease.
- Aortic or mitral valve stenosis, hypertrophic cardiomyopathy.
- Collagen vascular disease.
- Severe cardiac failure or underlying renal disease, including bilateral renal artery stenosis or stenosis of the artery to a single functioning kidney.
- Undergoing LDL lipid apheresis with dextrane sulfate, under-going haemodialysis with high-flux membranes, undergoing desensitising treatment with hymenoptera venom.
- Previously treated with oral antidiabetic drugs or insulin in the first month treating with imidapril.
- Driving/ operating machinery.
- Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.
- Imidapril is not recommended during the first trimester of pregnancy and during breast-feeding.
Storage
Store at temperature below 30°C, protect from light.
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