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Post-myocardial infarction
Adult: Short-term treatment (within 24 hours of the onset of symptoms): In clinically stable patients: 6.25 mg as a test dose, followed by 12.5 mg after 2 hours, and 25 mg after 12 hours. From the following day, increase to 100 mg daily in 2 divided doses for 4 weeks, if tolerated. Chronic treatment (>24 hours after the onset of symptoms): To improve survival in clinically stable patients with left ventricular dysfunction manifested as an ejection fraction of ≤40%: Initially, 6.25 mg to be started between days 3-16 post-infarction, followed by 12.5 mg tid for 2 days, then 25 mg tid depending on patient response. Maintenance: 75-150 mg daily in 2 or 3 divided doses.
Elderly: Initially, 6.25 mg bid. Titrate according to blood pressure response and maintain the lowest possible dose to achieve adequate control.
Child: Initially, 0.3 mg/kg. Patients requiring special precautions (e.g. premature infants, newborns and infants, or children with renal dysfunction): Initially, 0.15 mg/kg. Doses are given in 3 divided doses daily. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
Elderly: Initially, 6.25 mg bid. Titrate according to blood pressure response and maintain the lowest possible dose to achieve adequate control.
Child: Initially, 0.3 mg/kg. Patients requiring special precautions (e.g. premature infants, newborns and infants, or children with renal dysfunction): Initially, 0.15 mg/kg. Doses are given in 3 divided doses daily. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
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Hypertension
Adult: As monotherapy or in combination with other antihypertensive agents (e.g. thiazide diuretics): Initially, 25-50 mg daily in 2 divided doses; may increase gradually at intervals of at least 2 weeks to 100-150 mg daily in 2 divided doses as needed to reach target blood pressure. Once daily dosing may be appropriate if taken with other antihypertensive agents. Patients with strongly active renin-angiotensin-aldosterone system (e.g. hypovolaemia, renovascular hypertension, cardiac decompensation): Initially, 6.25 mg or 12.5 mg as a single dose; may increase gradually to 50 mg daily, or 100 mg daily if necessary, in 1 or 2 divided doses. Dosage recommendations may vary among countries and individual products (refer to specific product guidelines).
Elderly: Initially, 6.25 mg bid. Titrate according to blood pressure response and maintain the lowest possible dose to achieve adequate control.
Child: Initially, 0.3 mg/kg. Patients requiring special precautions (e.g. premature infants, newborns and infants, or children with renal dysfunction): Initially, 0.15 mg/kg. Doses are given in 3 divided doses daily. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
Elderly: Initially, 6.25 mg bid. Titrate according to blood pressure response and maintain the lowest possible dose to achieve adequate control.
Child: Initially, 0.3 mg/kg. Patients requiring special precautions (e.g. premature infants, newborns and infants, or children with renal dysfunction): Initially, 0.15 mg/kg. Doses are given in 3 divided doses daily. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
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Diabetic nephropathy in type 1 diabetes mellitus
Adult: 75-100 mg daily in divided doses.
Elderly: Initially, 6.25 mg bid. Titrate according to blood pressure response and maintain the lowest possible dose to achieve adequate control.
Child: Initially, 0.3 mg/kg. Patients requiring special precautions (e.g. premature infants, newborns and infants, or children with renal dysfunction): Initially, 0.15 mg/kg. Doses are given in 3 divided doses daily. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
Elderly: Initially, 6.25 mg bid. Titrate according to blood pressure response and maintain the lowest possible dose to achieve adequate control.
Child: Initially, 0.3 mg/kg. Patients requiring special precautions (e.g. premature infants, newborns and infants, or children with renal dysfunction): Initially, 0.15 mg/kg. Doses are given in 3 divided doses daily. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
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Heart failure
Adult: In combination with diuretics (or with digitalis and β-blockers, when appropriate): Initially, 6.25-12.5 mg bid or tid; may increase gradually according to patient’s response, clinical status, and tolerability at intervals of at least 2 weeks. Maintenance: 75-150 mg daily in divided doses.
Elderly: Initially, 6.25 mg bid. Titrate according to blood pressure response and maintain the lowest possible dose to achieve adequate control.
Child: Initially, 0.3 mg/kg. Patients requiring special precautions (e.g. premature infants, newborns and infants, or children with renal dysfunction): Initially, 0.15 mg/kg. Doses are given in 3 divided doses daily. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
Elderly: Initially, 6.25 mg bid. Titrate according to blood pressure response and maintain the lowest possible dose to achieve adequate control.
Child: Initially, 0.3 mg/kg. Patients requiring special precautions (e.g. premature infants, newborns and infants, or children with renal dysfunction): Initially, 0.15 mg/kg. Doses are given in 3 divided doses daily. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
