Patients with severe course of arterial hypertension or concomitant CHF in decompensation should begin treatment with Fosinotek in a hospital setting.
In rare cases, it is possible to develop arterial hypotension. Symptomatic arterial hypotension with ACE inhibitors is most likely in patients after intensive treatment with diuretics and / or restriction of salt intake or during hemodialysis. Transient arterial hypotension is not a contraindication for further use of the drug, after correction of the BCC.
In patients with CHF in the presence or absence of impaired renal function, therapy with ACE inhibitors can cause an excessive hypotensive effect,which can lead to oliguria or azotemia, and in rare cases to acute renal failure and death. Therefore, in the treatment of CHF with Fosinotek, monitoring of the patient's condition is necessary, especially during the first two weeks of therapy, as well as with any increase in dose and / or diuretic.
Patients with bilateral renal artery stenosis, renal artery stenosis or a single kidney, and while the use of diuretics ACE during therapy can increase the content of urea nitrogen and serum creatinine inhibitors. These effects are usually reversible and pass after discontinuation of therapy. You may need to reduce the dose of a diuretic and / or Fosinotek.
Before and during the treatment with Fozinotek necessary to monitor blood pressure, renal function, the content of potassium ions, hemoglobin, creatinine, urea, electrolytes and activity concentration "liver" enzymes in the blood.
While taking Fozinotek drug should periodically monitor the total number of leukocytes and leukocyte formula (1 once a month during the first 3-6 months of therapy.), Especially in patients with an increased risk of neutropenia: with impaired renal function and systemic connective tissue diseases, as well as first signs of infection.
In patients with CHF, diabetes mellitus, concurrently taking potassium-sparing diuretics, potassium supplements, potassium-containing salt substitutes, or other agents that increase serum potassium levels (eg, heparin), ACE inhibitors increase the risk of hyperkalemia.
Because of the increased risk of developing arterial hypotension, care should be taken when prescribing the drug to patients on a low-salt or salt-free diet.
The safety and effectiveness of the use of the drug Fosinotek in children under 18 years of age is not established.
Caution should be exercised when performing physical exercises or in hot weather due to the risk of dehydration and a decrease in blood pressure due to a decrease in BCC.
Before surgery (including dentistry), an anesthesiologist should be warned about the use of an ACE inhibitor.
Caution should be exercised when treating patients with ACE inhibitors during desensitization procedures.
Care must be taken when driving vehicles or performing any work that requires increased attention, especially after taking the initial dose of the drug in patients,taking diuretic drugs.