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This medication carries important safety warnings that need careful consideration before use. Please review the following details and consult with your healthcare provider if you have any questions or concerns.

• Pregnancy Warning: This drug should not be used during pregnancy as it can cause severe and potentially fatal harm to an unborn baby. If you discover you are pregnant while taking this medication, discontinue use immediately and inform your healthcare provider. If you are pregnant or planning to become pregnant, discuss alternative treatments with your provider.

• Angioedema Risk: Taking ACE inhibitors like this medication may lead to angioedema, a rare but serious condition characterized by swelling of the face, throat, or tongue, which can obstruct breathing. This risk is higher for individuals who are Black, older adults, or female. Seek immediate medical attention if you experience swelling or difficulty breathing. If you have a history of angioedema, inform your provider before starting this medication.

• Low Blood Pressure: This medication can sometimes cause a significant drop in blood pressure, resulting in dizziness, fatigue, or lightheadedness, particularly when starting the treatment or increasing the dosage. Stay hydrated and rise slowly from sitting or lying positions to prevent falls. Contact your healthcare provider if these symptoms occur, and seek immediate help if you fall and hit your head.

• Kidney Health: While generally beneficial for kidneys, this medication can worsen existing kidney problems, especially in individuals with severe heart failure or renal artery stenosis. Regular kidney function tests may be required. Report any decrease in urination to your provider immediately.

• High Potassium Levels: This medication may increase potassium levels in your body, which can lead to serious heart problems. Those with diabetes, kidney issues, or those taking other medications that increase potassium should be particularly cautious. Report symptoms such as nausea, muscle weakness, or irregular heartbeat to your healthcare provider.

• Liver Concerns: Although rare, this medication can cause liver issues, including blocked bile ducts leading to liver failure. Regular liver function tests may be necessary. Notify your provider if you experience symptoms like fatigue, stomach pain, or jaundice.

• Contraindications: Do not use this medication if you have a history of angioedema, are taking aliskiren (Tekturna) with high blood sugar, or are using neprilysin inhibitors like Entresto (sacubitril/valsartan) within 36 hours. Consult your healthcare provider for further guidance.

Please ensure that your healthcare provider is aware of your complete medical history and any other medications you are taking to avoid potential interactions and complications.

Common side effects:

• dizziness
• lightheadedness
• weakness
• feeling tired
• persistent dry cough

Serious side effects:

• muscle weakness
• irregular heartbeat
• worsening kidney issues
• changes in urine output
• severe liver problems
• rash
• itching
• swelling (particularly of the face, tongue, or throat)
• severe dizziness
• breathing difficulties

Interactions with high risk of serious adverse effects and should be avoided:

• Aliskiren
• Sacubitril
• Allergy shots for bee/wasp stings

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Everolimus
• Sirolimus
• Lithium
• Losartan
• Valsartan
• Birth control pills containing drospirenone
• NSAIDs (e.g., ibuprofen, naproxen)