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This medication carries significant risks, particularly for certain groups and under specific conditions. It is crucial to read and understand the following safety information, and consult your healthcare provider if you have any questions or concerns.

• Pregnancy Risk: This drug, like other ACE inhibitors, can cause serious harm to an unborn child. It should not be used during pregnancy. If you are pregnant, planning to become pregnant, or suspect you are pregnant, consult your healthcare provider immediately to discuss safer alternatives. If you become pregnant while on this medication, discontinue its use and inform your healthcare team at once.

• Angioedema and Allergic Reactions: There is a risk of experiencing angioedema, which involves swelling in areas such as the face, throat, and tongue. This condition can be life-threatening if it leads to breathing difficulties. Individuals who are Black, older adults, or female may have a higher risk. Discontinue use and seek immediate medical assistance if you observe unusual swelling or difficulty breathing.

• Infection Risk: A decrease in white blood cell count, which increases the risk of infections, has been noted in patients taking ACE inhibitors. This risk is particularly pronounced in individuals with kidney issues or autoimmune disorders. Inform your healthcare provider if you have these conditions.

• Low Blood Pressure: There is a chance of experiencing low blood pressure, leading to dizziness or lightheadedness, particularly when starting the medication or adjusting the dose. Stay hydrated and rise slowly from sitting or lying positions to prevent falls. Seek immediate help if you experience an injury from a fall.

• Kidney Issues: While generally beneficial for the kidneys, this medication can sometimes worsen existing kidney problems, especially in those with renal artery stenosis or severe heart failure. Regular kidney function tests may be recommended. Notify your healthcare team if you notice changes in urination.

• High Potassium Levels: This drug can increase potassium levels, which may be dangerous. The risk is higher in individuals with diabetes or kidney problems. Inform your healthcare provider about all medications you're taking. Seek medical help if you experience symptoms like nausea, muscle weakness, or irregular heartbeat.

• Liver Concerns: Rare but severe liver problems have been associated with ACE inhibitors. Your healthcare provider may conduct periodic liver function tests. Report any symptoms such as fatigue, abdominal pain, or jaundice.

Contraindications:

• A history of angioedema.
• Concurrent use with aliskiren (Tekturna) in patients with diabetes.
• Use within 36 hours of neprilysin inhibitors like Entresto (sacubitril/valsartan).

Ensure you discuss your full medical history and current medications with your healthcare provider before starting this medication to minimize risks and ensure safe use.

Common side effects:

• dry cough
• dizziness
• nausea
• vomiting

Less common but important to monitor:

• low blood pressure
• muscle pain
• diarrhea
• chest pain
• upper respiratory tract infections

Serious side effects:

• fainting
• swollen limbs
• severe dizziness
• trouble breathing
• muscle weakness
• irregular heartbeat
• signs of kidney problems
• liver problems
• severe allergic reaction

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

• Aliskiren
• Sacubitril

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

• Everolimus
• Sirolimus
• Lithium
• Losartan
• Valsartan
• Other ARBs (Angiotensin Receptor Blockers)
• Azathioprine
• Spironolactone

Interactions with low risk that usually do not require a change in therapy:

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) like Ibuprofen
• Naproxen