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This medication requires careful consideration before use due to its potential risks and necessary precautions. Below are key safety and warning details that should be reviewed and discussed with your healthcare provider:

• Pregnancy Risk: This drug can cause severe harm to an unborn baby, potentially resulting in life-threatening conditions. It is crucial to avoid pregnancy while on this medication. If you become pregnant or are planning to become pregnant, consult your healthcare provider immediately to discuss alternative treatments.

• Angioedema Risk: Some individuals may experience angioedema, a rare but serious condition characterized by swelling of the face, throat, or tongue, which can obstruct breathing. Those at higher risk include individuals with a history of angioedema, Black individuals, older adults, and females.

• Severe Allergic Reactions: This medication can trigger life-threatening allergic reactions such as anaphylaxis, which involves breathing difficulties, hives, or facial swelling. Seek emergency medical assistance if these symptoms occur.

• Liver Health Concerns: In rare cases, this medication has been linked to severe liver issues. Symptoms such as nausea, abdominal pain, or yellowing of the skin or eyes should be reported to your healthcare provider immediately, especially if you have a history of liver problems or consume large quantities of alcohol.

• Kidney Function Considerations: While generally beneficial for kidney health, this medication might worsen existing kidney issues, particularly for those with renal artery stenosis or severe heart failure. Regular kidney function tests may be necessary to monitor your condition.

• Blood Cell Count Monitoring: If you have a collagen-vascular condition like lupus or rheumatoid arthritis, you may be at increased risk for lower blood cell counts, particularly if you also have kidney issues. Your provider may conduct frequent blood tests to monitor your blood cell levels.

• Blood Pressure Monitoring: This medication can occasionally cause low blood pressure, leading to dizziness or lightheadedness, especially when starting the treatment or adjusting the dose. Staying hydrated is important. Report any severe symptoms to your healthcare provider, and take precautions to prevent falls if dizziness occurs.

• High Potassium Levels: This medication may increase potassium levels, which can be dangerous, especially for those with diabetes, kidney problems, or those taking other potassium-raising drugs. Notify your provider if you experience symptoms like nausea, muscle weakness, or an irregular heartbeat.

• Dry Cough: A persistent dry cough may develop during treatment. If it becomes bothersome, discuss alternative medications with your healthcare provider.

Contraindications:

• Do not use if allergic to any ACE inhibitors.
• Avoid concurrent use with neprilysin inhibitors like Entresto (sacubitril/valsartan) or aliskiren (Tekturna) if you have high blood sugar.

It is important to discuss these considerations with your healthcare provider to ensure this medication is safe and appropriate for you.

Common side effects:

• Dizziness
• Headaches
• Feelings of tiredness or weakness
• Dry cough

Less common but important to monitor:

• Low blood pressure

Serious side effects:

• Fainting
• Chest pain
• Nausea
• Vomiting
• Kidney function issues
• Liver problems
• Allergic reactions (rash, itching, swelling, severe dizziness, trouble breathing)

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

• Aliskiren
• Sacubitril
• Desensitization injections for bee/wasp sting allergies

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

• Everolimus
• Sirolimus
• Lithium
• Drugs that may increase potassium levels (including ARBs like Losartan, Valsartan, and birth control pills with Drospirenone)
• Telmisartan

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

• NSAIDs (such as Ibuprofen and Naproxen)
• Cough-and-cold remedies
• Diet aids