Additive hyperkalemic effects with potassium sparing diuretics, K supplements and other hyperkalemic drugs. Reduced antihypertensive effects or additive renal effects with NSAIDs Marked hypotension with diuretics, other antihypertensives, alcohol other agents that lower BP

Adverse drug reactions like cough ,headache, fatigue, GI and taste disturbances, persistent dry cough, other resoiratory tract symptoms, skin rash, angioedema, Photosensitivity, renal impairment, hyperkalemia, hyponutremia, blood disorders, proteinuria, tachycardia, stomatitis, pancreatitis, Cholestatic jsaundice, alopecia, muscle cramps, paraesthesias, mood and sleep disturbances, impotence. Excessive hypotension which result in MI or stroke in patients with ischemic heart disease or cerbrovasscular disease .

Aortic stenosis or outflow tract obstruction Renovascular diseases. Ascites Pregnancy and lactation

Special Precaution

Peripheral vascular diseases, generalised artherosclerosis, idiopathic heridatory angioedema, heart failure , patients likely to be salt or water depleted. Assess renal function before and during therapy. Monitor for proteinuria. Conduct regular WBC counts in SLE and scleroderma patients Discontinue diuretics 2-3 days before starting therapy and resume later if required Elderly.

Indication-

Mild to moderate hypertension

Dosage-

Treatment initiated with 5mg once daily . The dose should be titrated to give optimum control of blood pressure

Pharmacology

The hypotensive effect of imidapril in hypertension appears to result primarily from the suppression of plasma rennin-angiotensin-aldosterone system. Inhibition of ACE results from decreased plasma angiotensin II which leads to decreased vasopresser activity and to reduced aldosterone secretion.

Pharmacokinetics

Following oral administration Imidapril is rapidly absorbed from from the gastrointestinal tract and reaches its maximum plasma concentration within 2 hours. Half life is about 2 hours. Absorption is about 70% and the absolute bioavailability of imidapril is about 70% and the absolute bioavailability of imidapril is about 20% Plasa concentration of Imidapril has an initial half-life of about 7-9 hours and a terminal half life of more than 24 hours.

Contrindicated for use during pregnancy and lactation. Use with extreme caution if needed