Severity: Moderate
Onset: Rapid
Documentation: Good
Interaction Effect:
Concurrent use of ANGIOTENSIN CONVERTING ENZYME INHIBITORS and THIAZIDE DIURETICS may result in postural hypotension (first dose).
Clinical Management:
Start with a very low dose of the angiotensin converting enzyme (ACE) inhibitor in the evening and closely monitor blood pressure for a severe hypotensive response for four hours after the initial dose. Monitor for hypotension, fluid status, and body weight regularly for up to two weeks after dose adjustments.
Probable Mechanism:
vasodilation and relative intra-vascular volume depletion