considerations before introduction of treatment

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  • measurement of plasma/serum creatinine and electrolytes
  • measurement of blood pressure
  • referral to hospital for assessment and supervised initiation of treatment should be considered if:
    • plasma/serum sodium < 135 mmol/l
    • plasma/serum creatinine > 150 micromol/l
    • patient has a systolic blood pressure < 100 mmHg
    • symptoms of severe heart failure
  • ACEIs should be used with caution as the patient's age increases
  • ACEIs should be used with caution in patients with severe peripheral vascular disease because of association with possible renal artery stenosis


  1. BMJ (1998);316: 1369-75.

Last reviewed 01/2018