Hyperkalemia might occur (risk factors: renal dysfunction, diabetes mellitus, concomitant use of potassium-sparing diuretics, potassium supplements and/or potassium-containing salts). May be associated with deterioration of renal function and/or increases in serum creatinine, resulting in oliguria, acute renal failure, and progressive azotemia. Use with caution in unstented unilateral/bilateral renal artery stenosis (if unstented bilateral renal artery stenosis is present, use is generally avoided unless possible benefits outweigh risks). Use with caution in significant aortic/mitral stenosis. Use with caution when initiating in heart failure. Hypotension may occur during major surgery and anesthesia. Avoid use or use smaller dose in patients who are volume-depleted. Use with caution in moderate hepatic impairment (contraindicated in severe hepatic impairment and/or cholestasis). Concurrent therapy with ACE inhibitor may be rational in selected patients.