Recommended Dosage for Selected Hypertension Drug Therapy Drug Usual Dose Range Commentsa Thiazide-type Diuretics Chlorthalidoneb HCTZb Indapamide 12.5-25 mg daily 25-50 mg dailyc IR: 2.5 mg daily May cause hyperuricemia/ gout Monitor K+ levels May cause photosensitivity (rare) May cause hyponatremia (1-2%) May be less effective in eGFR <30 mL/minute Angiotensin- Converting Enzyme Inhibitors (ACEI) Benazepril Enalapril Fosinopril Lisinoprilb Ramiprilb 10-40 mg/day (daily or divided bid) 5-40 mg/day (daily or divided bid) 10-40 mg daily 10-40 mg daily 2.5-20 mg/day (daily or divided bid) (10 mg daily for CV risk prevention) Avoid in women who are planning to become pregnant or who are pregnant; when pregnancy is contemplated or detected, discontinue as soon as possible, due to potential for fetal and neonatal morbidity and death; patients of child-bearing potential should also be educated about the risks Do not use if history of angioedema Avoid concomitant use of ACEI with ARB or direct renin inhibitor due to increased risk of hypotension, syncope, increased K+, and changes in kidney function (see Recommendation 26) Monitor K+ and kidney function; use caution if combined with, K+ sparing diuretic, or K+ supplement Consider interruption or discontinuation in patients who develop clinically significant decline in kidney function after initiation of therapy, until further work-up, as indicated (e.g., kidney artery stenosis) Compelling indications include: CKD with albuminuria (refer to VA/DoD CKD ); HFrEF; recent MI 1 See the VA/DoD Clinical Practice Guideline for the Management of Chronic Kidney Disease. 