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A transient hypotensive response is not a contraindication to further doses of Vasotec, which usually can be given without difficulty once the blood pressure has stabilized. In patients with severe heart failure whose renal function may depend on the activity of the renin-angiotensin-aldosterone system, treatment with angiotensin converting enzyme inhibitors, including Vasotec, may be associated with oliguria and/or progressive azotemia and rarely with acute renal failure and/or death. Nonetheless, when patients become pregnant, physicians should make every effort to discontinue the use of Vasotec as soon as possible. If symptomatic hypotension develops, a dose reduction or discontinuation of Vasotec or concomitant diuretic may be necessary. Patients with heart failure given Vasotec commonly have some reduction in blood pressure, especially with the first dose, but discontinuation of therapy for continuing symptomatic hypotension usually is not necessary when dosing instructions are followed; caution should be observed when initiating therapy (see DOSAGE AND ADMINISTRATION). In patients treated with Vasotec, the maximum duration of therapy was three years; in placebo treated patients the maximum duration of therapy was 12 weeks.

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