Cosyrel Contraindications

Hypersensitivity to the active substances, or to any of the excipients listed in Description, or to any other angiotensin converting enzyme (ACE) inhibitor.
Acute heart failure or during episodes of heart failure decompensation requiring i.v. inotropic therapy.
Cardiogenic shock.
Second or third degree AV block (without pacemaker).
Sick sinus syndrome.
Sinoatrial block.
Symptomatic bradycardia.
Symptomatic hypotension.
Severe bronchial asthma or severe chronic obstructive pulmonary disease.
Severe forms of peripheral arterial occlusive disease or severe forms of Raynaud's syndrome.
Untreated phaeochromocytoma (see Precautions).
Metabolic acidosis.
History of angioedema associated with previous ACE inhibitor therapy (see Precautions).
Hereditary or idiopathic angioedema.
Second and third trimesters of pregnancy (see Precautions and Use in Pregnancy & Lactation).
Concomitant use of Cosyrel with aliskiren-containing products in patients with diabetes mellitus or renal impairment (GFR <60 ml/min/1.73m²) (see Precautions, Interactions and Pharmacology: Pharmacodynamics under Actions).
Concomitant use with sacubitril/valsartan therapy. Cosyrel must not be initiated earlier than 36 hours after the last dose of sacubitril/valsartan (see Precautions and Interactions).
Extracorporeal treatments leading to contact of blood with negatively charged surfaces (see Interactions).
Significant bilateral renal artery stenosis or stenosis of the artery to a single functioning kidney (see Precautions).