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What should I watch for while taking Micardis?

Visit your doctor or health care professional for regular checks on your progress. Check your blood pressure as directed. Ask your doctor or health care professional what your blood pressure should be and when you should contact him or her. Call your doctor or health care professional if you notice an irregular or fast heart beat.

Women should inform their doctor if they wish to become pregnant or think they might be pregnant. There is a potential for serious side effects to an unborn child, particularly in the second or third trimester. Talk to your health care professional or pharmacist for more information.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can make you more drowsy and dizzy. Avoid alcoholic drinks.

Avoid salt substitutes unless you are told otherwise by your doctor or health care professional.

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The brewing process begins with polishing hulled rice, the main ingredient. As it passes through a special polisher, the proteins and bran that can produce off flavors in the sake are removed.

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The polished rice is washed in water to remove the bran and is left to steep in water. When the grain has absorbed 30% of its weight in water it is steamed. One batch of steamed rice may be used to make koji, yeast starter, and to feed the moromi mash.

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Spores of the aspergillus oryzae mold (koji-kin) are added to the steamed rice, which is then incubated to produce koji. The koji is added to the yeast starter and the moromi mash to help convert the rice starch into glucose.

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This is made by mixing steamed rice, water, koji, and yeast. It contains large amounts of yeast, which promotes the moromi fermentation process.

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Koji, steamed rice, and water are added to the shubo and then left to ferment.

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Here (during the moromi preparation stage), a process unique to Japanese sake brewing takes place. It’s a three-step fermentation process known as sandan shikomi. On the first day, koji, steamed rice, and water are added to the yeast starter (this addition is called hatsuzoe). The mixture is left to stand on the following day to allow the yeast to slowly multiply (this step is called odori). On the third day, the second batch of koji, steamed rice, and water is added to the mixture (this addition is called nakazoe). Then finally on the fourth day, the third batch is added to the mixture (this addition is called tomezoe) to complete the three-part process.

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From this point, the koji will convert the starch in the rice into glucose, which the yeast will then use to create alcohol and carbon dioxide. The conversion of starch to sugar and sugar to alcohol takes place in parallel all in the same tank. This is known as "multiple parallel fermentation," and is a process that is entirely unique to sake.

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Once the moromi is completely fermented, it is passed through a press to separate out the sake lees. The sake is then filtered, pasteurized, and placed in cold storage where it matures before being bottled.