Perindopril | Perindopril tablets coated. 4 mg 30 pcs.
Special Price
$18.43
Regular Price
$26.00
In stock
SKU
BID477563
Release form
Tablets.
Tablets.
Release form
Tablets.
Packing
30 pcs.
Pharmacological action of
Perindopril is an ACE inhibitor (interacts with zinc ions in the ACE molecule and causes its inactivation). Perindopril acts through its active metabolite, perindoprilat. Eliminates the vasoconstrictor effect of angiotensin II, increases the concentration of bradykinin and vasodilator prostaglandins (ACE converts inactive angiotensin I to angiotensin II, which has a vasoconstrictor effect, and also causes the degradation of bradykinin and prostaglandins with vasodilating activity) reduces the production and release of aldosterone, inhibits the release of norepinephrine from the ends of the sympathetic nerve fibers and the formation of endothelin in the vascular wall.
A decrease in the formation of angiotensin II is accompanied by an increase in plasma renin activity (due to inhibition of negative feedback). ACE suppression is accompanied by an increase in the activity of both the circulating and tissue kallikrein-kinin system, as well as the prostaglandin system.
Helps to restore elasticity of large arterial vessels (reducing the formation of excessive amounts of subendothelial collagen), reduces pressure in the pulmonary capillaries, with prolonged administration, it reduces the severity of left ventricular myocardial hypertrophy and interstitial fibrosis, normalizes the isoenzyme profile of myosin and normalizes the functioning of the heart.
Reduces preload and afterload (reduces systolic and diastolic blood pressure (BP) while lying and standing), filling pressure of the left and right ventricles, total peripheral vascular resistance (OPSS) increases minute blood volume (IOC) and cardiac index, does not increase the frequency heart rate (HR) (in patients with chronic heart failure (CHF) moderately reduces heart rate), increases regional blood flow in the muscles. Increases the concentration of high density lipoproteins, in patients with hyperuricemia reduces the concentration of uric acid. Increases renal blood flow, does not change the glomerular filtration rate.
Indications
Arterial hypertension.
Chronic heart failure.
Contraindications
Hypersensitivity to perindopril and other components of perindopril or other ACE inhibitors, history of angioedema during therapy with ACE inhibitors, hereditary or idiopathic angioedema, pregnancy, lactation period, age and safety (under 18 years).
Precautions: Aortic valve stenosis, hypertrophic obstructive cardiomyopathy, cerebro- and cardiovascular diseases (including cerebrovascular insufficiency, coronary heart disease, coronary insufficiency - the risk of developing an excessive decrease in blood pressure and concomitant ischemia).
Severe autoimmune systemic diseases of the connective tissue (including systemic lupus erythematosus, scleroderma), inhibition of bone marrow hematopoiesis while receiving immunosuppressants (increased likelihood of developing neutropenia).
Renovascular hypertension, bilateral stenosis of the renal arteries, stenosis of a single kidney artery, condition after kidney transplantation (risk of impaired renal function and agranulocytosis), chronic renal failure (especially accompanied by hyperkalemia), hyperkalemia, a diet with a decrease in sodium, circulating conditions, accompanied by blood (including diarrhea, vomiting, diuretics), diabetes mellitus, advanced age, surgical intervention (general anesthesia).
Special instructions
The risk of developing arterial hypotension and / or renal failure while taking the drug increases with a significant loss of sodium and water (strict salt-free diet, and / or diuretics, diarrhea, vomiting) or renal artery stenosis (block in these situations, renin -angiotensin system can lead, especially during the first administration of the drug and during the first 2 weeks of treatment, to a sudden decrease in blood pressure and the development of chronic renal failure). Before starting and during therapy, it is recommended to determine the concentration of creatinine, electrolytes and urea (within 1 month).
In patients with arterial hypertension who are already receiving diuretic therapy, it is necessary to stop taking them (3 days before the start of the appointment of Perindopril) and, if necessary, later add to the treatment again.
In patients with chronic heart failure receiving diuretic therapy, if possible, their dose should also be reduced several days before the start of treatment.
In patients at risk, especially with chronic heart failure in the decompensation stage, elderly patients, as well as patients with initially low blood pressure, impaired renal function or receiving high doses of diuretics, the use of the drug should be supervised by medical personnel.
In patients undergoing hemodialysis, the use of polyacrylonitrile membranes should be avoided (anaphylactoid reactions may develop). It is necessary to stop taking before the upcoming surgical treatment for 12 hours and to warn the anesthetist about taking the drug.
Composition
1 tablet contains perindopril erbumin - 4 mg.
Dosage and administration of
Perindopril is taken orally, in the morning, before meals.
The initial dose for the treatment of hypertension is 4 mg / day, if necessary (after 1 month) the dose can be increased to 8 mg / day in one dose.
When prescribing ACE inhibitors to patients receiving diuretic therapy, there may be a sharp decrease in blood pressure, for the prevention of which it is recommended to stop taking diuretics 2-3 days before the intended initiation of perindopril therapy or to prescribe a drug in lower doses - 2 mg once a day.
In patients with renovascular hypertension, the initial dose is 2 mg 1 time per day. If necessary, the subsequent dose may be increased.
In elderly patients, therapy should be started with a dose of 2 mg per day, and then, if necessary, gradually increase it up to a maximum dose of 8 mg per day.
Treatment of patients with chronic heart failure in combination with a non-potassium-sparing diuretic and / or digoxin, it is recommended to start under close medical supervision, appoint Perindopril in an initial dose of 2 mg once a day, in the morning.
Further, after 1-2 weeks of therapy, the dose of the drug can be increased to 4 mg once a day.
In patients with impaired renal function, the dose should be selected taking into account the degree of renal failure: depending on the creatinine clearance.
With creatinine clearance greater than 60 ml / min - 4 mg perindopril per day. With creatinine clearance of 30-60 ml / min - 2 mg 1 time per day with creatinine clearance of 15-30 ml / min - 2 mg every other day for patients on hemodialysis (creatinine clearance less than 15 ml / min.) - 2 mg per day dialysis.
Patients with impaired liver function, dose changes are not required.
Side effects
The frequency of side effects is estimated based on: often - 1-10% rarely - 0.1-1% extremely rare, including individual reports - less than 0.1%.
From the cardiovascular system: often an excessive decrease in blood pressure and the associated symptoms, rarely arrhythmia, angina pectoris, myocardial infarction and stroke.
From the urinary system: decreased renal function, acute renal failure.
On the part of the respiratory system: often - dry cough, difficulty breathing rarely - bronchospasm, rhinorrhea.
From the digestive system: often - nausea, vomiting, abdominal pain, taste change, diarrhea or constipation, dry mouth, decreased appetite, cholestatic jaundice, pancreatitis, intestinal edema.
From the central nervous system: often - headache, asthenia, fatigue, dizziness, ringing in the ears, visual impairment, muscle cramps, paresthesias rarely - decreased mood, insomnia extremely rare - confusion.
Allergic reactions: often - skin rash, itching rarely - urticaria, angioedema extremely rare - erythema multiforme exudative.
Laboratory indicators: often - hypercreatininemia, proteinuria, hyperkalemia, hyperuricemia rarely (with prolonged use at high doses) - neutropenia, leukopenia, hypogemoglobinemia, thrombocytopenia, extremely low hematocrit - agranulocytosis, pancytopenia, hepatic hemorrhagea, increased liver activity background deficiency of glucose-6-phosphate dehydrogenase).
Other: increased sweating, impaired sexual function.
Drug interaction
Increases the severity of the hypoglycemic effect of insulin and sulfonylurea derivatives.
Baclofen, tricyclic antidepressants, antipsychotic drugs (antipsychotics), saluretics enhance the hypotensive effect and increase the risk of orthostatic hypotension (additive effect).
Antacids reduce the bioavailability of ACE inhibitors.
Glucocorticosteroids, non-steroidal anti-inflammatory drugs reduce the severity of the hypotensive effect (fluid and electrolyte retention).
Potassium-sparing diuretics (spironolactone, triamteren, amiloride), potassium preparations increase the risk of hyperkalemia. The simultaneous use of drugs that can cause hyperkalemia and ACE inhibitors is not recommended, except in cases of severe hypokalemia (serum potassium monitoring).
With simultaneous use with lithium preparations, it is possible to slow its elimination from the body (regular monitoring of lithium content in the blood is necessary).
Diuretics, drugs for general anesthesia and muscle relaxants, ethanol increase the risk of developing an excessive decrease in blood pressure. The risk of developing clinically pronounced arterial hypotension can be reduced by stopping the use of diuretics several days before starting treatment with perindopril.
Myelotoxic drugs - increased myelotoxicity.
Overdose
Symptoms: decreased blood pressure, shock, stupor, bradycardia, electrolyte disturbances, renal failure.
Treatment: gastric lavage, use of enterosorbents, restoration of water-electrolyte balance, intravenous administration of 0.9% sodium chloride solution. In the case of a marked decrease in blood pressure, the patient must be given a horizontal position with raised legs. Hemodialysis is effective (do not use highly permeable polyacrylonitrile membranes). With the development of bradycardia, atropine. In severe cases, temporary implantation of a pacemaker is indicated. It is necessary to control and correct the vital functions of the body.
Storage Conditions
Store in a dry, out of reach of children place protected from light at a temperature not exceeding 25 РC.
Expiration
2 years.
active substance
Perindopril
Terms leave through pharmacies
In retseptu
lekarstvennaja form
tablets
Izvarino Pharma, Russia
Tablets.
Packing
30 pcs.
Pharmacological action of
Perindopril is an ACE inhibitor (interacts with zinc ions in the ACE molecule and causes its inactivation). Perindopril acts through its active metabolite, perindoprilat. Eliminates the vasoconstrictor effect of angiotensin II, increases the concentration of bradykinin and vasodilator prostaglandins (ACE converts inactive angiotensin I to angiotensin II, which has a vasoconstrictor effect, and also causes the degradation of bradykinin and prostaglandins with vasodilating activity) reduces the production and release of aldosterone, inhibits the release of norepinephrine from the ends of the sympathetic nerve fibers and the formation of endothelin in the vascular wall.
A decrease in the formation of angiotensin II is accompanied by an increase in plasma renin activity (due to inhibition of negative feedback). ACE suppression is accompanied by an increase in the activity of both the circulating and tissue kallikrein-kinin system, as well as the prostaglandin system.
Helps to restore elasticity of large arterial vessels (reducing the formation of excessive amounts of subendothelial collagen), reduces pressure in the pulmonary capillaries, with prolonged administration, it reduces the severity of left ventricular myocardial hypertrophy and interstitial fibrosis, normalizes the isoenzyme profile of myosin and normalizes the functioning of the heart.
Reduces preload and afterload (reduces systolic and diastolic blood pressure (BP) while lying and standing), filling pressure of the left and right ventricles, total peripheral vascular resistance (OPSS) increases minute blood volume (IOC) and cardiac index, does not increase the frequency heart rate (HR) (in patients with chronic heart failure (CHF) moderately reduces heart rate), increases regional blood flow in the muscles. Increases the concentration of high density lipoproteins, in patients with hyperuricemia reduces the concentration of uric acid. Increases renal blood flow, does not change the glomerular filtration rate.
Indications
Arterial hypertension.
Chronic heart failure.
Contraindications
Hypersensitivity to perindopril and other components of perindopril or other ACE inhibitors, history of angioedema during therapy with ACE inhibitors, hereditary or idiopathic angioedema, pregnancy, lactation period, age and safety (under 18 years).
Precautions: Aortic valve stenosis, hypertrophic obstructive cardiomyopathy, cerebro- and cardiovascular diseases (including cerebrovascular insufficiency, coronary heart disease, coronary insufficiency - the risk of developing an excessive decrease in blood pressure and concomitant ischemia).
Severe autoimmune systemic diseases of the connective tissue (including systemic lupus erythematosus, scleroderma), inhibition of bone marrow hematopoiesis while receiving immunosuppressants (increased likelihood of developing neutropenia).
Renovascular hypertension, bilateral stenosis of the renal arteries, stenosis of a single kidney artery, condition after kidney transplantation (risk of impaired renal function and agranulocytosis), chronic renal failure (especially accompanied by hyperkalemia), hyperkalemia, a diet with a decrease in sodium, circulating conditions, accompanied by blood (including diarrhea, vomiting, diuretics), diabetes mellitus, advanced age, surgical intervention (general anesthesia).
Special instructions
The risk of developing arterial hypotension and / or renal failure while taking the drug increases with a significant loss of sodium and water (strict salt-free diet, and / or diuretics, diarrhea, vomiting) or renal artery stenosis (block in these situations, renin -angiotensin system can lead, especially during the first administration of the drug and during the first 2 weeks of treatment, to a sudden decrease in blood pressure and the development of chronic renal failure). Before starting and during therapy, it is recommended to determine the concentration of creatinine, electrolytes and urea (within 1 month).
In patients with arterial hypertension who are already receiving diuretic therapy, it is necessary to stop taking them (3 days before the start of the appointment of Perindopril) and, if necessary, later add to the treatment again.
In patients with chronic heart failure receiving diuretic therapy, if possible, their dose should also be reduced several days before the start of treatment.
In patients at risk, especially with chronic heart failure in the decompensation stage, elderly patients, as well as patients with initially low blood pressure, impaired renal function or receiving high doses of diuretics, the use of the drug should be supervised by medical personnel.
In patients undergoing hemodialysis, the use of polyacrylonitrile membranes should be avoided (anaphylactoid reactions may develop). It is necessary to stop taking before the upcoming surgical treatment for 12 hours and to warn the anesthetist about taking the drug.
Composition
1 tablet contains perindopril erbumin - 4 mg.
Dosage and administration of
Perindopril is taken orally, in the morning, before meals.
The initial dose for the treatment of hypertension is 4 mg / day, if necessary (after 1 month) the dose can be increased to 8 mg / day in one dose.
When prescribing ACE inhibitors to patients receiving diuretic therapy, there may be a sharp decrease in blood pressure, for the prevention of which it is recommended to stop taking diuretics 2-3 days before the intended initiation of perindopril therapy or to prescribe a drug in lower doses - 2 mg once a day.
In patients with renovascular hypertension, the initial dose is 2 mg 1 time per day. If necessary, the subsequent dose may be increased.
In elderly patients, therapy should be started with a dose of 2 mg per day, and then, if necessary, gradually increase it up to a maximum dose of 8 mg per day.
Treatment of patients with chronic heart failure in combination with a non-potassium-sparing diuretic and / or digoxin, it is recommended to start under close medical supervision, appoint Perindopril in an initial dose of 2 mg once a day, in the morning.
Further, after 1-2 weeks of therapy, the dose of the drug can be increased to 4 mg once a day.
In patients with impaired renal function, the dose should be selected taking into account the degree of renal failure: depending on the creatinine clearance.
With creatinine clearance greater than 60 ml / min - 4 mg perindopril per day. With creatinine clearance of 30-60 ml / min - 2 mg 1 time per day with creatinine clearance of 15-30 ml / min - 2 mg every other day for patients on hemodialysis (creatinine clearance less than 15 ml / min.) - 2 mg per day dialysis.
Patients with impaired liver function, dose changes are not required.
Side effects
The frequency of side effects is estimated based on: often - 1-10% rarely - 0.1-1% extremely rare, including individual reports - less than 0.1%.
From the cardiovascular system: often an excessive decrease in blood pressure and the associated symptoms, rarely arrhythmia, angina pectoris, myocardial infarction and stroke.
From the urinary system: decreased renal function, acute renal failure.
On the part of the respiratory system: often - dry cough, difficulty breathing rarely - bronchospasm, rhinorrhea.
From the digestive system: often - nausea, vomiting, abdominal pain, taste change, diarrhea or constipation, dry mouth, decreased appetite, cholestatic jaundice, pancreatitis, intestinal edema.
From the central nervous system: often - headache, asthenia, fatigue, dizziness, ringing in the ears, visual impairment, muscle cramps, paresthesias rarely - decreased mood, insomnia extremely rare - confusion.
Allergic reactions: often - skin rash, itching rarely - urticaria, angioedema extremely rare - erythema multiforme exudative.
Laboratory indicators: often - hypercreatininemia, proteinuria, hyperkalemia, hyperuricemia rarely (with prolonged use at high doses) - neutropenia, leukopenia, hypogemoglobinemia, thrombocytopenia, extremely low hematocrit - agranulocytosis, pancytopenia, hepatic hemorrhagea, increased liver activity background deficiency of glucose-6-phosphate dehydrogenase).
Other: increased sweating, impaired sexual function.
Drug interaction
Increases the severity of the hypoglycemic effect of insulin and sulfonylurea derivatives.
Baclofen, tricyclic antidepressants, antipsychotic drugs (antipsychotics), saluretics enhance the hypotensive effect and increase the risk of orthostatic hypotension (additive effect).
Antacids reduce the bioavailability of ACE inhibitors.
Glucocorticosteroids, non-steroidal anti-inflammatory drugs reduce the severity of the hypotensive effect (fluid and electrolyte retention).
Potassium-sparing diuretics (spironolactone, triamteren, amiloride), potassium preparations increase the risk of hyperkalemia. The simultaneous use of drugs that can cause hyperkalemia and ACE inhibitors is not recommended, except in cases of severe hypokalemia (serum potassium monitoring).
With simultaneous use with lithium preparations, it is possible to slow its elimination from the body (regular monitoring of lithium content in the blood is necessary).
Diuretics, drugs for general anesthesia and muscle relaxants, ethanol increase the risk of developing an excessive decrease in blood pressure. The risk of developing clinically pronounced arterial hypotension can be reduced by stopping the use of diuretics several days before starting treatment with perindopril.
Myelotoxic drugs - increased myelotoxicity.
Overdose
Symptoms: decreased blood pressure, shock, stupor, bradycardia, electrolyte disturbances, renal failure.
Treatment: gastric lavage, use of enterosorbents, restoration of water-electrolyte balance, intravenous administration of 0.9% sodium chloride solution. In the case of a marked decrease in blood pressure, the patient must be given a horizontal position with raised legs. Hemodialysis is effective (do not use highly permeable polyacrylonitrile membranes). With the development of bradycardia, atropine. In severe cases, temporary implantation of a pacemaker is indicated. It is necessary to control and correct the vital functions of the body.
Storage Conditions
Store in a dry, out of reach of children place protected from light at a temperature not exceeding 25 РC.
Expiration
2 years.
active substance
Perindopril
Terms leave through pharmacies
In retseptu
lekarstvennaja form
tablets
Izvarino Pharma, Russia
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