Perineva tablets 4mg, No. 90

arterial hypertension;

chronic heart failure;

prevention of recurrent stroke (as part of complex therapy with indapamide) in patients with a history of cerebrovascular diseases (stroke or transient cerebral ischemic attack);

stable coronary artery disease: reducing the risk of developing cardiovascular complications in patients who have previously had myocardial infarction and / or coronary revascularization.

Inside, it is recommended to take 1 time per day, before meals, preferably in the morning.

The dose of the drug is selected individually for each patient, depending on the severity of the disease and the individual response to treatment.

Arterial hypertension. The drug PerinevaЃ can be used in monotherapy and in combination with other antihypertensive drugs.

The recommended starting dose is 4 mg once a day, in the morning. For patients with pronounced activation of the renin-angiotensin-aldosterone system (for example, with renovascular hypertension, hypovolemia and / or hyponatremia, CHF in the stage of decompensation or severe hypertension), the recommended initial dose is 2 mg / day in one dose. If therapy is ineffective within a month, the dose can be increased to 8 mg 1 time per day and if the previous dose is well tolerated.

Adding ACE inhibitors to patients taking diuretics may cause hypotension. In this regard, it is recommended to carry out therapy with caution, to stop taking diuretics 2-3 days before starting treatment with PerinevЃ or start treatment with PerinevЃ with an initial dose of 2 mg / day, in one dose. It is necessary to control blood pressure, renal function and the concentration of potassium ions in the blood serum. In the future, the dose of the drug can be increased, depending on the dynamics of the blood pressure level. If necessary, diuretic therapy can be resumed.

In elderly patients, the recommended initial daily dose is 2 mg at a time. In the future, the dose can be gradually increased to 4 mg and, if necessary, to a maximum of 8 mg once a day, provided that the lower dose is well tolerated.

CHF. The recommended starting dose is 2 mg in the morning, under medical supervision. After 2 weeks, the dose can be increased to 4 mg / day in one dose, under the control of blood pressure. Treatment of CHF with clinical manifestations is usually combined with potassium-sparing diuretics, beta-blockers and / or digoxin.

In patients with CHF, with renal failure and with a tendency to electrolyte disturbances (hyponatremia), as well as in patients taking diuretics and / or vasodilators at the same time, drug treatment is started under strict medical supervision.

In patients with a high risk of developing clinically pronounced arterial hypotension (for example, when taking high doses of diuretics), if possible, hypovolemia and electrolyte disturbances should be eliminated before taking PerinevaЃ. It is recommended to carefully monitor the blood pressure level, the state of renal function and the concentration of potassium ions in the blood serum before and during therapy.

Prevention of recurrent stroke in patients with a history of cerebrovascular disease. Therapy with PerinevaЃ should be started with 2 mg during the first 2 weeks before taking indapamide. Treatment should be started at any time (from 2 weeks to several years) after a stroke.

Stable ischemic heart disease. In patients with stable coronary artery disease, the recommended initial dose of PerinevaЃ is 4 mg / day. After 2 weeks, the dose is increased to 8 mg / day, provided that the dose of 4 mg / day is well tolerated and renal function is monitored. Treatment of elderly patients should begin with a dose of 2 mg, which can be increased to 4 mg / day after a week. In the future, if necessary, after another week, you can increase the dose to 8 mg / day with mandatory preliminary monitoring of renal function. In elderly patients, the dose of the drug can be increased only if the previous, lower dose is well tolerated.

With renal failure. In patients with kidney disease, the dose of PerinevaЃ is set depending on the degree of renal dysfunction. Monitoring the patient's condition usually includes regularly determining the concentration of potassium and creatinine ions in the blood serum.

Table

Recommended doses

* Dialysis clearance of perindoprilat is 70 ml / min. The drug PerinevaЃ must be taken after a dialysis session.

For liver diseases: dose adjustment is not required.

hypersensitivity to perindopril or other components of the drug, as well as to other ACE inhibitors;

a history of angioedema (hereditary, idiopathic or angioedema due to taking ACE inhibitors);

age up to 18 years (efficacy and safety have not been established);

hereditary galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption syndrome.

With caution: renovascular hypertension, bilateral stenosis of the renal arteries, stenosis of the artery of a single kidney - the risk of severe arterial hypotension and renal failure; CHF in the stage of decompensation, arterial hypotension; chronic renal failure (Cl creatinine - <60 ml / min); significant hypovolemia and hyponatremia (due to a salt-free diet and / or previous diuretic therapy, dialysis, vomiting, diarrhea), cerebrovascular diseases (including cerebrovascular insufficiency, coronary heart disease, coronary insufficiency) - the risk of developing an excessive decrease in blood pressure; stenosis of the aortic or mitral valve, hypertrophic obstructive cardiomyopathy, hemodialysis using high-flow polyacrylonitrile membranes - the risk of developing anaphylactoid reactions;condition after kidney transplantation - no clinical experience; before the LDL apheresis procedure, simultaneous desensitizing therapy with allergens (for example, hymenoptera venom) - the risk of developing anaphylactoid reactions; connective tissue diseases (including systemic lupus erythematosus (SLE), scleroderma), inhibition of bone marrow hematopoiesis while taking immunosuppressants, allopurinol or procainamide - the risk of agranulocytosis and neutropenia; congenital deficiency of glucose-6-phosphate dehydrogenase - isolated cases of hemolytic anemia; in representatives of the black race - the risk of developing anaphylactoid reactions; surgical intervention (general anesthesia) - the risk of developing an excessive decrease in blood pressure; diabetes mellitus (control of blood glucose concentration); hyperkalemia; elderly age.