As follows from the instructions for use, tablets "Perindopril" belong to the class of ACE inhibitory drugs. Already in the first hour after taking the dose, the effect of lowering the pressure develops, gradually increasing over eight hours. The drug effectively controls the pressure indicators for about a day, so it is relatively rare to use tablets.
It is possible and impossible
The instructions for use with Perindopril tablets indicate that the main indication for using the drug is high blood pressure. The tool is not intended for persons suffering from hypersensitivity to the components of the drug. You can not use it if in the past an inadequate reaction of the body to other drugs from the ACE inhibitor class was noticed. Do not use tablets while carrying a baby and breastfeeding.
In the instructions for use of Perindopril Plus, the manufacturer pays special attention to the permissibility of using the medicine only strictly under the supervision of a doctor. You can not prescribe these tablets on your own only on the basis of high blood pressure, you can easily encounter adverse reactions. The doctor also selects the dose, the choice is always individual and based on the characteristics of the body of a particular patient. A strict adherence to the recommendations of the attending physician and instructions for the use of the drug “Perindopril” is the key to the safety and effectiveness of the therapeutic course.
Dosage details
It is recommended to use the tablets in the amounts prescribed by the doctor orally. The best time is in the morning, before breakfast. The doctor will tell you how to correctly follow the instructions for use of Perindopril, at what pressure to use the tablets, and in which case to take a break (if this is necessary for a particular patient). It is impossible to use the medication without specialist supervision - attention is paid to this in the accompanying documentation for the tablets.
Typically, patients are prescribed first 4 mg for one day. Over time, the dose can be doubled, if required by pressure indicators. Perhaps a dosage increase a month after the start of the course and later.
According to the instructions for use, “Perindopril” can be used for heart failure if renovascular hypertension is detected. The medication is approved for use by people over seventy years of age, as well as those who have previously undergone diuretic therapy. For these groups of patients, the optimal initial dosage is 2 mg of medication per day, used at a time. With an insufficiently pronounced effect, in a week or two you can increase the volumes to 4 mg, then to 8 mg, if the patient's condition requires it.
In case of chronic kidney failure and creatinine clearance of 60 ml per minute or more, Perindopril is recommended for use in standard mode. A similar condition applies to those suffering from impaired liver function. With creatinine clearance in the range of 30-60 ml / min, the optimal dose is 2 mg per day. At rates of more than 15 ml / min, 2 mg of the drug should be used once every two days. With even lower creatinine clearance, instructions for use of Perindopril are allowed only on the day of dialysis in an amount of 2 mg.
Pharmacology
The effectiveness of the medication in question is confirmed by the numerous responses of patients undergoing treatment. About the drug, mainly only positive reviews. In the instructions for use of Perindopril, the manufacturer explains the effectiveness of the drug, describing the pharmacological effect.
ACE inhibitors react with positively charged zinc ions present in the ACE molecule. It is this process that inhibits the activity of an element. The effectiveness of taking the tablets is achieved by influencing the active metabolite of the main component of the tablets on the human body. This substance is called perindoprilat.
Perindoprilat affects the second angiotensin, inhibiting the vasoconstrictor effect. The content of bradykinin increases, and the first angiotensin passes into the second under the influence of a drug metabolite. Under the influence of the agent, as indicated in the instructions for use of Perindopril, the generation and release of aldosterone is reduced, and the reactions of release of norepinephrine are inhibited. In the vascular wall, endothelin is less actively formed.
A decrease in the activity of the processes of production of the second angiotensin leads to a higher efficiency of plasma renin, since these processes have an inverse negative relationship. ACE is inhibited, while the activity of the kinin-kallikreinovoy system increases.
Features of pharmacological action
Under the influence of the active component, the vascular walls of large arteries become more elastic - this is indicated in the instructions for use of Perindopril (4 mg, 8 mg - form of the drug). The effect is due to a decrease in the generation of subendothelial collagen. Blood pressure in the capillaries of the lungs decreases. Prolonged use of the drug can reduce left ventricular myocardial hypertrophy. A positive effect is observed with interstitial fibrosis. Myosin profile comes back to normal. Against the background of such changes, the work of the cardiac system as a whole is stabilized.
In the instructions for use of "Perindopril" (8 mg, 4 mg, 2.5 mg - any form of release), the manufacturer indicates that under the influence of the drug, pre-, afterload decreases. This affects various aspects of pressure: systolic and even diastolic indicators decrease, the effect is in almost any position of the patient. The index of the work of the heart, IOC, is growing. The heart rate does not increase, and with CHF it becomes somewhat less frequent (changes are assessed as moderate). Muscular regional blood flow is stimulated, activated.
Studies have shown that the manufacturer drew attention in the instructions for use of Perindopril tablets (the price of which starts at 80 rubles per pack), when using the drug, the content of high-density lipoproteins in the circulatory system increases. With hyperuricemia, uric acid levels decrease. The drug stimulates blood flow in the kidneys without correcting glomerular filtration.
Note!
In the instructions for use of Perindopril (2.5 mg, 4 mg, 8 mg - any release option), the manufacturer indicates that the use of tablets in heart failure leads to a decrease in the manifestations of heart muscle failure. The patient's resistance to physical activity increases - specialized tests were performed to identify this fact. Blood pressure does not decrease - this fact was revealed during confirmed tests.
After the average single amount is ingested, the antihypertensive effect is observed on average five hours later, the possible deviations up and down - within an hour. The duration of the effect is up to a day. After a month of constant use, the effect of lowering the pressure is stabilized - this is indicated in the instructions for use of Perindopril. At what pressure the doctor will prescribe this drug, the manufacturer does not mention. This aspect is left to the discretion of a qualified physician. The manufacturer pays attention to the admissibility of the use of tablets only after a doctor's recommendation.
Cancellation is not accompanied by unpleasant phenomena. The so-called withdrawal syndrome "Perindopril" does not cause.
Negative consequences
Limitations on the possibility of using the described drug at its discretion are largely associated with side effects that can provoke improper, unreasonable, irrational use of the medication. The possibility of a negative body response is also mentioned in a number of reviews about Perindopril (and analogues). Instructions for use indicate the possibility of lowering the pressure beyond measure, which leads to specific symptoms of hypotension. In rare cases, patients experience symptoms of kidney failure. If one already exists, there is a risk of aggravation of the situation.
Against the background of the use of tablets, cough, bronchospasm, shortness of breath can develop. Some feel sick and vomit. The stomach can hurt. "Perindopril" can provoke stool disturbance, dry mucous membranes and improper taste perception. Some patients quickly get tired, complain that it rings in the ears, it hurts and is dizzy, and vision deteriorates. There is a risk of seizures, depression, sleep disturbances, and confusion.
In the instructions for use of “Perindopril 4 mg”, the price of which is from 80 rubles and above, as well as in the accompanying documentation for other forms of release of this drug, it is indicated that tablets can cause an allergic reaction. More often, this is manifested by rashes on the skin, itchy areas, but there is a risk of developing urticaria, angioedema, erythema.
Important Nuances
The instructions for use "Perindopril plus Indapamide" indicates that the likelihood of hypotension is higher if the patient adheres to a diet without salt, takes diuretics, suffers from severe vomiting or diarrhea. Under these conditions, sodium ions and water are actively removed from the body, which can cause disturbances, and also negatively affects the work of the kidneys. Hypotension may be accompanied by a lack of functioning of the kidneys. Each of these pathological conditions can develop independently. The dangers associated with taking pills against stenosis of the arteries.
According to the instructions for use, "Indapamide + Perindopril" should be taken only after blood tests have been carried out, quantitative indicators reflecting urea, creatinine, and the ratio of basic electrolytes have been identified. Such studies are recommended to be carried out regularly during the first month of treatment, in order to control the patient's response to the prescribed therapy. This allows you to prevent negative reactions and adjust the program in time.
In the instructions for use of Perindopril (the price for packaging of which starts from 80 rubles), special attention is paid to the case when the drug is prescribed to people who have previously used diuretics. The composition in question can be started to be applied only three days after the last dose of a diuretic into the patient’s body. If in the future this becomes necessary, diuretics are again introduced into the therapeutic program. If the intake of diuretics is due to heart failure and refusal from them is impossible, before starting to use the drug in question, the dose of diuretics is reduced.
Security and other nuances
The fact that the drug is available is indicated by reviews about the price of Perindopril. Instructions for use contain instructions on the rules for using this tool by some individual groups of patients, in particular, those suffering from chronic heart failure in a decompensated form. There is no absolute prohibition on use with such a diagnosis. This makes Perindopril extremely widely applicable, since this condition imposes serious limitations on the possibilities of drug therapy.
For people at risk, for those who initially have low blood pressure, Perindopril is allowed for those suffering from impaired renal function, but at the beginning of the course the condition of the patient should be controlled by a doctor. This also applies to those who use diuretics in high dosage.
During blood dialysis, polyacrylonitrile membranes should not be used, since the combination with Perindopril can cause an anaphylactic response. If surgery is planned, the pill is stopped 12 hours before the start of the intervention. The anesthesiologist should be aware of the therapy the patient is undergoing.
Pregnancy period
All of the ACE inhibitors, Perindopril and analogues (instructions for use draw attention to this) may be associated with an increased risk of abnormal development of the fetal skull if the mother used such medications for the entire period of gestation. There are separate reports of such problems, at the moment there is absolutely absolutely no confirmed information that the ACE inhibitors were the causes of the anomalies. If a woman becomes pregnant during therapy, there is no need for interruption, but the fetus will have to be monitored. First of all, an ultrasound examination of the child's skull is prescribed.
The use of “Perindopril” after the first trimester may cause a decrease in the activity of the child's kidneys. There is a risk of a reduction in amniotic fluid volume. Mother's administration of the drug carries a risk of anuria in the child, low blood pressure, and neonatal renal failure.
What to replace. Perindopril analogs and prices
Instructions for use of the described preparation contain mention of the main active compound - this is perindopril. Medicines are based on it:
- "Prestarium A" (about 500 rubles per pack).
- Parnawel (about 300 rubles).
- "Perineva" (about three hundred rubles per package).
Of the options listed, the most affordable is the described drug. When choosing an alternative, it is important not only to compare prices, reviews, instructions for the use of Perindopril and analogues, but consult a doctor. It is necessary to explain to the doctor why there is no way to take the recommended drug. Only a specialist, guided by the diagnosis, will be able to determine which particular drug options in a particular case will bring maximum benefit.
A drug that is close to the drug in question is Indapamide. It is based on a different active compound than Perindopril, but has a similar effect on the human body, so in some cases the doctor recommends it as an alternative.
Mutual influence
When combining insulin, sulfonylurea “Perindopril” can cause a stronger hypoglycemic effect of these substances.
Antipsychotics, saluretics, baclofen, anti-depression drugs from the tricyclic class can activate the hypotensive effect. Against the background of such a combination, the likelihood of orthostatic hypotension is higher, since there is a summation and increased effect of the drugs.
Anti-inflammatory drugs from the hormonal, non-steroidal class can reduce the effect of Perindopril on pressure. This also applies to those who selectively inhibit the activity of only the second COX. The effect is explained by the accumulation in the body against the background of the use of these electrolytes, liquids.
Diuretics aimed at preserving potassium in the body, as well as potassium preparations in combination with Perindopril, provoke an increased risk of potassium poisoning. A combination of drugs that can provoke an increased concentration of potassium and ACE inhibitors should be avoided. An exceptional case is a lack of potassium in the body in a severe form.
Possible combinations
If you combine Perindopril and lithium preparations, the process of excretion of this microelement may slow down somewhat.
When using myelotoxic drugs against the background of a combination with Perindopril, the toxic effects are enhanced.
The combination with diuretics, relaxing muscle tissue and general anesthetics can cause unnecessarily low blood pressure. Clinically pronounced hypotension is less likely if you stop using diuretics a few days before the start of the course of the drug in question.
Release Features
Presented tablets in pharmacies are in different formats. The most popular options are 4 mg of the active ingredient in one tablet and twice as much. There are also 5 mg, 10 mg formats. The combined drug "Perindopril plus Indapamide" contains 4 mg of the first substance and 1.25 mg of the second or twice as much of each of them. There are combinations of 5 mg + 1.25 mg and 2.5 mg + 0.625 mg. The doctor will recommend a specific form, taking into account the characteristics of the condition, the needs of the patient's body.
The tablets are packaged in polymer cans or loop cells. In one blister - 10 pills, in the bank - 30 pieces. , , , , . , . , , , , , .
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