The drug "Prestance" is a combined antihypertensive drug that performs a dual role in the body:
- calcium channel blocker (slow) - BMKK;
- ACE inhibitor (angiotensin-converting enzyme);
The brand name of the drug is Prestance. Its international nonproprietary name reflects the composition of the drug - perindopril arginine + amlodipine. The medicine "Prestance" is produced in tablets, the instruction indicates different combinations within the dosage form, on this basis, there are 4 different forms of the drug:
- 5 + 5, that is, 5 mg perindopril arginine, 5 mg amlodipine;
- 10 + 10 (composition according to numbers);
- 5 + 10;
- 10 + 5.
In order to understand the mechanism of the drug “Prestance”, the instruction recommends that you first familiarize yourself with the pharmacological properties of each component separately, and only then study the effect of the drug in combination.
The enzyme inhibitor - perindopril - is able to convert angiotensin first to second (ACE inhibitor). It has a therapeutic effect due to its active metabolite. Perindopril is used in the treatment of arterial hypertension in both mild and severe, while minimizing peripheral vascular resistance, as a result, there is a decrease in blood pressure. Perindopril is able to improve peripheral blood flow, leaving the heart rate unchanged - the heart rate. The antihypertensive properties of the drug can manifest after a maximum of 6 hours. Absorption of the drug occurs quickly, after an hour in plasma its highest concentration is reached, due to this speed of exposure there is a rapid decrease in blood pressure. For the beneficial effect of the drug, it is necessary to convert perindopril in the body to perindoprilat, if you take the medicine with food, this process slows down. Therefore, a single dose every day in the morning before meals is recommended. From the body, the drug is excreted by the kidneys.
Amlodipine - the second component of the drug "Prestance", the instruction calls it a derivative of the dihydropyrid type, BMKK. The action of amlodipine, as an antihypertensive drug, is based on a direct effect on the vascular walls, namely, smooth muscle cells. Dilated arterioles reduce the afterload on the peripheral vessels, without changing the heart rate and reducing the need for myocardial oxygen. The antihypertensive properties of amlodipine develop slowly, due to some characteristics of the drug, it can be taken in patients with bronchial asthma, gout, and diabetes mellitus. After taking amlodipine, its maximum concentration is reached only after 12 hours, while the time of taking the drug with respect to food does not matter, it is excreted by the kidneys.
In the ASCOT-BPLA studies, the effectiveness of long-term co-administration of perindopril and amlodipine was studied, in which patients with arterial hypertension aged 40 to 79 years participated. The main evaluation criterion was the number of non-fatal outcomes of myocardial infarction. The result showed in patients of this group the frequency of such diseases is 10% less.
Among the indications for the use of the drug "Prestance", the instruction indicates arterial hypertension accompanied (or not accompanied) by coronary heart disease.
Of the contraindications to the use of the drug "Prestance" instructions noted:
- high sensitivity to the components of the drug;
- age up to 18 years: contraindications are substantiated by insufficient knowledge of the effect of the drug on the young body;
- renal failure;
- lactose intolerance (hereditary).
The drug "Prestans" instruction prohibits taking during pregnancy and lactation. Information on treatment in case of overdose is not available.
Before prescribing treatment with Prestance, it is necessary to carefully study the instructions, including possible side effects. They can manifest themselves on the part of the lymphatic and circulatory system, central nervous system and immune system, negative reactions have been observed on the part of the digestive, cardiovascular, musculoskeletal and respiratory systems, there are cases of allergic reactions, changes in body weight.
They take the drug strictly according to the individual dosage regimen prescribed by the doctor, the maximum shelf life is 2 years, there are no special instructions at the place of storage.