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Perindopril - instructions for use, reviews, analogs and formulations (2 mg, 4 mg and 8 mg tablets, including indapamide, amlodipine) for hypertension and pressure reduction in adults, children and pregnancy. Composition

Perindopril - instructions for use, reviews, analogs and formulations (2 mg, 4 mg and 8 mg tablets, including indapamide, amlodipine) for hypertension and pressure reduction in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Perindopril. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Perindopril in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Perindopril in the presence of existing structural analogues.Use to treat hypertension and reduce blood pressure in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

 

Perindopril - ACE inhibitor. It is a prodrug, from which an active metabolite of perindoprilat is formed in the body. It is believed that the mechanism of antihypertensive action is associated with competitive inhibition of ACE activity, which leads to a decrease in the rate of conversion of angiotensin 1 into angiotensin 2, which is a potent vasoconstrictor. As a result of a decrease in the concentration of angiotensin 2, a secondary increase in plasma renin activity occurs due to elimination of negative feedback during the release of renin and a direct decrease in aldosterone secretion. Due to vasodilator effect, reduces OPSS (afterload), wedging pressure in the pulmonary capillaries (preload) and resistance in the pulmonary vessels; increases the minute volume of the heart and tolerance to the load.

 

The hypotensive effect develops within the first hour after taking perindopril, reaches a maximum at 4-8 hours and lasts for 24 hours.

 

Composition

 

Perindopril erbumine + excipients.

 

Perindopril arginine + excipients.

 

Pharmacokinetics

 

After ingestion, perindopril is rapidly absorbed from the digestive tract. Bioavailability is 65-70%. In the process of metabolism, perindopril is biotransformed to form an active metabolite - perindoprilat (about 20%) and 5 inactive compounds. The binding of perindoprilat to plasma proteins is insignificant (less than 30%) and depends on the concentration of the active substance. Do not cumulate. Repeated reception does not result in cumulation (accumulation). When you eat while eating, the metabolism of perindopril slows down. Perindoprilat is excreted from the body by the kidneys. In elderly patients, as well as in renal and heart failure, excretion of perindoprilat slows down.

 

Indications

  • arterial hypertension (pressure reduction);
  • chronic heart failure (CHF).

 

Forms of release

 

Tablets 2 mg, 4 mg and 8 mg (including those coated).

 

Instructions for use and dosage

 

The initial dose is 1-2 mg per day in 1 dose. Supportive doses - 2-4 mg per day with congestive heart failure, 4 mg (less often - 8 mg) - with arterial hypertension in 1 dose.

 

In case of violations of the kidney function, a correction of the dosing regimen is required depending on the CK values.

 

Side effect

  • dry cough;
  • dyspeptic phenomena;
  • dry mouth;
  • violation of taste;
  • headache;
  • sleep and / or mood disorders;
  • dizziness;
  • convulsions;
  • lowering of hemoglobin level (especially at the beginning of treatment);
  • decrease in the number of red blood cells and / or platelets;
  • reversible increase in the level of creatinine and uric acid;
  • angioedema;
  • skin rash;
  • itching;
  • erythema;
  • sexual disorders.

 

Contraindications

  • angioedema in history;
  • pregnancy;
  • lactation;
  • childhood;
  • hypersensitivity to perindopril.

 

Application in pregnancy and lactation

 

Perindopril is contraindicated in pregnancy and lactation (breastfeeding).

 

Use in children

 

Contraindicated in childhood.

 

special instructions

 

Use with caution in renal failure and severe arterial hypertension.

 

Before starting treatment with perindopril, all patients are recommended to study the function of the kidneys.

 

During treatment with perindopril, kidney function, hepatic enzyme activity in the blood, peripheral blood tests (especially in patients with diffuse connective tissue diseases, in patients receiving immunosuppressive agents, allopurinol) should be monitored regularly.Patients with sodium and liquid deficiency before the start of treatment should be corrected water-electrolyte disorders.

 

During treatment with perindopril, hemodialysis using polyacrylonitrile membranes can not be performed (the risk of anaphylactic reactions is increased).

 

Perindopril should be used with caution at the same time with drugs that can cause an increase in the level of potassium in the blood (indomethacin, cyclosporine). It is not recommended simultaneous use with potassium-sparing diuretics and potassium preparations.

 

Drug Interactions

 

When used simultaneously with antihypertensive agents, muscle relaxants, anesthesia agents, an increase in antihypertensive action is possible.

 

When used simultaneously with loop diuretics, thiazide diuretics, antihypertensive action may be enhanced. Severe arterial hypotension, especially after taking the first dose of a diuretic, appears to be due to hypovolemia, which leads to a transient increase in the hypotensive effect of perindopril. Increased risk of impaired renal function.

 

With simultaneous use with sympathomimetics, a decrease in the antihypertensive effect of perindopril is possible.

 

With simultaneous use with tricyclic antidepressants, antipsychotic drugs (neuroleptics) increases the risk of postural hypotension.

 

In an application with Indomethacin decreased antihypertensive activity of perindopril is apparently influenced by inhibiting nonsteroidal antiinflammatory drugs (NSAIDs), prostaglandin synthesis (which is believed to play a role in the development of hypotensive effect of ACE inhibitors).

 

When used simultaneously with insulin, hypoglycemic agents, derivatives of sulfonylureas may develop hypoglycemia due to increased tolerance to glucose.

 

The joint administration of perindopril and ethanol (alcohol) is not recommended, but does not have consequences for the human body.

 

While the use of potassium-sparing diuretics (including spironolactone, triamterene, amiloride), potassium preparations, salt substitutes and food supplements containing potassium may develop hyperkalemia (particularly in patients with impaired renal function), asACE inhibitors reduce the content of aldosterone, which leads to a delay in potassium in the body against the background of the limitation of the excretion of potassium or its additional intake into the body.

 

With the simultaneous application of lithium carbonate, it is possible to reduce the excretion of lithium from the body.

 

Analogues of Perindopril

 

Structural analogues of the active substance (including in combination with other elements):

  • Arentopress;
  • Hypernica;
  • Dalnev;
  • Cooverex;
  • Ko Perineva;
  • Noliprel;
  • Noliprel A;
  • Noliprel forte;
  • Parnavell;
  • Perindid;
  • Perindopril Pfizer;
  • Perindopril Richter;
  • Perindopril arginine;
  • Perindopril erbumine;
  • Perindopril Indapamide Richter;
  • Perindopril plus Indapamide;
  • Perineva;
  • Perinpress;
  • Piristar;
  • Prestan;
  • Prestarium;
  • Prestarium A;
  • Stoppress.

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Other medicines:
Reviews (35):
Visitors
Natalia 08042015
Hello!
Please explain, if possible, how much and how perindopril differs from enalapril. There was an unsuccessful experience with enalapril in combination with euglocomas for several days (absence of expected pressure reduction, pain in left scapula, dry mouth feeling, numbness in hands) (age patient with MI, fibrillation and hypertension).
The doctor gives perindopril in the appointment at once in a dose of 4 mg. About the above is notified. Do I need to talk about giving a small initial, recommended dose?
As far as we could understand, perindopril is a very active medicine, and on the list of side-effects there is both a heart attack and a stroke. How much is this medication possible at home with the already transferred MI and shimmer?
Excuse me, please, that it did not turn out briefly.
Sincerely.
Administrators
admin
Natalia 08042015, The active substance of the drugs is different, and the pharmacological group is one (ACE inhibitors). The decision on whether to take this or that medicine and in what dosage is taken by the attending physician, in case of cardiovascular problems - the cardiologist.For my part, I can say that the dosage of medications is sometimes prescribed to the maximum if there is an aggravation of the problem with concomitant diagnoses (in your case this is a transferred myocardial infarction), as well as high baseline blood pressure figures. Perindopril I would also try, since the active substance is different and the mechanisms of its transformation in the body are different than that of Enalapril, so it is possible that the effect will be better. Here it is also necessary to take into account that in elderly patients it is better to change preparations without their knowledge, so as not to cause unnecessary psychological reactions. And yes, many packages do not buy (and preferably half the package), since the medicine is not cheap, but how will your mother not understand.
Visitors
Natalia 08042015
If it is possible, one more small question about perindoprile. In the manual, among side effects, a decrease in the level of hemoglobin (especially at the beginning of treatment) is called. How much can this be serious and can the age of the patient and already existing anemia affect the occurrence of such a side effect? Whether it is possible, accepting perindopril, to go to hand over the general or common analysis of a blood,which is appointed just to clarify the level of hemoglobin, such an analysis will be effective or will show only that the patient is taking perindopril? Please explain, if possible.
Administrators
admin
Natalia 08042015In your question, it is more likely to start from the timing of the appearance of anemia and the connection with taking Perindopril tablets. If anemia occurred before taking Perindopril, the reason for the occurrence in something else is not the fact that taking the drug can hurt the patient more. I so understood in your case so it was and anemia was diagnosed before the drug Perindopril. Otherwise, the attending physician decides whether to cancel the drug or replace it with another, so as not to harm the patient with his appointment.
Visitors
kochet.val.
At me a question it is possible or probable to you to appoint or nominate to me a preparation? At me the hypertonia of 2 degrees the doctor has appointed or nominated - an inadj 2.5 mg and berlipril 5 mg. I drink within three years.
Administrators
admin
kochet.val.If you are doing well on Indapa and Berliprile, there is no point in replacing it. I do not even cancel ancient Adelphan to my old people, but you have adequate hypertension drugs. If you have any problems, you need to go to the doctor, take tests, ideally get a consultation with a cardiologist and then a specialist can prescribe Perindopril or another drug to reduce blood pressure. Otherwise, you act at your own risk and bear the responsibility for further consequences, including possible negative ones.
Visitors
slavnikov.vova
Hello! I have hypertension of the first degree, risk 3, angiopathy of the retina. At a primary pressure rise of 180/110, perindopril 8 mg and bisoprolol 2.5 were prescribed. During the month, the pressure dropped 100/60, at which I felt well, because in the norm there was always 110/70. Together with the doctor, we lowered the dosage to 4 mg perindopril and left bisoprolol 2.5. I take this dosage for 2 years, the pressure is within 120/80, the only concern is the rapid heartbeat, 80 strokes already bring me anxiety, although sometimes there are also 100 strokes.The attending physician, referring to the stable good pressure, offered to try to give up perindopril and drink thiotriazoline. Tell me please, is it possible to give up perindopril at normal stable pressure or not to tempt fate?
Administrators
admin
slavnikov.vovaIf the oculist with your retina angiopathy says that a possible increase in pressure will not cause fatal changes in the retina, you can try. Of course, for this it would be still good to indicate the age, but from the question I feel that I am young, so I understand your doctor. But it is necessary to evaluate the entire complex of the disease, including the concomitant diseases and conditions, and to control the pressure, if it goes up, go back to the previous therapy and no longer experiment.
Guests
Andrei
Andrei, Postponed your feedback to the preparation of Prestarium, where it is more appropriate.
admin
Visitors
Natalia 08042015
Hello, dear admin! Tell me, please, for reference, what is your opinion on the reception with anemia (hemoglobin 100, erythrocytes 2.53) perindopril and acetyl? Man, 75 years old.The question is that the instructions indicate anemia as a possible pobochka when taking these medications. Diagnoses of hypertension 3 stage, stenocardia of grade 4, aortic stenosis of the 2nd degree. The cause of anemia has not yet been established, we undergo a survey. Of the tests assigned for referral, there are already results on the serum iron (19.3). Thank you very much in advance.
Administrators
admin
Natalia 08042015If you dig deeply, then all drugs will have this or that contraindication for admission at the age of 75 years. Than then we will stop hypertension or maintain stable angina, and this is more life-threatening disease than anemia? Such anemia is most likely caused by internal causes, but not by treatment, or the hemopoiesis suffers (hematologist determines), or vitamin B12 deficiency is possible (it is necessary to pass an analysis) or problems with the spleen (ultrasound of the abdominal cavity for help). The patient's iron is normal, so the reason is different.
Visitors
Natalia 08042015
Dear admin, tell me, please, in the reference order, what tests must be submitted to determine about the "germ of hematopoiesis." We would have knowledge of this very much helped. The fact is that there is no hematologist in the district hospital, and when you address the nearest city doctor of this specialty to a patient on the road, it is more practical to take tests on an empty stomach in the morning.
Administrators
admin
Natalia 08042015A detailed blood test is being submitted, in some centers it is also called hematological. There's a lot of indicators and it's expensive, it's not an ordinary general blood test. This blood test is prescribed by hematologists to control the germ of the hematopoiesis. Well, of course all the tests for iron, vitamin B12, a biochemical blood test. Plus ultrasound of internal organs. FGDS and colonoscopy, if there are suspicions of a tumor or ulcers of the LCG and large intestine. I think this will be enough for the doctor to find out the true causes of anemia.
Visitors
Natalia 08042015
Dear admin, I am very grateful to you for the detailed explanation.
Guests
Alinna
Dear admin, my doctor prescribed perindopril 2 mg. But in this dosage perindopril goes along with indapamide 0.625. How is it better to take this drug, in such a configuration or buy 4 mg and drink 1/2 tablet without indapamide? I am 55 years old. Before the treatment: pressure from the morning of 142/85 and during the day jumps 132 / 82-138 / 89.
Administrators
admin
Alinna, Looked, there are on sale Perindopril 2 mg of domestic and imported production and without indapamide. Contact a different pharmacy where you will be sold the prescribed dosage of the medicine. You can divide the tablet 4 mg, they are chamfered and without the shell, so you must share correctly.
Visitors
26041960
Hello. When visiting a cardiologist with a pressure of 160/112, I received pills: Arifone 1.5 mg, Bisoprolol 2.5 mg once a day and Perindopril 4 mg twice a day. I accept two weeks. The pressure dropped to 115/85, but Perindopril was over and I had to buy a new package. In the first case, the manufacturer was OOO IZVARINO PHARM Moscow, and in the second OOO PRANAFARM Samara.After two days of taking Perindopril by Pranafarm, I noticed a pressure increase of up to 125/100. Tell me, please, from what it can happen?
Administrators
admin
26041960If you are talking about fakes, I will not say anything about this at this time. In Russia, this is found and artless forgery is determined by the request for certificates for a particular drug in the pharmacy, where you buy drugs, and to determine visually nothing happens. In principle, the values ​​of blood pressure are now within the range of fluctuations, it is possible that after a couple of days the pressure stabilizes at a lower level, if not - there is an occasion to consult a doctor for correcting prescriptions and substituting drugs or increasing dosages. Tablets from pressure should be taken regularly and without interruptions.
Visitors
26041960
Hello. I am 57 years old. At a pressure of 160/110 went to the cardiologist. The following medicines were prescribed: perindopril 4 mg; bisoprolol 2.5 mg; arifon 1,5mg. Took it all for 2 months. Everything was fine. The pressure dropped to 110-120 / 75-80.A month ago I went to see another cardiologist. He somehow canceled all these pills and appointed others: Lori 50 mg; nebivolol 5 mg and rosucard 20 mg. The pressure began to increase gradually and for four days it had already increased to 135-140 / 90/100. Tell me, please, can I go back to the initial medication?
Administrators
admin
26041960, For this you need to know what motive the second specialist had to change to you the already selected scheme of therapy. If these are personal motives (there are specialists who write out to everyone their tested schemes and think that they work, regardless of whether this treatment is suitable for the patient or not) or the commercial interest of the doctor in the discharge of certain medications (in your case it is unlikely, so as manufacturers of drugs from the second scheme a lot and the drugs themselves are not branded) then yes, you can replace without problems. But if this is a concomitant pathology, which at 57 years is quite possible to assume, then you can not replace yourself. Perhaps not immediately, but over time this treatment can have serious consequences for that concomitant disease,which was discovered by a specialist who prescribed a different therapy regimen.
Visitors
26041960
Tell me, please, and can the pressure increase from the fact that I quit smoking and take the Champix tablets? I do not smoke for 7 days.
Administrators
admin
26041960, Champix tablets as a side effect have indications for increased blood pressure, but considering your previous history of fighting hypertension, this reason seems unlikely to me. In any case, quitting smoking will make the body healthier, and Champix's influence can be checked by refusing a couple of days from receiving it, while avoiding breakdowns in smoking cessation.
Visitors
26041960
Hello. I take bisoprolol 2.5 mg, arifone 1.5 mg and perindopril 4 mg. My wife is soon an anniversary. Tell me, please, can I use alcohol when taking such medicines? Or can not take pills temporarily? Thank you very much in advance.
Administrators
admin
26041960You can use, you can not abuse.I'm generally against drinking alcohol in any form during treatment. And my wife is not offended if her husband is healthy, and not under a dropper to meet the next day. Although if you choose between alcohol and cancellation of drugs, it's better to drink.
Visitors
Vitaliy dkv
Dear Admin! Prompt, please, to me 32 years, in the childhood have diagnosed a syndrome Frejli on the left and an angiopathy of a retina of eyes (the dark maculae fly, especially stir or prevent, when it is light). Only 5 years ago I began to drink medicine (to perineva). The pressure dropped to 140 by 90 at a dosage of 8 mg perindopril. Before, there were 170 to 130, but with constant use of the legs began to hurt like a trauma. Changed to hard, but it does not help, other ACEs too. I took a break, now I drink perindopril again, while everything is fine. Does it make sense to take breaks to avoid side effects or continue searching for new active drugs?
Administrators
admin
Vitaliy dkv, Interruptions in taking antihypertensive drugs are unacceptable, this is fraught with pressure spikes that, in addition to worsening the course of existing diseases, may increase the risk of heart attacks and strokes.So I would continue to search for effective drugs to reduce high blood pressure, but without side effects. Now the market is full of drugs from different pharmacological groups for any set of concomitant diseases. Better with this issue, given the pathology of the kidneys, apply in person to a specialized specialist - a cardiologist.
Visitors
Natalia 08042015
Hello, dear admin.
Tell me, please, is there any difference and, if there is, what kind of forms of perindopril available for sale in pharmacies (somehow perindopril, perineva, prestarium A, others)? Which of these forms can be better for a 76-year-old man with diagnoses of hypertension, angina, aortic stenosis, gallstones?
Thank you very much in advance.
Visitors
Natalia 08042015
And more, if you can. I have already written about anemia. After the events of that report, iron and folic acid (a forte form) were prescribed. After the course, as is now clear, folic acid, red blood cells rose to 4.0. And soon the neurological problems began (in fact there was a vitamin B12 deficiency, the doctor at that time did not send the appropriate analysis in time).Experienced a lot.) In general, now, after changing the treating cardiologist and restoring the normal level of vitamin B12 in the blood, red blood cells are 4.4 (almost normal).
The question itself. Perindopril in rare cases, according to the instructions, can cause anemia and a decrease in red blood cells. With such a prehistory, its (perindopril) reception is theoretically possible, do you think? The question is in the background.
Administrators
admin
Natalia 08042015Given gallstones, perindopril-based drugs are a poor choice, because it is rare for drugs based on this substance, but there have been cases of development of cholestatic jaundice, that is, the course of cholelithiasis may worsen, so it is necessary to look and choose according to the risk- The benefit with respect to this particular group of funds. If the drugs of other groups do not help or cause reactions then choose from two evils less. I prefer imported drugs from the whole range, so I prefer Prestarium rather than a domestic analogue, but the price factor interferes here because the medicine is taken for a long time.
Administrators
admin
Natalia 08042015, Influence on blood is possible not only theoretically, but also practically, if such an outcome is specified in the instruction. Another question that rarely indicates in the instructions is the hundredths of percentages of patients from the general sample taking the drug, so here again the balance of risk-benefit of using the drug is assessed.

I think that the patients who got into these hundredths of a percent were no less disturbing and insulting, but there is nothing to be done about it. Individual tablets are not yet invented, they only try to make them, but without any visible results.
Visitors
Natalia 08042015
Second we have a concor, there too, according to the instructions, similar side effects on bilirubin, ALT, AST.
Do you think, dear admin, is it possible in our case to prevent pobochki reception of a drug or a means to maintain the normal state of the liver and bile, while taking an antihypertensive drug?
The question is in the background. I'm getting ready to talk with my father's doctor.
Thank you very much for your reply.
Administrators
admin
Natalia 08042015If there is a reaction to Perindopril (hypothetically) any supporting or blocking this negative effect on the liver and bile ducts, the drugs most likely will not work. Exceptions so far for other drugs, I do not remember in my practice. Even a combination of antibiotics and antihistamines, loved by many doctors, after the end of the procedure, led allergic patients to anaphylactic shock. This is another mechanism of impact. Therefore, only the trial and selection.
Guests
love
I want to give up perindopril, tk. I feel after a year of taking the condition close to dizziness, weakness and drowsiness after one year of admission. The doctor replaced with lisinopril, it became even worse: the stool became turbid, stomach began to ache. I'm 52 years old, the pressure was 150 to 95.
Visitors
Stella
Hello. I had a high blood pressure of 160/90. The doctor prescribed Metoprolol for the prolonged action in the morning and Perindopril / Amlopidine in the evening. At me twisted bilious and there can be a stagnation of bile. After taking medications, he pulls in the right hypochondrium.I read that some of the active substances provoke stagnation of bile. Has addressed to the doctor she has changed a medicine on Gopten 4 mg. Tell me, what is more suitable for me? What active ingredient of drugs from the pressure I have less harm in terms of side effects?
Administrators
admin
Stella, All-pril, indicated by you in the question are metabolized in the liver, therefore can lead to side effects and changes in indicators in the analyzes. It is necessary to select your medicine that will not cause negative phenomena or try medicines from other groups (angiotensin 2 receptor antagonists, calcium channel blockers and other groups), although drugs from these groups can also affect the liver and their use should be allowed by the attending physician.

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