Perindopril original drug. Pressure tablets Perindopril: reviews, instructions. Other foreign analogues

Hypertension and heart failure are very common diagnoses in the modern world. Both elderly people and patients aged thirty years complain about them. Nowadays, these ailments are rejuvenated. Of course, there are more reasons for them in modern times. Stress, malnutrition, nervous tension, overwork have never had an excellent effect on good health.

Treatment of diseases of the circulatory system requires special attention. When the pressure jumps sharply, measures should be taken, by itself it will not stabilize. If this is not done, a person can get a myocardial infarction or stroke, the consequences of which can be very sad.

Arterial hypertension and other diseases associated with pressure instability should be treated under the supervision of a doctor. Any self-activity is inappropriate in this case.

Often, in order to bring the pressure back to normal, patients are prescribed a very expensive drug, Perindopril. Analogues, synonyms for this medicine, are also not cheap medicines. However, knowing all the properties of the drug, you can still choose a less expensive replacement for it in the modern pharmaceutical market.

This is a medicine from the group of ACE inhibitors that affect the restoration of muscle tone of the vessels, due to which the pressure returns to normal. Pharmacological features boil down to the fact that perindopril, decomposing to perindopilate, reduces the content in the blood of elements that make the vessels inoperative. By expanding them, it is possible to increase the minute volume of blood and a tolerant mode of the heart is developed under such a load. A more detailed description is indicated in the instructions for the drug.

The drug is produced in the form of tablets containing the active substance perindopril in the amount of 4 mg, 5 mg, 8 mg, 10 mg.

The drug is produced in the form of tablets containing the active substance perindopril in the amount of 4 mg, 5 mg, 8 mg, 10 mg.

The effect of the drug is noticeable an hour after taking it. After four hours, it reaches its maximum concentration and normalizes the pressure for the whole day. It does not affect conscious thinking, stimulates the brain, concentrates attention. Excreted from the body through the kidneys.

Reception is very simple, one tablet (the dose is prescribed by the doctor) is drunk once a day before meals. If you take the medicine after a meal, it will act slowly.

The drug is produced in Germany and Hungary. The cost of packing tablets varies from 500 to 600 rubles.

Medicines similar to "Perindopril" (analogues), instructions for use do not describe. Let's take a look at them below.

This drug is suitable for the treatment of patients with type 1 and type 2 diabetes, which is why it is so popular.

The drug "Perindopril" is prescribed for arterial hypertension, as well as chronic heart failure, and is used to prevent recurrent heart attacks and strokes.

This drug has a fairly wide list of side effects. Topical: dry cough, headache, insomnia, weakness accompanied by chest pain, convulsions, pruritus, bronchospasm, rhinitis, shortness of breath, muscle spasms, sexual disorders, depression, pneumonia, taste disturbance.

The composition of the drug "Perindopril" includes: the active substance perindopril, erbumine salt and auxiliary components - magnesium stearate, anhydrous colloidal silicon dioxide, a mixture of starch and lactose, acesulfame potassium.

Since the composition of the drug has been improved over the course of several years, the drug Prestarium A, an analogue of Perindopril, appeared in pharmacies. So the differences between them are in the trade name of the drug and one component. The drug "Prestarium A" instead of erbumine salt includes arginine. Their effect on the human body is identical. Arginine only allowed the drug to be stored for three years longer.

That's just the drug "Prestarium A" is more expensive than the drug "Perindopril", its price is 700 rubles per pack.

Many doctors advise patients to use in the treatment of hypertension a cheap analogue of Perindopril (hence, Prestarium A drugs) - Perinev tablets, which also include perindopril. Its cost varies from 200 to 300 rubles.

The group of analogues of the drug "Perindopril" includes such drugs as "Parnavel" (costs 300 rubles), "Hypernik" (300 rubles), "Piristar" (250-400 rubles), "Stopress" (360 rubles), " Arentopres" (400 rubles), "Parnavel" (280 rubles).

If you select substitutes for drugs such as Prestarium A, which contain arginine in addition to perindopril, the analogs listed above are also suitable for replacing them.

If substitute medicines are identical both in composition and in their effect on the patient's body, then other similar medicines may contain other components, but be characterized by the same effect in the treatment of heart failure and arterial hypertension.

For example, the drug Lisinopril is an analogue of Perindopril, which contains an active substance that is similar in action to perindopril - lisinopril. This is also a remedy from the group of ACE inhibitors.

The average cost of this analogue is 200 rubles. It is also available in the form of tablets. You can also find in pharmacies the medicine "Lizinopril" of Ukrainian production, German or Israeli. Buyers give preference to a drug manufactured in Germany.

This tool is ideal for people who are obese and diabetic, who find it very difficult to find drugs to lower blood pressure, since many of them have a large list of side effects that are life-threatening for such patients.

The drug "Lizinopril" is widely used in the treatment of patients with pathological diseases of the heart and vascular system.

The drug "Lizinopril" is widely used in the treatment of patients with pathological diseases of the heart and vascular system.

Of course, this remedy, along with its advantages, also has disadvantages, it can cause dizziness, nausea, dry cough, diarrhea.

The drug is contraindicated for use in diseases of the kidneys and liver, during pregnancy, breastfeeding, children under 18 years of age, with hereditary Quincke's edema, with intolerance to lisinopril and other components of the drug.

Choosing analogues for the drug "Perindopril", you can also stop at the drug "Enalapril". Its composition includes a substance similar in effect on the body of a patient with perindopril, enalapril maleate. This medicine is also an ACE inhibitor, therefore, lowers blood pressure and at the same time reduces the workload on the heart, preventing the complex consequences of hypertension.

The medicine is produced in Serbia, Macedonia. The drug has established itself in medical practice as reliable. Release form - tablets. The cost of one package of pills is from 100 to 200 rubles.

It is necessary to pay attention to the fact that this drug is contraindicated in diabetes mellitus, pregnancy, renal and hepatic insufficiency, breastfeeding, and is not intended for the treatment of children.

May cause the following side effects: dizziness, asthenia, skin rash and itching, fatigue, drowsiness, anxiety, dry cough. Also, this drug can cause a sharp decrease in pressure, so its intake should be accompanied by the supervision of the attending doctor, since the wrong dose can cause an overdose, therefore, a deterioration in the patient's condition.

There are many substitutes for the drug "Perindopril". Analogues of the drug can also be selected from the group of ACE inhibitors containing in their composition the active substance captopril, similar to perindopril. This is the drug "Captopril", which is applicable in the treatment of arterial hypertension, coronary heart disease and heart failure.

The drug is produced in Slovenia and Ukraine. The average cost of this medicine is 300 rubles.

The drug "Capotopril" is not prescribed during pregnancy, lactation, children under 18 years of age, with severe dysfunction of the kidneys and liver, cardiogenic shock, in the presence of obstructions in the outflow of blood from the left ventricle of the heart, Quincke's edema.

This medicine may also cause side effects such as blurred vision, fatigue, headaches, thrombocytopenia, decreased appetite, stomatitis, pruritus, tachycardia, acidosis.

Before using cheap analogues of the drug "Perindopril", you should carefully study the instructions for them. Only the attending physician should prescribe them. Each of them has its own list of side effects and a list of contraindications that should not be underestimated.

The treatment of hypertension is not simple, each patient has his own tendency to tolerate one or another component of medicines, and it is not so easy to choose the right drug that will not cause discomfort during treatment.

It is possible to choose an individual therapeutic agent only by testing drugs.

For many patients, taking only the Perindopril medication is not sufficient to normalize the pressure, the therapy is supplemented with several more effective means. To facilitate the work of doctors, pharmacists have created combined preparations with the basis of perindopril.

So, perindopril + indapamide analogues of perindopril with an enhanced effect on the patient's body are composed of such as Noriprel and Co-Pyreneva. Naturally, combined preparations are more expensive than pure perindopril. The cost of the drug "Noriprel" (perindopril + arginine + indapamide) is 800 rubles, the drug "Co-Pyreneva" (perindopril + erbumine + indapamide) - 650 rubles.

Cheaper, containing indapamide and perindopril, analogues-synonyms from the group of combined drugs: tablets "Prilamid" costing from 200 to 400 rubles, tablets "Co-Prenessa" - 400 rubles, "Perindid" - 300 rubles. The difference in price, as you can see, is palpable.

The combination of "perindopril plus indapamide" analogues can also be selected from the group of combined ACE inhibitors, which include other active substances. For example, Ampril Hd tablets (ramipril + hydrochlorothiazide) cost 400 rubles, and similar Euroramipril tablets cost 200 rubles.

On indapamide, the experiments did not end, because perindopril shows its effect very well in combination with amlodipine. Recently, the combined preparations Prestans (perindopril + arginine + amlodipine) have appeared, their cost is from 700 to 900 rubles, and Dalneva (perindopril + erbumine + amlodipine) - 500 rubles.

Which of the drug combinations is suitable for the patient, only the doctor knows, who has before his eyes a picture of the diagnosis after a thorough examination of the patient. If you need to choose cheaper analogues for the drug "Perindopril", then the attending physician also deals with this task, since only he can evaluate in practice the effectiveness of the action of a particular drug.

The pharmaceutical market is flooded with ACE inhibitors. Of these, there are a lot of drugs that replace the drug "Perindopril". Analogues and replacement, as you have already seen, can be identical both in composition and in effects on the body. But, despite such a variety of cheap substitutes for the drug in question, many patients still prefer to be treated with the original, as evidenced by their reviews.

Of course, if the patient cannot afford the original treatment, then there is a transition to cheap combined medicines, among which doctors have singled out more or less high-quality ones. Naturally, even among cheap drugs, doctors choose European-made medicines, among which there are practically no fakes.

The medicine "Perindopril" itself in medical practice has established itself as reliable and effective, thanks to it, doctors today manage to restore the health of 80% of patients with arterial hypertension and heart failure, and also prevent complications in 50% of them in the form of myocardial infarction and stroke.

Having, of course, knowledge of what drugs can replace the drug "Perindopril", it is much easier to navigate in a large list of ACE inhibitor drugs. And when prescribing, it becomes easy to understand what exactly the doctor recommends for therapy - the original drug or its cheap analogue.

The drug "Perindopril" is a good medicine, very often prescribed to patients with hypertension or heart failure. Reviews about it exist mostly only good ones. And of course, many patients with high blood pressure or with problems of the cardiovascular system would probably like to know which analogue of Perindopril can be purchased at the pharmacy, more effective in one case or another, sold without a prescription or less expensive. Drugs with the same pharmacological effect on the market, of course, exist. Some of them are made on the basis of the same substances as Perindopril, others have a completely different composition.

Perindopril is produced, reviews of which on the Web are mostly only positive, in tablets of 4, 8, 5 or 10 mg. This medicine is sold in pharmacies only by prescription. The composition of the tablet includes the following substances:

active salt (arginine, erbumine);

lactose monohydrate;

magnesium stearate;

One package usually contains 10-30 tablets of Perindopril.

The medicine "Perindopril" works quite simply. Once inside the human body, the drug inhibits the release of HA from the fibers of the sympathetic system and inhibits the synthesis of endothelin in the vessels. In addition, the drug enhances the activity of renin of a secondary nature and reduces the secretion of aldosterone. As a result of all this, vasoconstriction occurs and, as a result, an increase in the minute volume of the myocardium. The decrease in blood pressure when taking this drug does not lead to tachycardia.

The beneficial effect of perindopril begins approximately 1 hour after ingestion. The greatest effect from the use of this drug is observed after 4-8 hours. In total, Perindopril has a healing effect on the body during the day.

Depending on the type of active salt included in the composition, there are two main types of the drug "Perindopril":

"Prestarium A" (perindopril arginine);

"Perindopril erbumine".

In terms of pharmacological action, there is practically no difference between these two varieties of the drug. They differ only in composition.

Perindopril erbumine is the earliest type of drug. Until recently, only this type of drug was prescribed to patients. Perindopril based on erbumine salt was tested on 50 thousand patients and showed excellent results. However, this medicine also has one rather significant drawback - not too long a shelf life.

Thus, initially there was only erbumine "Perindopril" on the market. "Prestarium A" appeared in the pharmacies of the Russian Federation and Ukraine only in 2000. Instead of erbumine salt, arginine began to be used in it. The pharmacological effect on the patient's body, this substance has exactly the same. But at the same time, it is devoid of the main drawback of erbumine. A medicine based on arginine salt can be stored for 2-3 years. Initially, doctors doubted that this substance could really replace erbumine. However, clinical trials have clearly shown the effectiveness of the new salt.

Today, doctors are officially allowed to prescribe a drug based on both arginine and erbumine to patients. Indications for the use of these funds are exactly the same. The cost of these drugs differ slightly. Erbumine-based preparations cost about 200-300 rubles for 30 tabs. 4 mg each, based on arginine - 300-400 rubles (depending on the manufacturer).

Instead of this main remedy, patients in some cases can use substitutes such as:

"Prestarium Arginine Combi";

"Prestance";

"Dalneva";

"Ko-Perineva";

"Lisinopril";

"Enalapril";

"Captopril".

All these pills are quite effective and efficient. But you should take them, of course, only after consulting with your doctor.

These drugs are also prescribed to patients quite often. The composition of "Prestarium Arginine Combi" in addition to the salt of the same name includes the sulfonamide diuretic indapamide. Most often, this analogue of "Perindopril" is prescribed for additional control of blood pressure when using the main type of medication itself. Indapamide, which is part of the drug:

reduces left ventricular hypertrophy;

makes the arteries more elastic;

has a hypotensive effect.

It costs "Arginine Combi" about 350 rubles. for 30 tablets.

Both drugs containing perindopril + indapamide are quite affordable, and it will not be difficult to purchase them if necessary. "Arginine Combi" and "Ko-Perineva" are available in almost any pharmacy.

This modern drug, in addition to perindopril, contains the substance amlodipine. The latter belongs to the group of calcium channel blockers. The pharmacological action of amlodipine lies primarily in the fact that it has an antihypertensive effect by reducing vascular vasodilation and OPSS. The intake of this remedy leads to a decrease in the need of the heart muscles for oxygen, promotes vasodilation in ischemic areas, and delays the development of angina attacks.

The use of the drug "Prestans" by elderly people suffering from arterial hypertension reduces the risk of myocardial infarction. Perindopril + amlodipine costs about 500-600 rubles for 30 tablets of 10 mg + 5 mg. This is, of course, quite expensive.

Like Prestans, this remedy simultaneously contains both amlodipine and perindopril. The difference between the drug "Dalneva" and "Prestanza" is that this medicine is made on the basis of not arginine, but erbumine. Dalnev costs about 480 rubles for 30 pieces. 5 mg + 8 mg.

You can buy medicines "Prestans", "Dalneva", "Arginine Combi", etc., as already mentioned, in a pharmacy only with a prescription issued by a doctor. Since the main active ingredient of all these drugs is perindopril, the instructions for use are similar for them. However, differences in the reception of such funds, of course, exist. Below, in the table, instructions for each of the drugs described above are presented.

The above dosages are approximate. Treatment with drugs of the perindopril group can only be prescribed by a doctor. Depending on the state of health of the patient, the individual characteristics of his body, etc., the dosages of such drugs can vary significantly. Therefore, self-medication with the use of preparations based on perindopril is by no means possible. This can lead to more than sad consequences.

Means based on the substance perindopril, the instructions for use of which are quite simple, unfortunately, are not suitable for all patients with high blood pressure or heart failure. These medications have the following contraindications:

allergy to the main active substance or auxiliary;

pregnancy and breastfeeding.

For Arginine Combi, the main active substances of which are perindopril + indapamide, among other things, there is such a contraindication as the patient has Quincke's edema. Also, this drug should not be taken:

with renal failure;

violations of the liver;

hypokalemia and some other diseases.

Approximately the same contraindications have an analogue of "Perindopril" - the medicine "Co-Pyreneva". This drug, in addition, is not yet prescribed to children under 18 years of age. Elderly people should use it with caution.

Prestans (perindopril plus amlodipine) should not be taken by people:

with angioedema;

severe hypotension;

cardiogenic shock;

aortic stenosis;

unstable angina.

Also do not prescribe this drug after a heart attack (within 28 days). The medicine "Dalneva" in addition to the general ones also has such contraindications:

angioedema;

low pressure;

kidney pathology;

age up to 18 years.

The means of this group are considered by both doctors and their patients to be effective and effective. According to many patients, at the same time, Prestarium A is tolerated by patients a little better than Perindopril erbumine. Doctors and patients explain this primarily by the fact that the first drug is manufactured mainly by foreign companies. Simple "Perindopril" is produced mostly by domestic manufacturers. Therefore, his quality, according to many doctors and patients, is worse.

The advantages of all preparations based on perindopril arginine or erbumine include ease of use. You only need to take these medicines once a day. They begin to act quickly enough. These drugs do not have any too unpleasant side effects.

This is the approximate action of drugs made on the basis of a substance called perindopril. The price for them, as you can see, is quite high. Yes, and you can not buy such drugs in pharmacies without a prescription. Meanwhile, there are much cheaper analogues, moreover, they are sold completely freely. One such remedy is Lisinopril.

Like Perindopril tablets, this medicine is used to lower blood pressure. The main active ingredient in the composition of the drug is lisinopril dihydrate. This remedy is produced, like Perindopril, in tablets. The cost of this drug is only 17 rubles for 30 pcs. 5 mg.

This medicine, like perindopril-based drugs, is usually taken once a day. Patients with arterial hypertension are initially most often prescribed 10 mg per day. Then the dose gradually rises to 20 mg. The patient can continue to increase the amount of medication used. However, the maximum allowable daily dose of Lisinopril is 40 mg.

With heart failure, this medicine is drunk a little differently. In this case, the initial dose is only 2.5 mg. Then every 5 days the amount of the drug used is increased by another 2.5 mg. The maximum dose for such patients is 20 mg.

You can drink "Lizinopril" and people who have had a heart attack. In this case, the doctor usually prescribes 5 mg of the drug in the first days. Further, the dosage is increased to 10 mg per day (gradually). The course of treatment with the drug for patients who have had a heart attack is at least 6 weeks.

You can not take Lisinopril to people:

allergic to dihydropyridines;

angioedema;

aortic stenosis;

severe degree of hypertension;

hypertrophic cardiomyopathy;

mitral stenosis.

About this medicine, as well as about drugs made on the basis of perindopril, patients with high blood pressure also had a very good opinion. These pills lower blood pressure almost instantly. But when buying Lisinopril, since it is usually produced by domestic companies, patients and doctors are advised to be more careful. The fact is that there are similar drugs on the market, made including by unscrupulous manufacturers.

When buying Lisinopril, you should pay attention to where it was manufactured and packaged. It's better if it's the same place. This medicine is usually produced from high-quality components. But when packing, it often happens that third-party components are added to it to obtain large profits. And not all of them can be safe and harmless to health. By the way, it is worth following this recommendation when buying absolutely any medicine intended to lower blood pressure.

If we talk about a specific manufacturer, then Lisinopril, manufactured by Alsi, in pink packaging, deserved very good reviews. Buying the drug, produced in the Republic of Macedonia and packaged in the Moscow region (in yellow packs), is highly discouraged by patients. This medicine may not even lower the pressure, but raise it very much. And this, in turn, is fraught with serious troubles. Especially for the elderly.

This medicine can also be a good substitute for Perindopril. The price for it, as well as for Lisinopril, is very low. You can buy a package of Enalapril medicine with 30 tablets of 5 mg, for example, for 15-20 rubles. This remedy is used both for high blood pressure and for heart failure.

With arterial hypertension, Enalapril is usually prescribed to the patient in an amount of 5 mg per day. In this case, the patient is placed under medical supervision for 3 hours until the pressure stabilizes. After a couple of weeks, the doctor increases the dose to 10 mg. Then the amount of the drug taken by the patient can be gradually increased to 40 mg. The course of treatment with Enalapril in this case is 7-14 days. Next, the patient is transferred to a maintenance dose of 10-40 mg, depending on the state of health.

In heart failure, this medicine is first taken in an amount of 2.5 mg per day. Then every 4 days the dose is increased by 5 mg. The amount of the drug used for treatment can be increased to no more than 40 mg per day.

This drug is not prescribed to patients if they have:

angioedema;

hypersensitivity to ACE inhibitors.

Pregnant women should also not drink this medicine. Do not prescribe this remedy to children under 18 years of age. It can have a very negative effect on their body.

The drug "Enalapril" reduces pressure, according to many patients, very well. It works, according to the majority of patients, no worse than many expensive imported drugs of the same group. At the same time, Enalapril is much cheaper. But as many patients believe, this medicine has one rather serious drawback. The fact is that it gives such an unpleasant side effect as a strong and very dry cough. Moreover, it occurs in almost all patients taking this drug.

If necessary, "Perindopril", indications for the use of which are high blood pressure and heart failure, can also be replaced with this cheap analogue. Sold "Captopril" usually in tablets of 25-50 mg. There is a package of this medicine of 40 tablets about 40 rubles. This remedy can be taken with arterial hypertension, dysfunction of the ventricle due to a heart attack, heart failure.

Drink the drug "Captopril" necessarily an hour before meals. The initial dose for patients with elevated blood pressure in this case is 25 mg 2 times a day. If necessary, the amount of medication taken can be increased to 50 mg 2-3 times a day. The maximum daily dose of this drug is 50 mg.

For patients with heart failure, this medicine is usually prescribed in an amount of 6.25 mg 2-3 times a day. Then the dose is gradually increased over two weeks. A patient with such problems can take no more than 150 mg of this drug per day. "Captopril" is prescribed for people with heart failure in the event that diuretics do not give the desired effect.

So, "Captopril" is a good substitute for the drug "Perindopril". The indications for use are the same. But this drug should not be drunk in the presence of:

arterial hypotension;

cardiogenic shock;

impaired liver function;

mitral stenosis;

stenosis of the renal arteries;

primary hyperaldosteronism.

This medicine, like Perindopril, is not prescribed, also during lactation and during pregnancy. It should not be taken by persons under the age of 18.

People with high blood pressure call this medicine a real emergency. In addition to the fast and effective action, the advantages of the drug "Captopril" include the fact that, unlike drugs based on perindopril, it is dispensed in pharmacies without a doctor's prescription. However, according to many patients, it is not worth drinking this medicine uncontrollably or simply for prevention. It is suitable for the most part precisely as an emergency remedy for a pressure surge. Side effects, like any other similar drugs, it has a lot.

In this article, you can read the instructions for using the drug Perindopril. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Perindopril in their practice are presented. We kindly ask you to actively add your reviews about the drug: the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Perindopril in the presence of existing structural analogues. Use for the treatment of arterial hypertension and pressure reduction in adults, children, as well as during pregnancy and lactation. The composition of the drug.

Perindopril- ACE inhibitor. It is a prodrug from which the active metabolite 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 to angiotensin 2, which is a powerful vasoconstrictor. As a result of a decrease in the concentration of angiotensin 2, a secondary increase in plasma renin activity occurs due to the elimination of negative feedback on renin release and a direct decrease in aldosterone secretion. Due to the vasodilating effect, it reduces OPSS (afterload), wedge pressure in the pulmonary capillaries (preload) and resistance in the pulmonary vessels; increases cardiac output and exercise tolerance.

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

Compound

Perindopril erbumine + excipients.

Perindopril arginine + excipients.

Pharmacokinetics

After oral administration, perindopril is rapidly absorbed from the gastrointestinal tract. Bioavailability is 65-70%. In the process of metabolism, perindopril is biotransformed with the formation of 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. Does not accumulate. Repeated reception does not lead to cumulation (accumulation). When taken with food, 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, the excretion of perindoprilat slows down.

Indications

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

Release forms

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

Instructions for use and dosage

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

In case of impaired renal function, a correction of the dosing regimen is required, depending on the CC values.

Side effect

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

Contraindications

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

Use during pregnancy and lactation

Perindopril is contraindicated for use during 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 kidney function.

During treatment with perindopril, kidney function, the activity of liver enzymes in the blood, and peripheral blood tests should be regularly monitored (especially in patients with diffuse connective tissue diseases, in patients who receive immunosuppressive drugs, allopurinol). Patients with sodium and fluid deficiency should be corrected for fluid and electrolyte disturbances before starting treatment.

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

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

drug interaction

With simultaneous use with antihypertensive agents, muscle relaxants, anesthetic agents, an increase in the antihypertensive effect is possible.

With simultaneous use with loop diuretics, thiazide diuretics, an increase in the antihypertensive effect is possible. Severe arterial hypotension, especially after taking the first dose of a diuretic, apparently occurs due to hypovolemia, which leads to a transient increase in the hypotensive effect of perindopril. The risk of impaired renal function is increased.

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

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

With simultaneous use with indomethacin, the antihypertensive effect of perindopril decreases, apparently due to inhibition of the synthesis of prostaglandins (which are believed to play a role in the development of the hypotensive effect of ACE inhibitors) under the influence of non-steroidal anti-inflammatory drugs (NSAIDs).

With simultaneous use with insulin, hypoglycemic agents, sulfonylurea derivatives, hypoglycemia may develop due to an increase in glucose tolerance.

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

With simultaneous use with potassium-sparing diuretics (including spironolactone, triamterene, amiloride), potassium preparations, salt substitutes and dietary supplements containing potassium, hyperkalemia may develop (especially in patients with impaired renal function), because. ACE inhibitors reduce the content of aldosterone, which leads to a retention of potassium in the body against the background of limiting the excretion of potassium or its additional intake into the body.

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

Analogues of the drug Perindopril

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

• Arentopres;
• Hypernicus;
• Dalneva;
• Coverex;
• Ko Perineva;
• Noliprel;
• Noliprel A;
• Noliprel forte;
• Parnavel;
• Perindide;
• Perindopril Pfizer;
• Perindopril Richter;
• perindopril arginine;
• perindopril erbumine;
• Perindopril Indapamide Richter;
• Perindopril plus Indapamide;
• Perineva;
• Perinpress;
• Piristar;
• Prestance;
• Prestarium;
• Prestarium A;
• Stoppress.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases from which the corresponding drug helps and see the available analogues for the therapeutic effect.

A huge percentage of the world's population suffers from cardiovascular problems. Failures in the work of this body occur, as in the elderly, and in quite young people. In recent years, diseases such as heart failure, as well as persistent high blood pressure, have begun to significantly reduce age restrictions. This is affected by the influence of external factors, such as poor ecology, stressful situations and bad habits.

Treatment and normalization of the cardiovascular system requires special attention and control. A careless attitude dramatically increases the risk of a heart attack or stroke. Such indications insistently require the use of a special kind of remedy. Any modern pills for such diseases are expensive.

The best and relatively inexpensive drug is Perindopril. Analogues cheaper than it exist. They are usually from a domestic manufacturer. But it’s not so much the prices that scare people, but the composition of the medicine itself.

The active substance, which is included in Perindopril, causes a lot of side effects and has various contraindications. Therefore, it is possible to choose safer and cheaper analogues of the drug or close substitutes. After reading this material, the question of how to replace Perindopril will be settled.

The table of similar Russian-made drugs is presented with cheaper options. The most famous are the following substitutes.

The list of analogues of the Ukrainian manufacturer is more extensive than the Russian one.

For those who are concerned about the replacement with a cheaper and safer drug, we can recommend the products of the pharmaceutical industry of this country:

1. Euroramipril. This medicine is recommended for use for the prevention of cardiovascular diseases, reducing the risk of a heart attack, as well as optimizing the body's work after suffering an acute form of this disease.

   It is prescribed to patients with diabetes mellitus if they have the possibility of developing problems with the cardiovascular system. Its price varies within hundreds of rubles.

2. Ramizes. It is used to treat patients with cirrhosis of the liver with ascites. It is used in relation to people who have undergone extensive surgery, which provoked the occurrence of arterial hypotension.
3. Tritace. During pregnancy or planning a child, this medicinal substance is contraindicated. It is included in the course for people suffering from diseases of the cardiovascular system, as well as diabetics with a risk of problems with this organ.

   This drug is actively used to restore normal kidney function.

4. Lizinovel. This drug belongs to the group of inhibitors. It is a treatment for patients with heart failure, acute myocardial infarction, persistent high blood pressure and diabetic nephropathy.
5. Lisinopril. Indications for its use coincide with the previous drug.

Synonyms for pharmaceutical shook are not uncommon. This also covered Belarusian generics. This drug has a good analogue of the production of this country.

Imported substitutes, although distinguished by their high cost, cause fewer side effects. Their concomitant action is softer, which allows them to be competitive in the domestic pharmaceutical market.

They are represented by the following drugs:

• Erupnil. This drug is manufactured in India. Adverse reactions Perindopril causes only partially.
• perestaraium. It is a French pharmaceutical product. Helps prevent the recurrence of a stroke.
• Stoppress. This drug is produced in Poland. Its peculiarity is that it does not produce the phenomenon of recoil.

Thus, we can conclude that the treatment of diseases of the cardiovascular system should be safe for the whole organism. In order not to encounter side effects and reactions, you can choose a drug similar in action to Perindopril.

The choice of pharmaceutical products in this sense is wide. You can pick up both inexpensive domestic medicinal substances and imported tablets of a higher price category.

Perindopril pressure tablets have proven themselves in the pharmaceutical market due to good tolerability, infrequent occurrence of unwanted manifestations and a small list of contraindications to the appointment.

What are Perindopril tablets? Instructions for use gives an exhaustive description of the features of this medicine.

The first thing we see when opening the annotation for the drug Perindopril is the trade name. Further in the instructions for use of the drug, the composition of the drug is described. It is represented by the main active ingredient - perindopril erbumine, and several additional ingredients, including croscarmellose sodium, lactose and others.

For the convenience of long-term use and the correct dosing of the drug, the release form is limited to a tablet type at a dosage of perindopril 2 mg, 4 mg, 8 mg. Some of the foreign analogues of the drug are available in tablets of 5 mg and 10 mg according to the content of perindopril.

What are Perindopril tablets for?

Knowing that the group of the drug Perindopril - (ACE inhibitors), we can say what effect the drug has on the human body:

• antihypertensive;
• by reducing the tone of blood vessels (arterioles and veins) facilitates the work of the heart;
• increases exercise tolerance in cardiological patients.

What Perindopril tablets help from, the instructions for use describe in the paragraph - indications for the appointment.

Mechanism of action

We can say that it is the pharmacological group of the drug that determines the main mechanism of action of the drug. Entering the body, under the influence of hepatic esterases, it turns into an active metabolite - perindoprilat, which has the following effects:

• causes expansion of peripheral (mainly resistive) vessels and a moderate drop in blood pressure;
• reduces pre- and afterload on the heart muscle;
• corrects blood circulation in the pulmonary circulation and respiratory function;
• lowers the vascular resistance of the renal arteries, improving blood flow in them.

At what pressure should I take it?

The question - at what pressure and how to take Perindopril - instructions for use are considered only partially. That is, it is limited to instructions for prescribing a medicine - in case of an increase in blood pressure. The annotation does not specify specific pressure figures for the use of the medication.

Therapy of hypertension suggests that Perindopril should be taken constantly, regardless of the current values ​​on the tonometer.

Indications for use

For a drug such as Perindopril, indications for use are limited to the following conditions:

• high blood pressure;
• insufficiency of cardiac activity in a chronic form.

Given the pharmacodynamics of the drug, indications for use can be expanded by using it for prophylactic purposes in patients:

• after a stroke or transient (transient) cerebrovascular accident of an ischemic type;
• with stable ischemic (coronary) heart disease;
• when hypertension is renovascular in nature.

Instructions for use

The prescription for Perindopril is written in Latin. All the necessary information about the features of the drug contains instructions for use. The components of Perindopril tablets, their mechanism of action and indications for use were described in the previous sections. Contraindications for use, dosages, side effects and some other issues remained unconsidered.

Contraindications to the use of Perindopril are standard factors:

• individual intolerance to perindopril and other components of the medication or ACE inhibitors in general;
• predisposition to angioedema in history during therapy with ACE blockers, angioedema of hereditary or idiopathic origin;
• periods of childbearing and breastfeeding;
• adolescence (up to 18 years) age (there are no studies to establish efficacy and safety).

Causes of hypertension

Dosage

If the doctor has prescribed you the medicine Perindopril, the instructions for use recommend that you comply with the following conditions for its use:

• take regularly;
• in the morning hours;
• before breakfast;
• 1 per day.

For the drug Perindopril, the dosage is selected individually, taking into account data on:

• the presence of concomitant pathology, especially if there were changes in the work of the urinary system;
• concurrent use of other drugs;
• patient's age.

Therapy begins with minimal doses of 1-2 mg for perindopril and, if necessary, gradually, at intervals of several weeks, is increased. The maximum daily dose of the drug is 8 mg. Patients who have been diagnosed with pathology of the hepatobiliary system do not need dosage adjustment.

Side effects

Taking the medication in question, like any other drug, does not exclude the possibility of developing unwanted reactions.

For Perindopril tablets, side effects in terms of frequency of occurrence can be represented as follows:

• often - up to 10% of cases of admission: excessive drop in blood pressure; asthenoneurotic syndrome, dry hacking cough, shortness of breath; tinnitus and blurred vision; dyspeptic manifestations, impaired stool, change in taste sensations; allergic manifestations; convulsive twitching of muscles;
• rarely - up to 1%: sleep disturbance, mood swings; bronchospasm; dry mucous membranes; Quincke's edema, deterioration of kidney function, increased sweating, impotence;
• extremely rarely - in less than 0.1%: disorders of the cardiovascular system in the form of rhythm disturbance, chest pain in the form of angina pectoris, acute; inflammation of the lungs with eosinophilic infiltration; rhinitis; change in the blood test; disruption of the liver and pancreas; confusion, exudative erythema.

We can say that this medication is better tolerated than some other representatives of the ACE inhibitor group. For the drug Perindopril, side effects can be minimized by prescribing minimal doses.

Effect on potency

When starting therapy with an antihypertensive drug, many men often worry about one of the side effects of drugs of this kind - the effect on potency. Perindopril, like other ACE inhibitors, does not impair erectile function and does not reduce libido. Moreover, studies have shown that antihypertensive therapy with ACE inhibitors stimulates the production of androgens, which, on the contrary, improves potency.

Medicine and alcohol

For Perindopril tablets, the instructions for use state the fact that for the entire course of therapy it is necessary to refrain from drinking alcohol. Their joint reception can cause the following reactions:

• sudden loss of consciousness;
• acute insufficiency of cerebral circulation;
• coronary (heart) insufficiency;
• erectile dysfunction.

Do not neglect the information provided by the instructions for use for Perindopril tablets regarding alcohol.

Reviews of patients taking the drug

It cannot be said that the reviews about the drug Perindopril are purely negative or positive. Tolerability of the drug is a rather individual characteristic of the drug. And the reviews of patients taking the drug can be represented as follows:

• some patients note the onset of a rapid and stable decrease in pressure in the absence of any undesirable effects from taking the medication;
• others reveal such side effects as dry cough, sore throat, weakness with a moderate therapeutic effect.

However, the occurrence of certain adverse reactions depends on many factors, for example:

• drug doses;
• patient's age;
• the degree of hypertension and the presence of concomitant pathology;
• company and country of origin.

But, reviews are reviews, and before you start taking it, you need to consult a doctor.

To enhance the therapeutic effect, some drugs with perindopril as the active substance are produced in combination with other antihypertensive substances. For example, Perindopril Indapamide Richter, produced by a well-known company in Poland, contains perindopril and indapamide (a diuretic).

This drug, thanks to the combination of such components, has a wider list of indications for use, as detailed in the annotation to the combined Perindopril - instructions for use. At what pressure it is worth paying attention to this medication, it is better to decide with your doctor.

Another drug based on perindopril is an analogue of the above drug, but Russian-made - Perindopril PLUS Indapamide. Despite the almost 100% identity of the composition with the Polish synonym for Perindopril with a diuretic, some distinguishing factors are still present in it.

For example, as part of the auxiliary ingredients of Russian tablets, Perindopril PLUS Indapamide, the instructions for use do not indicate lactose monohydrate. This circumstance can be considered an advantage for patients with rare intolerance to this disaccharide.

The composition of the calcium channel blocker - amlodipine besylate - and the angiotensin-converting enzyme blocker - perindopril erbumine - is the basis of several drugs that are often used as analogues and replacements for perindopril, although they are not its full synonyms. The calcium antagonist ensures the release of "slow" calcium channels from the excess of this macronutrient (Ca), the excess of which indirectly contributes to vasoconstriction (vasoconstriction). Thus, there is a double antihypertensive effect on the vascular system.

Analogues, synonyms, replacements

In some cases, when the purchase of the original medicine is impossible for a number of reasons, patients are interested in what can replace Perindopril.

The search for an absolute analogue (that is, a drug with an identical composition) for the treatment of hypertension is not always justified, because drugs with other active ingredients of a similar pharmacological action are usually no less effective. The main thing is to carry out the selection of an analogue together with the attending physician.

Experts know for sure (from practice) which is better - Perindopril or Ramipril, Perindopril or Lisinopril, and so on.

The antihypertensive agent of the French manufacturer Laboratories Servier Prestarium is a one-component analogue of Perindopril. The excipients contain lactose monohydrate, the drug is produced in the form of tablets for oral administration and for resorption under the tongue.

The question of which is better - Perindopril or Prestarium, can only be answered after the practical use of these drugs. One thing is certain - the medicine of the French manufacturer will be several times more expensive than, say, the Russian drug Perindopril SZ.

The active ingredient lisinopril in the drug of the same name, produced by a large number of European, Russian and Indian companies, is an ACE inhibitor. That is, the pharmacological action of the drug is akin to Perindopril and its analogues and can be used in the treatment of hypertension instead of these drugs.

Auxiliary components do not contain lactose, and the drug itself is excreted from the body unchanged through the kidneys. There are no such conditions from which Perindopril tablets would be powerless, and Lisinopril would cope with incredible efficiency. Therefore, reasoning about the advantages of a particular remedy should be based on an individual approach to each case.

Do not try to find out which is better - Perindopril or Enalapril - in a pharmacy. Of course, the pharmacy worker will describe the benefits of the drug that is available at the pharmacy. If you have to choose between these two drugs, it is better to consult a doctor.

Let's compare another pair of medicines - Monopril and Perindopril. Which of the drugs is better, it is still difficult to answer. The active substance of Monopril is fosinopril - an ACE blocker; The composition contains lactose in an anhydrous compound. The list of side effects presented in the instructions for use is similar to the list under consideration for Perindopril. Most likely, it will be possible to talk about preference only after careful selection of doses and practical use of the drug.

The antihypertensive drug Perinev, produced by the Russian branch of the company Krka, can confidently be called a synonym for the drug in question.

According to the instructions for use, the composition of the drug, with the exception of a slight difference in excipients, is the same, respectively, the pharmacological properties and effectiveness are the same. Which is better - Perindopril or Perineva, as in most cases, should show practical experience in the use of these drugs.

The active substance of Ramipril tablets and their direct analogues is ramipril, a precursor of the active metabolite of ramiprilat, an angiotensin-converting enzyme blocker. According to the instructions for use, the composition of the excipients of Ramipril does not differ significantly from the composition of Perindopril, but the list of indications for use is much more extensive, in particular, due to the use in nephropathy (diabetic and non-diabetic), severe proteinuria, especially accompanied by hypertension.

The question of replacing Perindopril with Ramipril should be considered after carefully studying the instructions for use of both drugs and comparing them with the characteristics of the course of hypertension in the patient.

What to replace with a cough?

One of the side effects of the drug, like other representatives of the ACE inhibitor group, is an unproductive cough. Often this undesirable manifestation acquires a persistent, long-term character and complicates further therapy.

If during the course of treatment a person notes the appearance of this and other side effects, it is recommended to seek help.

How to replace Perindopril with a cough can only be suggested by a doctor. It is possible that a drug from the Israeli concern Perindopril TEVA will be offered, or the patient will be recommended to completely abandon the ACE inhibitor group and treat hypertension with calcium channel blockers, beta-blockers or other medicines. Do not self-medicate and change the drug, following the advice of a pharmacist, neighbors or relatives.

Useful video

You can learn about common side effects of blood pressure drugs in this video:

Conclusion

1. According to the instructions for use, Perindopril tablets belong to the angiotensin-converting enzyme (ACE) group and are intended for the treatment of arterial hypertension and heart failure.
2. According to the instructions for use, Perindopril does not show a depressant effect on erectile function, however, when used in parallel with alcohol, such a side effect can manifest in an enhanced form.
3. The active ingredient perindopril is included in many antihypertensive drugs, both as the sole active ingredient and in combination with other antihypertensive drugs.
4. You can replace this drug with any medicines with a similar composition (indicated in the instructions for use) or similar active ingredients. However, this issue can only be resolved with the attending physician.

C.09.A.A.04 Perindopril

Latin name

PERINDOPRIL-TEVA

Release form

Film-coated tablets

1 tablet contains:

Active substance: perindopril tosylate 5 mg;

Excipients: lactose monohydrate - 71.962 mg, corn starch - 2.7 mg, sodium bicarbonate - 1.586 mg, pregelatinized corn starch - 7.2 mg, povidone K30 - 1.8 mg, magnesium stearate - 0.9 mg.

Shell composition: opabray II green 85F210014 (partially hydrolyzed polyvinyl alcohol - 1.8 mg, titanium dioxide (E171) - 1.0935 mg, macrogol-3350 - 0.9090 mg, talc - 0.666 mg, indigo carmine (E132) - 0.0144 mg, brilliant blue dye (E133) ) - 0.0081 mg, iron dye yellow oxide (E172) - 0.0045 mg, quinoline yellow dye (E104) - 0.0045 mg).

Package

(30) - polypropylene containers (1) - cardboard packs

pharmachologic effect

Perindopril is an angiotensin-converting enzyme (ACE) inhibitor. ACE, or kininase, is an exopeptidase that converts angiotensin 1 into the vasoconstrictor angiotensin II, as well as the destruction of bradykinin, which has a vasodilating effect, to an inactive heptapeptide.

Suppression of ACE activity leads to a decrease in the concentration of angiotensin II in the blood plasma, as a result of which the activity of renin in the blood plasma increases (due to the inhibition of negative feedback, which prevents the release of renin) and the secretion of aldosterone decreases. Since ACE inactivates bradykinin, ACE suppression is accompanied by an increase in the activity of both the circulating and tissue kallikrein-kinin systems, while the prostaglandin system is activated. It is possible that this effect is part of the mechanism of the antihypertensive action of ACE inhibitors. as well as the mechanism of development of some undesirable reactions of drugs in this group (for example, cough).

Perindopril has a therapeutic effect due to the active metabolite, perindoprilat. Other metabolites of the drug do not have an inhibitory effect on ACE in vitro.

Arterial hypertension

With arterial hypertension on the background of the use of perindonril, there is a decrease in both systolic and diastolic blood pressure (BP) in the "lying" and "standing" positions. Perindopril reduces total peripheral vascular resistance (OPVR), which leads to a decrease in blood pressure. At the same time, peripheral blood flow is accelerated, but the heart rate (HR) does not increase. Renal blood flow usually increases while glomerular filtration rate does not change. The maximum antihypertensive effect is achieved 4-6 hours after a single oral administration of perindonril; the antihypertensive effect persists for 24 hours, and after 24 hours the drug still provides from 87% to 100% of the maximum effect. The reduction in blood pressure is achieved fairly quickly. Stabilization of the antihypertensive effect is observed after 1 month of therapy and persists for a long time. Termination of therapy is not accompanied by a "withdrawal" syndrome.

Perindopril has a vasodilating effect, helps to restore the elasticity of large arteries and the structure of the vascular wall of small arteries, and also reduces left ventricular hypertrophy. Simultaneous administration of thiazide diuretics enhances the antihypertensive effect. In addition, the combination of an ACE inhibitor and a thiazide diuretic also reduces the risk of hypokalismia while taking diuretics.

Chronic heart failure (CHF)

Perindopril normalizes the work of the heart, reducing preload and afterload. In patients with CHF treated with perindopril, a decrease in filling pressure in the left and right ventricles of the heart, a decrease in TPVR, an increase in cardiac output and an increase in cardiac index were found.

Cerebrovascular diseases

When using perindopril tertbutylamine 2-4 mg / day (equivalent to 2.5-5 mg perindopril arginine or perindopril tosylate), both in monotherapy and in combination with indapamide, simultaneously with standard therapy for stroke and / or arterial hypertension or other pathological conditions, in patients with a history of cerebrovascular disease (stroke or transient ischemic attack) over the past 5 years, the risk of recurrent stroke (both ischemic and hemorrhagic nature) is significantly reduced. Additionally, the risk of developing fatal or disabling strokes is reduced; major cardiovascular complications, including myocardial infarction, incl. fatal; stroke-related dementia; severe cognitive impairment.

These therapeutic benefits are seen in both hypertensive and normal BP patients. regardless of age, gender, presence or absence of diabetes and type of stroke.

Stable coronary heart disease (CHD)

Therapy with perindopril tertbutylamine 8 mg (equivalent to K) mg of perindopril arginine or perindopril tosylate) in patients with stable coronary artery disease without signs of heart failure, with a history of myocardial infarction and coronary revascularization in history, while using antiplatelet agents, lipid-lowering drugs and beta-blockers leads to a significant reduction in the absolute risk of the primary endpoint (cardiovascular death, non-fatal myocardial infarction and/or cardiac arrest followed by successful resuscitation).

Indications

Arterial hypertension.

Chronic heart failure.

Prevention of recurrent stroke (combination therapy with indapamide) in patients who have had a stroke or transient ischemic cerebrovascular accident.

Stable coronary artery disease: reduced risk of cardiovascular complications in patients with stable coronary artery disease.

Contraindications

History of angioedema, concomitant use with aliskiren and aliskiren-containing drugs in patients with diabetes mellitus or impaired renal function (GFR2), pregnancy, lactation, children and adolescents under 18 years of age, hypersensitivity to perindopril, hypersensitivity to other ACE inhibitors.

Use during pregnancy and lactation

Perindopril is contraindicated for use during pregnancy and lactation (breastfeeding).

Dosage and administration

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

In case of impaired renal function, a correction of the dosing regimen is required, depending on the CC values.

Side effects

On the part of the hematopoietic system: eosinophilia, decreased hemoglobin and hematocrit, thrombocytopenia, leukopenia / neutropenia, agranulocytosis, pancytopenia, hemolytic anemia in patients with congenital glucose-6-phosphate dehydrogenase deficiency.

From the side of metabolism: hypoglycemia, hyperkalemia, reversible after discontinuation of the drug, hyponatremia.

From the nervous system: paresthesia, headache, dizziness, vertigo, sleep disturbances, mood lability, drowsiness, fainting, confusion.

From the senses: visual disturbances, tinnitus.

From the side of the cardiovascular system: excessive decrease in blood pressure and related symptoms, vasculitis, tachycardia, palpitations, cardiac arrhythmias, angina pectoris, myocardial infarction and stroke, possibly due to excessive reduction in blood pressure in high-risk patients.

From the respiratory system: cough, shortness of breath, bronchospasm, eosinophilic pneumonia, rhinitis.

From the digestive system: constipation, nausea, vomiting, abdominal pain, taste disturbance, dyspepsia, diarrhea, dryness of the oral mucosa, pancreatitis, hepatitis (cholestatic or cytolytic).

From the skin and subcutaneous fat: skin itching, rash, photosensitivity, pemphigus, increased sweating.

Allergic reactions: angioedema, urticaria, erythema multiforme.

From the musculoskeletal system: muscle spasms, arthralgia, myalgia.

From the urinary system: renal failure, acute renal failure.

From the reproductive system: erectile dysfunction.

General reactions: asthenia, chest pain, peripheral edema, weakness, fever, falls.

On the part of laboratory parameters: increased activity of hepatic transaminases and bilirubin in blood serum, increased concentration of urea and creatinine in blood plasma.

special instructions

With caution, perindopril should be used with bilateral stenosis of the renal arteries or stenosis of the renal artery of a single kidney; renal failure; systemic connective tissue diseases; therapy with immunosuppressants, allopurinol, procainamide (risk of developing neutropenia, agranulocytosis); reduced BCC (diuretics, salt-restricted diet, vomiting, diarrhea); angina; cerebrovascular diseases; renovascular hypertension; diabetes mellitus; chronic heart failure IV functional class according to the NYHA classification; simultaneously with potassium-sparing diuretics, potassium preparations, potassium-containing table salt substitutes, with lithium preparations; with hyperkalemia; surgery/general anesthesia; hemodialysis using high-flow membranes; desensitizing therapy; LDL apheresis; condition after kidney transplantation; aortic stenosis/mitral stenosis/hypertrophic obstructive cardiomyopathy; in black patients.

Cases of arterial hypotension, syncope, stroke, hyperkalemia and impaired renal function (including acute renal failure) have been reported in predisposed patients, especially when used simultaneously with drugs that affect the RAAS. Therefore, dual blockade of the RAAS by combining an ACE inhibitor with an angiotensin II receptor antagonist or aliskiren is not recommended.

Before starting treatment with perindopril, all patients are recommended to study kidney function.

During treatment with perindopril, kidney function, the activity of liver enzymes in the blood, and peripheral blood tests should be regularly monitored (especially in patients with diffuse connective tissue diseases, in patients who receive immunosuppressive drugs, allopurinol). Patients with sodium and fluid deficiency should be corrected for fluid and electrolyte disturbances before starting treatment.

drug interaction

The risk of developing hyperkalemia increases with the simultaneous use of perindopril with other drugs that can cause hyperkalemia: aliskiren and aliskiren-containing drugs, potassium salts, potassium-sparing diuretics, ACE inhibitors, angiotensin II receptor antagonists, NSAIDs, heparin, immunosuppressants such as cyclosporine or tacrolimus, trimethoprim.

When used concomitantly with aliskiren in patients with diabetes mellitus or impaired renal function (GFR

Simultaneous use with aliskiren is not recommended in patients who do not have diabetes mellitus or impaired renal function, because. possible increased risk of hyperkalemia, deterioration of renal function and increased incidence of cardiovascular morbidity and mortality.

It has been reported in the literature that in patients with established atherosclerotic disease, heart failure, or diabetes mellitus with end organ damage, concomitant therapy with an ACE inhibitor and an angiotensin II receptor antagonist is associated with a higher incidence of hypotension, syncope, hyperkalemia, and deterioration of renal function (including acute renal failure) compared with the use of only one drug that affects the RAAS. Double blockade (for example, when an ACE inhibitor is combined with an angiotensin II receptor antagonist) should be limited to individual cases with careful monitoring of renal function, potassium and blood pressure.

Simultaneous use with estramustine may lead to an increased risk of side effects such as angioedema.

With the simultaneous use of lithium preparations and perindopril, a reversible increase in the concentration of lithium in the blood serum and associated toxic effects are possible (this combination is not recommended).

Simultaneous use with hypoglycemic drugs (insulin, oral hypoglycemic agents) requires special care, because. ACE inhibitors, incl. perindopril, may enhance the hypoglycemic effect of these drugs up to the development of hypoglycemia. As a rule, this is observed in the first weeks of simultaneous therapy and in patients with impaired renal function.

Baclofen enhances the antihypertensive effect of perindopril, while the use of baclofen may require dose adjustment of the latter.

In patients receiving diuretics, especially those that remove fluid and / or salts, an excessive decrease in blood pressure may be observed at the beginning of perindopril therapy, the risk of which can be reduced by discontinuing the diuretic, replenishing the loss of fluid or salts before starting perindopril therapy, and using perindopril in low initial dose followed by a gradual increase.

In chronic heart failure in the case of the use of diuretics, perindopril should be used at a low dose, possibly after reducing the dose of the simultaneously used potassium-sparing diuretic. In all cases, renal function (creatinine concentration) should be monitored during the first weeks of ACE inhibitor use.

The use of eplerenone or spironolactone in doses from 12.5 mg to 50 mg / day and ACE inhibitors (including perindopril) in low doses: in the treatment of heart failure II-IV functional class according to the NYHA classification with left ventricular ejection fraction

The simultaneous use of perindopril with NSAIDs (acetylsalicylic acid at a dose that has an anti-inflammatory effect, COX-2 inhibitors and non-selective NSAIDs) can lead to a decrease in the antihypertensive effect of ACE inhibitors. The simultaneous use of ACE inhibitors and NSAIDs can lead to deterioration of renal function, including the development of acute renal failure, and an increase in serum potassium, especially in patients with reduced renal function. Use this combination with caution in elderly patients. Patients should receive adequate fluids; it is recommended to carefully monitor renal function, both at the beginning and during treatment.

The hypotensive effect of perindopril may be enhanced when used simultaneously with other antihypertensive drugs, vasodilators, including short-acting and long-acting nitrates.

Simultaneous use of gliptins (linagliptin, saxagliptin, sitagliptin, vitagliptin) with ACE inhibitors (including perindopril) may increase the risk of angioedema due to suppression of dipeptidyl peptidase IV activity by gliptin.

Simultaneous use of perindopril with tricyclic antidepressants, antipsychotics and general anesthesia agents may lead to an increase in the antihypertensive effect.

Sympathomimetics can weaken the antihypertensive effect of perindopril.

When using ACE inhibitors, incl. perindopril, in patients receiving an intravenous gold preparation (sodium aurothiomalate), a symptom complex was described, in which facial skin hyperemia, nausea, vomiting, arterial hypotension were observed.

Overdose

Symptoms: pronounced decrease in blood pressure. shock, stupor, bradycardia, fluid and electrolyte imbalance (hyperkalemia, hyponatremia), renal failure, hyperventilation, tachycardia, palpitations, dizziness, anxiety, cough.

Treatment: emergency measures are reduced to removing the drug from the body: gastric lavage and / or taking activated charcoal, followed by restoration of water and electrolyte balance.

With a pronounced decrease in blood pressure - give the patient a horizontal position with raised legs and take measures to replenish the volume of circulating blood (BCC). With the development of severe bradycardia, not amenable to drug therapy (including atropine), an artificial pacemaker is indicated. It is necessary to monitor vital functions and concentrations of creatinine and electrolytes in the blood serum. Periidoprilat, the active metabolite of perindopril, can be removed from the systemic circulation by hemodialysis. The use of high flow polyacryl nitrile membranes should be avoided.

Storage conditions

Store at a temperature not exceeding 25°C. Keep out of the reach of children.

The drug is a reliable, affordable antihypertensive, antiarrhythmic agent.

It is prescribed for cardiac failures provoked by various factors, including dysfunctions of the renal genesis.

It is used in the treatment of the elderly, people with diabetes, with ischemic processes in the heart. This article will describe in detail about the drug Perindopril, instructions for use, price, reviews, analogues and other information about which is presented below in an accessible, understandable form.

This medicine has a hypotensive, cardioprotective, vasodilating effect, as well as natriuretic.

The mechanism of action of Perindopril determines the expediency of using this drug in the treatment regimen for the following pathologies:

• essential, renovascular;
• secondary hypertension;
• stable ischemic heart disease;
• unspecified heart failure;
• stroke;
• high blood pressure in diabetics.

Compound

• the substance perindopril in the form of a tert-butylamine salt;
• lactose monohydrate;
• magnesium stearate;
• aerosil.

The active substance is one, is at the head of the list, and the remaining four components perform auxiliary functions in the preservation of the active element, its proper breakdown, absorption in the body.

Release form

This medicine is produced exclusively in tablet form. There are two dosage options: Perindopril 4 mg and 8 mg of the active ingredient. Packing is always the same: in each pack of 30 pieces.

pharmachologic effect

The drug contains a substance that, after a series of transformations, turns into an active metabolite called perindoprilat. It has the ability, has a depressing effect on the production of NA from the endings of sympathetic fibers, significantly slows down the formation of endothelin in the vessels.

Perindopril Sandoz

The therapeutic effect of the drug is based on the inhibition of the rate of conversion of angiotensin-1 into an octapeptide with a bright vasoconstrictor activity and the ability to reduce the secretion of aldosterone - angiotensin-2. In parallel, there is also a secondary increase in renin activity.

The drug has a vasodilatory effect, significantly reduces vascular resistance in the pulmonary system, and reduces afterload. During use, a pronounced cardioprotective, as well as natriuretic effect is observed. Taking the drug also increases the minute volume of the myocardium, increases its tolerance to various loads.

The effect develops slowly, one hour after oral administration of the drug.

It should be noted that the decrease in blood pressure is not accompanied by an increase in heart rate.

The drug optimizes blood circulation not only in the cardiovascular system, but also in the GM, kidneys, reduces the need for cells in oxygen in chronic ischemia.

In addition, the agent improves tissue sensitization to the action of insulin. This medicine also has a well-pronounced antioxidant effect, slows down the formation of dependence on nitrates.

The best therapeutic effect is observed 4-6 hours after the introduction of the drug into the body, lasts almost a day.

Dosage

The initial dosage of Perindopril is 1-2 mg per day, gradually adjusting the dose to an effective therapeutic one. The optimal daily intake for hypertension is 4-8 mg of the active substance daily.

Accompanying pills Perindopril, instructions for use at what pressure it is to use them does not indicate. With congestive CHF, the doctor usually prescribes 2-4 mg.

If the baseline pressure in elderly patients is low, the amount of the drug will be 1 mg per day, if the treatment is combined and there is a risk of undesirable effects.

In order to prevent a second stroke, 2 mg is initially prescribed for 14 days, and then 4 mg for the same period of time. With stable CAD, therapy starts with 4 mg, and after two weeks, subject to a satisfactory response and tolerability, the dose is doubled.

The increase in doses is carried out very carefully, slowly, within a month. Take the medicine once a day. The standard dose for renovascular hypertension is 2 mg.

Contraindications

The instructions for use accompanying Perindopril MIC and SZ indicate the following contraindications:

• hypersensitivity to components;
• age up to 18 years;
• pregnancy planning;
• bearing a child;
• angioedema;
• lactation.

Use the drug with extreme caution when:

• aortic stenosis;
• dehydration;
• constrictive pericarditis;
• moderate renal failure;
• mitral stenosis;
• atherosclerosis of the arteries of the extremities;
• the presence of a donor kidney;
• bilateral stenosis of the renal arteries;
• thrombocytopenia;
• autoimmune diseases;
• obstruction of blood vessels;
• low concentration of sodium;
• hyperkalemia;
• obliterating atherosclerosis.

Side effects of the drug

Perindopril tablets can cause side effects and effects, such as:

• dry mouth;
• asthenia;
• cough;
• perversion of taste;
• rash;
• inflammation of the pancreas;
• cranialgia;
• worsening sleep;
• paresthesia;
• chest pain;
• dyspeptic disorders;
• mood lability;
• convulsions;
• change in the amount of hemoglobin;
• alopecia;
• increased levels of uric acid;
• weakness;
• bronchospasm;
• increased creatinine;
• erythema;
• eosinophilic inflammation of the lungs;
• agranulocytosis;
• angioedema;
• sexual dysfunction;
• muscle spasms;
• vasculitis;
• rhinitis;
• dyspnea;
• stomatitis;
• tinnitus;
• dysgeusia;
• erythema multiforme;
• hemolytic anemia;
• cytolytic hepatitis;
• hyperhidrosis;
• arterial hypotension;
• renal dysfunction;
• erythrocytopenia.

Overdose

If the dose is exceeded, the following symptoms are possible:

• acute hypotension;
• angioedema.

Treatment includes the following items:

• drug withdrawal;
• gastric lavage;
• antihistamines;
• Hydrocortisone;
• epinephrine;
• dialysis with a significant excess of the dose.

Interaction

Able to increase hypotension are muscle relaxants, anesthetics, other antihypertensive drugs (this includes ophthalmic drugs with beta-blockers), diuretics, alcohol, antipsychotics, imipramine antidepressants.

Antacids reduce absorption, and any NSAIDs, sympathomimetics, estrogens weaken the effects. A combination of Perindopril and is often used (instructions for use for this drug are subject to separate consideration).

perindopril and amlodipine

The drug increases the hypoglycemic effect of antidiabetic drugs, which can cause hypoglycemia. All loop diuretics enhance the hypotensive effect of the drug, which brings to the fore the risk of renal dysfunction.

Potassium-containing drugs, diuretics, cyclosporine increase the risk of hyperkalemia. The agent increases the toxic effect, the concentration of lithium, the risk of neutropenia with the parallel use of interferons. Any tetracyclines reduce the volume, the rate of absorption of the drug.

When interacting with Nimodipine, it is possible to increase congestive CHF, rhythm disturbances. Parallel intake of nitrates can cause critical hypotension. The use of antipsychotics simultaneously with the agent under discussion can cause orthostatic hypotension.

Analogues

Analogues should be understood as means with the same non-proprietary international name.

There are many substitutes for the medicine, they are presented below for informational purposes:

• Accupro;
• Ampril;
• Berlipril;
• Gopten;
• Zocardis;
• Irumed;
• Cardipril;
• Coverex;
• Lysigamma;
• Lysinocol;
• Lizoril;
• Meryl;
• Moex;
• Normopress;

The drug Perindopril-C3

The exact cost is determined by each pharmacy chain and may differ significantly from the prices presented for informational purposes.

Related videos

How to take Perindopril correctly, you can learn from this video:

In conclusion, it should be said that, despite its effectiveness, relative availability, Perindopril has a number of side effects, and can also interact with a large list of drugs, which is why it cannot be prescribed independently. The treatment regimen should be prescribed by a competent specialist, since only he can choose the right drugs in optimal dosages.