Perinev's medicine includes the following components:
- perindopril erbumin;
- lactose monohydrate, calcium chloride hexahydrate, crospovidone;
- silicon dioxide colloidal, MCC, magnesium stearate.
The drug is available in the form of round white biconvex tablets with a risk of 8, 4 or 2 mg on one side. The blister contains 10, 14 or 30 tablets.
Perineva has a hypotensive, vasodilating and cardioprotective effect.
Pharmacodynamics and pharmacokinetics
Perindopril has a therapeutic effect due to perindoprilat (active metabolite). It reduces systolic and diastolic pressure, OPSS, as a result of which blood pressure decreases. The peripheral blood flow is accelerated, but the pulse does not increase.
The maximum effect is manifested after taking an average of 4-6 hours and lasts for a day.
Arterial pressure dropping pretty fast. Pressure stabilization is observed after about a month of therapy. After discontinuation of treatment, withdrawal syndrome does not develop.
Increases the elasticity of arteries, helps eliminate their structural changes. Normalizes the functioning of the heart muscle, reduces preload and afterload.
Maximum concentration perindopril in the blood after taking an hour is observed. It is rapidly absorbed from the digestive tract. Bioavailability is 65-70%.
Simultaneous food intake with the drug reduces the conversion of perindopril to perindoprilat, which, accordingly, reduces its bioavailability. It is excreted through the kidneys, does not cumulate.
Indications for use
What are the tablets of Perinev from? Perinev's drug is prescribed in the following cases:
- re-stroke prevention (complex therapy in conjunction with Indapamide);
- chronic heart failure;
- arterial hypertension;
- stable ischemia of the heart.
The drug should not be taken with:
- sensitivity to any component of the drug;
- glucose / galactose malabsorption syndrome;
- age up to 18 years;
- lactase deficiency;
- history of angioedema (angioedema, idiopathic or hereditary edema as a result of taking ACE inhibitors);
- galactose intolerance.
With caution, the drug is used for:
- bilateral renal artery stenosis;
- chronic renal failure;
- Renovascular Hypertension;
- stenosis of a single kidney artery;
- decompensation stages of heart failure;
- hyponatremia, hypovolemia;
- cerebrovascular disease;
- hypertrophic obstructive cardiomyopathy;
- after kidney transplantation;
- connective tissue diseases;
- general anesthesia;
- in old age.
The following side effects may occur as a result of taking Perinev's drug:
- paresthesia, dizziness, headache;
- noise in ears;
- visual impairment;
- a significant decrease in blood pressure, angina pectoris, arrhythmias, stroke, myocardial infarction, vasculitis;
- dyspneabronchospasm, cough, rhinitis, eosinophilic pneumonia;
- abdominal pain, nausea, dysgeusia, vomiting, constipation, diarrhea, dyspepsiadry mouth pancreatitis, cholestatic or cytolytic hepatitis;
- itching, swelling of the extremities, face, rash, hives, erythema multiforme;
- muscle cramps;
- impotence, renal failure;
- increased sweating asthenia;
- decrease in hemoglobin and hematocrit, neutropenia, leukopenia, thrombocytopenia, pancytopenia, agranulocytosis (manifested when applied in high dose over a long period of time), hemolytic anemia (rarely appears in patients with glucose-6-phosphate dehydrogenase deficiency);
- increased concentration of urea and creatinine, hyperkalemia (reversible after discontinuation of the drug), hypoglycemia, increased activity of liver enzymes.
Instructions for use Perineva (Method and dosage)
The drug should be taken 1 time, in the morning, inside, before meals.
The instructions for the tablets indicate that the dose is selected for each patient individually, depending on the severity of the disease and the reaction to therapy.
At arterial hypertension Perinev’s medicine can be used both in monotherapy and simultaneously with other drugs that reduce blood pressure. The initial daily dose should not exceed 4 mg. If therapy fails within a month, the dose can be raised to 8 mg (with normal transfer of the previous dose).
Before you start taking this drug, you must stop taking diuretics at least 3 days in advance, since the combined use of these drugs can lead to arterial hypotension.
Elderly patients it is not recommended at the beginning of the course to take a dose above 2 mg per day. If necessary, with normal tolerance can be increased to 4 mg, and then up to 8 mg.
At chronic heart failure take the drug only under medical supervision, you should start with a minimum dose (2 mg). You can increase the dose to 4 mg no earlier than a week later.
As prophylactic from a repeated stroke, the dose of the drug to start with is 2 mg. You can start taking the drug within two weeks after suffering a stroke.
Recommended Dose for Ischemic heart disease is 4 mg. When monitoring kidney function, after two weeks, the dose can be doubled (8 mg).
At kidney disease the dose of the drug is prescribed individually, based on the diagnosis and degree of violations. It is necessary to constantly monitor the patient's condition, in particular, the level of creatinine and potassium ions in the blood.
Adjust dose when liver diseases no need.
In case of an overdose, the patient may experience the following symptoms: shock, renal failure, bradycardiaa sharp decrease in blood pressure, hyponatremiadizziness, cough, hyperkalemia, tachycardiaanxiety hyperventilationheartbeat.
With a sharp decrease in blood pressure the patient should take a supine position, slightly raise his legs, it is also necessary to carry out measures to replenish the BCC. With bradycardiawhich is not amenable to therapy (in particular, anthropin), you need to install pacemaker (artificial pacemaker). Perindopril can be removed from the bloodstream by hemodialysis.
Simultaneous adoption of Perineva with diuretics may lead to arterial hypotension. It is possible to reduce the risk of its occurrence by canceling the intake of diuretics or taking the drug in lower doses. In the future, an increase in the dose of Perineva should be prescribed with caution.
The combination of perindopril with potassium-sparing diuretics, products and additives, as well as potassium preparations may lead to the development of hyperkalemia. They should be prescribed exclusively with hypokalemia with maximum caution, while controlling the level of ions.
Perindopril with lithium preparations can cause lithium toxicity and increase lithium levels in the blood, so it is not recommended to prescribe them at the same time. If necessary, such a combination should monitor the concentration of lithium in the blood.
A decrease in the antihypertensive effect may occur as a result of the combination of Perineva with NSAIDs. Also, such therapy can lead to a deterioration in the condition of the kidneys. In some cases, this can lead to acute renal failure.
The antihypertensive effect of perindopril can be enhanced by the simultaneous use of other drugs that lower blood pressure, or vasodilators.
Hypoclycemic agents (including insulin) and Perinev in joint use can cause an increase in the hypoglycemic effect, up to glycemia.
Sympathomimetics eradicate the therapeutic effect of perindopril, with their appointment it is necessary to monitor the effectiveness of Perineva.
To enhance the hypotensive effect can antidepressants, antipsychotics and general anesthetics.
Possible combination of Perineva with nitrates, acetylsalicylic acid, beta blockers and thrombolytic agents.
Terms of sale
In a dark place at a temperature of 25 ° C.
Perindopril is not recommended to be taken along with lithium preparations, potassium-sparing diuretics and potassium-containing drugs, products and additives.
At diabetes the first 3 months of taking Perineva in patients should monitor the level of glucose in the blood.
When driving, the risk of side effects such as dizziness and a sharp decrease in pressure should be taken into account.
Analogs of PerinevMatches for ATX Level 4 code:DilaprelPrenesaEnapDirotonLiprilReniprilParnawelFozinapTritaceEnamZokardisFosinoprilLisinoprilCaptoprilMonoprilRenetekHartilFosicardAmprilanRamipril
The following drugs are considered analogues of this drug: arentopres, hypernik, carpet cover, paranovel, perinpress, perindopril.
Reviews about Perinev
Among patients, reviews about this drug are rather controversial. On the one hand, many note its effectiveness, on the other - the effect of taking the medicine spoils side effects, in particular coughing and dizziness.
The cost of tablets in Russia depending on the packaging is 220 rubles (4 mg), 330 rubles (8 mg). In Ukraine, the price of 8 mg - 180 UAH., 4 mg - 130 UAH.
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