Table of Contents
Usage (Indication)
Treatment of hypertension. Treatment of symptomatic heart failure. Reduces risk of cardiovascular events in patients with a history of myocardial infarction and or revascularization.
Dosage
Hypertension: can be used alone or in combination with other antihypertensive drugs. Recommended starting dose: 5mg once daily in the morning. Patients with a highly active renin-angiotensin-aldosteron system (in particular, renal artery hypertension, salt loss and or or hypovolemia, cardiac decompensation or severe hypertension) may experience hypotension. strong pressure after the first dose: an initial dose of 2.5 mg should be recommended and initiation of therapy should be under medical supervision. Dosage may be increased to 10mg once daily after 1 month of treatment.
Symptomatic hypotension may occur after initiation of perindopril, which occurs more often in patients receiving concomitant diuretic therapy. If possible, the diuretic should be stopped 2-3 days before starting perindopril. In patients with hypertension who are unable to stop the diuretic: perindopril should be started with 2.5 mg. Monitoring of renal function and serum potassium should be observed. The perindopril dose supplement should be adjusted according to the blood pressure response. If required, diuretic treatment can be restarted.
In elderly patients: can start 2.5mg and gradually increase dose to 5mg after 1 month and then 10mg if necessary depending on kidney function.
Symptomatic Heart Failure: When combining perindopril with non-potassium-sparing diuretics and or digoxin and / or beta blockers, medical supervision should be performed and the recommended starting dose is 2.5mg in the morning. Dosage may be increased to 5mg once daily after 2 weeks if tolerated. The dose adjustment should be based on the clinical response of the individual patient.
Stable coronary artery disease: The starting dose should be started at 5mg once daily for 2 weeks, then increased to 10mg once daily, depending on kidney function and a well-tolerated 5mg dose. Elderly patients: The dose should be 2.5 mg once daily for the first week, then 5 mg once daily for the next week before increasing to 10 mg once daily, depending on renal function. The dose should be increased only if the previous dose is well tolerated.
Renal impairment: should be adjusted based on creatinine clearance: CIcr ≥ 60: 5mg / day; 30 <CIcr <60: 2.5mg / 1 day; 15 <CIcr <30: 2.5mg every 2 days; CIcr <15: 2.5mg on day of hemodialysis
Patients with hepatic impairment: no dose adjustment is required
Children: not recommended.
Usage: Use once daily before breakfast.
Do not use in the following cases (Contraindicated)
Are allergic to the active ingredient or any ingredient in the drug, or to any other ACE inhibitor. History of angioedema associated with previous use of ACE inhibitors. Inherited or idiopathic angioedema. Stage two and three of pregnancy. Concomitant use of Coversyl with products containing aliskiren in patients with diabetes or renal impairment.
Cautions for use (Warnings and precautions)
- Stable coronary artery disease.
- Lower blood pressure.
- Aortic and mitral stenosis / hypertrophic cardiomyopathy
- CKD.
- Patients on hemodialysis
- Kidney transplant
- Hypersensitivity / Angioedema
- Anaphylactic reactions during filtration of low density lipoprotein (LDL) type
- Anaphylactic reactions during desensitization
- Liver failure
- Neutropenia / Agranulocytosis / Thrombocytopenia / Anemia
- Race
- A cough
- Surgery / Anesthesia
- Increased serum potassium
- Glycorrhea patient
- Lithium
- Potassium-sparing diuretics, potassium supplements or potassium-containing salts
- Renin-angiotensin-aldosteron (RAAS) double blockers
- Pregnant
Undesirable effects (Side effects)
In clinical and observed studies: Common: dizziness, headache, paresthesia, dizziness, visual disturbances, tinnitus, hypotension, cough, dyspnea, abdominal pain, constipation, diarrhea diarrhea, loss of taste, gastrointestinal disturbances, nausea, vomiting, pruritus, rash, cramps and weakness.
In clinical trials and / or in circulation:
Common: dizziness; headache; paresthesia; dizziness; visual disturbances; Tinnitus; lowering blood pressure; a cough; shortness of breath; stomachache; constipation; diarrhea; loss of taste; digestive disorders; nausea; vomit; itching; foreign committee; cramp; attenuate.
Uncommon: leukocytosis; Hypoglycemia; hyperkalemia, reversible when stopping the drug; hyponatremia; mood disturbances; sleep disorders; dozing off; faint; palpitations; fast heart beat; vasculitis; bronchospasm; Dry mouth; Urticaria; edema of the face, limbs, lips, mucous membranes, tongue, glottis and / or larynx; photosensitivity; bullous nodules on the skin; sweating a lot; athritis; muscle pain; impaired kidney function; erectile dysfunction; chest pain; feeling of difficulty; peripheral edema; fever; increased blood urea; increase in blood creatinine; fall.
Rarely: increased serum creatinine; increased liver enzymes.
Very rare: agranulocytosis or a decrease in the whole erythrocyte; decreased hemoglobin and red blood cell volume reduction; leukopenia / neutropenia; hemolytic anemia in patients with congenital G-6PDH deficiency; thrombocytopenia; confused; chest pain; arrhythmia; myocardial infarction, which may be secondary to an episode of excessive hypotension in high-risk patients; stroke, which can be secondary to an episode of excessive hypotension in high-risk patients; eosinophilia pneumonia; rhinitis; pancreatitis; cytostatic hepatitis or cholestatic hepatitis; Morphological erythema multiforme; acute renal failure.
References:
- Coversyl 5mg Perindopril arginine for the treatment of cardiovascular blood pressure
- Perindopril | Side Effects, Dosage, Uses, and More – Healthline
- Perindopril: medicine to treat high blood pressure
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