Indications |
Oral Hypertension Adult: As erbumine: Initially, 4 mg once daily. 1st dose preferably given at bedtime. Patients with renovascular hypertension, volume depletion, severe hypertension: Initially, 2 mg once daily. Max: 8 mg daily. Patients on diuretics: Withdraw diuretics 2 or 3 days before perindropil therapy. Resume later if required. If diuretic cannot be discontinued, an initial dose of 2 mg once daily may be given. Elderly: As erbumine: Initially, 2 mg once daily. May be progressively increased to 4 mg after 1 mth then to 8 mg if needed according to renal function.
Oral Heart failure Adult: As erbumine: Initially, 2 mg in the morning. Increase by 2-mg increments at no <2 wk intervals to a maintenance dose of 4 mg/day.
Oral Stable ischaemic heart disease Adult: As erbumine: Initially, 4 mg once daily for 2 wk then titrate up to a maintenance dose of 8 or 10 mg once daily if tolerated. Elderly: As erbumine: Initially, 2 mg once daily on the 1st wk, increase as tolerated to 4 mg once daily on the 2nd wk, then increase again as tolerated to a maintenance dose of 8 mg once daily.
Special Populations: Renal impairment: CrCl >60 mL/min: 4 mg/day; 30-60 mL/min: 2 mg/day; 15-29 mL/min: 2 mg every other day; <15 mL/min: 2 mg on the day of dialysis. Maintenance dose: 2 mg daily or on alternate days, depending on the ° of impairment. Hepatic impairment: No dosage adjustment needed. Patients receiving diruetics: Discontinue diuretics 2 or 3 days before starting perindopril, resumed later if necessary. |
||||||||||||||||||||||||
Contraindications |
History of angioedema related to previous ACE inhibitor treatment. Pregnancy (2nd/3rd trimesters). | ||||||||||||||||||||||||
Warnings / Precautions |
History of airway surgery. Withdraw if there is significant increase in LFTs. Risk factors for hyperkalaemia; monitor potassium closely. Patients dependent on renin-angiotensin-aldosterone system; consider withdrawal in patients with progressive deterioration in renal function. Collagen vascular disease. Hypovolaemia; monitor BP with the 1st dose. Unilateral renal artery stenosis and pre-existing renal insufficiency; valvular aortic stenosis. Before, during, or immediately after anaesthesia. May impair ability to drive or operate machinery. Lactation. | ||||||||||||||||||||||||
Adverse Reactions |
Headache, dizziness, sleep disorders, depression, fever, nervousness, somnolence; cough, upper respiratory tract infection, sinusitis, rhinitis, pharyngitis; oedema, chest pain, abnormal ECG, palpitation; rash; hyperkalaemia, elevated triglycerides, menstrual disorder; nausea, diarrhoea, vomiting, dyspepsia, abdominal pain, flatulence: UTI, sexual dysfunction; increased LFTs; weakness, musculoskeletal pain, upper and lower extremity pain, hypertonia, paraesthesia; proteinuria; tinnitus, ear infection; viral infection, allergy. Potentially Fatal: Anaphylactoid reactions, angioedema. |
||||||||||||||||||||||||
Overdose Reactions |
Symptom: Mild hypotension, bradycardia, hyperkalaemia (especially in patients with renal insufficiency), circulatory shock, renal failure, hyperventilation, tachycardia, palpitations, dizziness, anxiety, and cough. Treatment: Symptomatic and supportive. Haemodialysis may be beneficial. | ||||||||||||||||||||||||
Drug Interactions |
Excessive BP reduction may occur in patients on diuretics. Increased risk of hyperkalaemia with potassium supplements, potassium-sparing diuretics, trimethoprim. May increase lithium levels/toxicity. May increase hypersensitivity reactions to allopurinol. Effects may be reduced by aspirin or other NSAIDs and/or adverse renal effects may be increased. May increase nephrotoxicity of ciclosporin. May increase the adverse/toxic effects (nitritoid reaction) of gold sodium thiomalate. Increased risk of hypoglycaemia with insulin. Increased risk of neutropenia with mercaptopurine. See Below for More perindopril Drug Interactions |
||||||||||||||||||||||||
Food Interactions |
Conversion to active form reduced with food. Ephedra, yohimbe and ginseng may worsen hypertension. Garlic may increase antihypertensive effect. | ||||||||||||||||||||||||
Mechanism of Actions |
Perindopril is a prodrug of perindoprilat, which is a competitive ACE inhibitor. Perindoprilat prevents conversion of angiotensin I to angiotensin II. It acts as a vasodilator and it reduces peripheral resistance. Onset: Within 1 hr; max effect at about 4-8 hr. Duration: 24 hr. Absorption: Rapidly absorbed from the GI tract. Bioavailability: 65-75%. Peak plasma concentrations of perindoprilat: 3-4 hr after an oral dose of perindopril. Distribution: Protein-binding: Perindopril: 60%. Perindoprilat: 10-20%. Metabolism: Mainly hepatic; extensively metabolised to perindoprilat (active metabolite) and inactive metabolites. Food may reduce the conversion to perindoprilat. Excretion: Mainly via urine (as unchanged drug, as metabolites). Elimination half-life of perindoprilat: 25-30 hr or longer; excretion reduced in renal impairment. Both drug and active metabolite are dialysable. |
||||||||||||||||||||||||
Administration |
Should be taken on an empty stomach. (Take before meals.) |
||||||||||||||||||||||||
Storage Conditions |
Oral: Store at 20-25°C (68-77°F). Protect from moisture. | ||||||||||||||||||||||||
ATC Classification |
C09AA04 - perindopril ; Belongs to the class of ACE inhibitors. Used in the treatment of cardiovascular disease. | ||||||||||||||||||||||||
Storage |
Oral: Store at 20-25°C (68-77°F). Protect from moisture. | ||||||||||||||||||||||||
Available As |
|
Perindopril (Perindopril Erbumine)
Post Review about Perindopril (Perindopril Erbumine) Click here to cancel reply.
Perindopril (Perindopril Erbumine) Containing Brands
Perindopril (Perindopril Erbumine) is used in following diseases
Drug - Drug Interactions of Perindopril (Perindopril Erbumine)
Latest News
- FDA approves Ruconest for treatment of hereditary angioedema
- FDA recommend against aspirin to prevent First Heart Attacks
- FDA approves Pomalyst (pomalidomide) for advanced multiple myeloma
- FDA approves three new drug treatments for type 2 diabetes
- Long-term consequences of vaginal delivery on the pelvic floor
No comments yet.