Description overdue on 09/23/2014

• Composition
• Product form
• Pharmacological action
• Pharmacokinetics and pharmacodynamics
• Indications Noliprel
• Contraindications
• Side effects
• Instructions for use Noliprel (method and dosage)
• Overdose
• Cooperation
• Terms of sale
• Storage conditions
• Shelf life
• Cautions
• Analogs
• Babies
• With alcohol
• During pregnancy (and lactation)
• Reviews
• Price, where to buy

Composition

The preparation Noliprel   available in several different forms. The composition of the drug include all variations perindopril   and indapamide . The combined pill Noliprel   are composed of 2 mg of perindopril or 0 625 mg indapamide. The structure of funds Noliprel Forte   It includes 4 mg perindopril and 1, 25 mg indapamide. A Noliprel   seats 2, 5 mg of perindopril or 0 625 mg indapamide. This drug is associated with perindopril amino acid arginine, which favorably affects the cardiovascular system.

In tablets A Noliprel Forte   - 5 mg of perindopril and 1, 25 mg indapamide. The vehicle Noliprel A Bi-forte   - 10 mg of perindopril, and 2, 5 mg indapamide.

As additional substances in a preparation have Noliprel magnesium stearate, lactose monohydrate, colloidal silica, hydrophobic, microcrystalline cellulose.

Product form

The formulations are produced in the form of tablets white oblong tablet on both sides of risk. Accommodates carton of 14 and 30 pieces. in blisters.

Pharmacological action

Noliprel - a combined tool, in which structure there perindopril (angiotensin-converting factor) and indapamide (diuretic that is included in the sulfonamide group).

The pharmacological action of the drug is determined by a combination of some of the effects of these components .  This combination of the two components are mutually enhance the action .  Noliprel - hypertensive drug, effectively reducing both diastolic and systolic blood pressure .  The degree of influence depends on the dose .  After receiving the money is not marked palpitation .  The clinical effect is observed after 1 month after treatment was initiated .  The antihypertensive effects persists for one day .  Once therapy is stopped, the patient is not marked withdrawal .  In the treatment reduced the severity of left ventricular hypertrophy, reduced the overall level of atrial and postcardiac load .  Large vessels become more elastic walls of small blood vessels are restored .  Metabolic processes which occur in the body, the drug has no effect .

Perindopril reduces secretion of aldosterone, resulting in enhanced activity of renin in the blood. Arterial pressure   is reduced in people with different levels of activity Renin . Under the influence of this component dilates blood vessels.

Before the drug is less likely hypokalemia . The mechanism of action of indapamide is similar to thiazide diuretics: Efforts urination and urinary excretion of sodium, chlorine.

Hyperreactivity vessels under the influence of adrenaline reduced. The amount of lipids in the blood is not changed.

Pharmacokinetics and pharmacodynamics

Pharmacokinetics of perindopril and indapamide when used in the complex is the same as in the separation of their use. After ingestion of perindopril is rapid adsorption. The level of bioavailability - 65-70%. About 20% of the total absorbed later converted into perindopril perindoprilat (active metabolite). Perindoprilat maximum concentration in the plasma is observed after 3-4 hours. Blood proteins binds less than 30%, depending on the concentration in the blood plasma. The half-life is 25 hours. The placental barrier substance penetrates. Perindoprilat excreted through the kidneys displayed. Its half-life time - 3-5 hours. There slower introduction of perindoprilat the elderly and in patients with heart failure and renal failure.

Indapamide entirely and relatively rapidly absorbed from the gastrointestinal tract. Maximum concentration in plasma observed one hour after oral administration.

The plasma protein material binds 79%. Half-life - 19 hours. Displayed substance in the form of inactive metabolites kidneys (approximately 70%) and intestine (about 22%). Persons with renal insufficiency, changes in the pharmacokinetics of the substance is observed.

Indications Noliprel

There have been indications for the use of such medications:

• Essential hypertension ;
• the need to reduce the risk of microvascular complications manifestations in people with kidney disease, blood vessels and the heart, which then suffer   hypertension , and diabetes   the second type.

Contraindications

Contraindications to the use of all types of drug Noliprel are those diseases and conditions:

• High sensitivity to the constituents of the preparation or the existence allergic reactions   into its components;
• renal failure In which creatinine clearance is less than 30 ml / min;
• hepatic failure At which a disposition to encephalopathy ;
• combination with drugs prolong the interval QT, and antiarrhythmic drugs;
• hypokalemia ;
• renal artery stenosis ;
• lactase deficiency, glucose galactose malabsorption syndrome, galactosemia;
• angioedema in history;
• pregnancy . lactation ;
• the age of eighteen.

Also, do not take the vehicle at the same time with the preparations of potassium, potassium-sparing diuretics, if the patient has hyperkalemia.

In the absence of sufficient information is not recommended to use a tablet for the treatment of people who are on hemodialysis And in patients with decompensated heart failure.

Carefully appointed people with systemic connective tissue diseases, those who are taking antidepressants, the oppression of bone marrow hematopoiesis. Also with caution to patients being treated angina , Renovascular hypertension, cerebrovascular disease, hyperuricemia, labile blood pressure.

Side effects

• The functions of the cardiovascular system : Severe hypotension, orthostatic collapse, in rare cases: arrhythmia . stroke . myocardial infarction .
• The functions of the genitourinary system : Worsening of renal function, proteinuria in people with glomerular nephropathy, in rare cases - acute renal failure. There may be a decrease in potency.
• The functions of the central and peripheral NA : Severe fatigue, dizziness . headache , Asthenia, unstable mood, hearing, vision, loss of appetite, seizures, in some cases - a stupor.
• The functions of the respiratory system Cough, difficulty breathing, bronchospasm, nasal discharge.
• The functions of the digestive tract : Dyspepsia, abdominal pain, pancreatitis , Cholestasis, increased activity of transaminases, hyperbilirubinemia.
• The functions of the blood system : Against the background of dialysis or a kidney transplant patients may develop anemia, in rare cases - thrombocytopenia, pancytopenia, agranulocytosis, hemolytic anemia.
• Allergic symptoms : Itching, rash, swelling, hives.
• Patients with hepatic insufficiency may develop hepatic encephalopathy. In people with impaired water and electrolyte balance may show hyponatremia, hypovolemia, hypokalemia, dehydration.

Instructions for use Noliprel (method and dosage)

Tablets Noliprel desirable to take in the morning. The drug is assigned one tablet a day. Instructions on Noliprel Forte provides for a similar treatment regimen. Noliprel A and B Noliprel A Forte given to patients: 1 tablet per day. If creatinine clearance in patients greater than or equal to 30 ml / min, then there is no need to reduce the dosage. If the clearance is equal to or greater than 60 ml per day, the treatment must carefully control the level of potassium in the blood, and creatinine.

If necessary, after a few months of treatment, your doctor may increase the dose, instead of appointing Noliprel drug Noliprel A Fort or the other version of this drug.

Overdose

With an overdose of the drug observed a strong decrease in pressure, nausea, vomiting,   dizziness , Instability of mood, symptoms of renal failure, electrolyte imbalance. In this case, you should immediately bring to normal fluid and electrolyte balance, stomach wash, take chelators. Print noliprel metabolites can be by dialysis. If necessary, the intravenous administration of physiological saline.

Cooperation

Do not take Noliprel at one time with lithium. If it is impossible to cancel one of the drugs should be closely monitored in the lithium content in the blood.

Simultaneous treatment of potassium-sparing diuretics or drugs with potassium can increase the concentration of potassium in the blood. This combination is recommended only if hypokalemia.

When combined indapamide   with vincamine, bepridilom, sultopride, halofantrine, and while intravenous administration Erythromycin   may show arrhythmia, bradycardia.

Sometimes, while treatment Insulin   and Noliprel may develop hypoglycaemia.

When you receive a non-steroidal anti-inflammatory drugs inhibited Noliprel antihypertensive properties. During dehydration, this combination of drugs can cause kidney damage or kidney failure.

When treating Noliprel and neuroleptics or tricyclic antidepressants may develop orthostatic hypotension.

In view of the delay in the body of water and electrolytes while Noliprel and mineralocorticoid treatment, corticosteroids, stimulant laxatives, tetrakozaktidom, amphotericin B reduced hypotensive effects and increases the likelihood of hypokalemia.

Because of the possibility of hypokalemia increases the risk of toxic effects of cardiac glycosides.

When combined with metformin may develop lactic acidosis .

Before using iodinated radiopaque agents with Noliprel need to spend adequate hydration of the body.

Concomitant use of calcium can cause hypercalcemia.

Simultaneous treatment with cyclosporine may increase the level of creatinine in the blood.

Terms of sale

The pharmacy Noliprel all varieties can be purchased by prescription.

Storage conditions

Store should be at a temperature not exceeding 30 ° C, the drug should be protected from access by children.

Shelf life

Shelf life 3 years.

Cautions

People who received treatment Noliprel necessary to conduct adequate dehydration of the body, to prevent a sharp decline in pressure.

People with heart failure can simultaneously treat beta-blockers.

When treating Noliprel noted a positive reaction during the doping test.

In the first week of treatment, it is important to carefully drive trucks or work with the precise mechanism for the treatment of Noliprel.

If the treatment is noted strong pressure reduction may require the introduction of 0.9% sodium chloride intravenous.

Treatment of patients with circulatory insufficiency of the brain or coronary heart disease you need to start with small doses Noliprel.

People who have very high levels of uric acid in the blood, in the treatment of varieties of the drug increases the risk of Noliprel gout .

Analogs Noliprel

Analogs Noliprel and preparations Noliprel A Bi Forte, Forte Noliprel And - this is the other tools that are used to reduce blood pressure and contain similar active ingredients, that is, perindopril and indapamide. These drugs are drugs Co-prenesa . Prestarium   et al. Price analogs may be lower than the cost Noliprel and its variants.

Babies

The drug is not indicated for the treatment of children under 18 years of age, as there is no accurate data on the efficacy and safety of this treatment.

With alcohol

Do not drink alcohol during treatment Noliprel.

During pregnancy and lactation

Pregnant women   and mothers during feeding   child breast milk Noliprel use is contraindicated. A systematic treatment of these drugs can lead to anomalies and diseases of the fetus and cause fetal death. If a woman finds out about the pregnancy during treatment, there is no need to interrupt the pregnancy, but the patient should be aware of the possible consequences. In the case of high blood pressure is assigned to other antihypertensive therapy. If a woman takes the drug in the second and third trimesters, fetal ultrasound should be performed to assess the state of his skull and the kidneys.

Newborns whose mothers took the drug can suffer from symptoms of hypotension, so they need to provide constant supervision of specialists.

When feeding, the drug is contraindicated in breast milk, so the lactation at the time of treatment should stop, or to find another drug.

Reviews Noliprel

Reviews on the forums about Noliprel, as well as the preparations Noliprel A Noliprel A Forte, Forte Noliprel A BBC indicate that the drug effectively lowers blood pressure. Medicine supports normal blood pressure, to reduce the risk of stroke and myocardial infarction.

Reviews for Forte Noliprel often contain information that the drug and its other variants it possible to obtain positive results in those cases when other drugs are ineffective. Sometimes patients note the development of certain adverse events, in particular, dry cough, headache, but they are not very intense.

Doctors also note the positive impact of drugs, but it is always pointed out that a means must be taken strictly according to instructions and with the advice of a specialist. In particular, the drug must be taken regularly, not only during the period of intensive blood pressure surges.

Price Noliprel where to buy

Price Noliprel an average of 500 rubles per pack of 30 pieces. Price in Moscow Noliprel A equals 500 to 550 rubles. Price Noliprel Forte ranges from 550 rubles per pack. A Noliprel Forte 5 mg can be bought at the price of 650 rubles. Cost Noliprel A Bi Forte ranges from 700 rubles. 30 pieces per pack.