Description overdue on 04/15/2014

• Composition
• Product form
• Pharmacological action
• Pharmacodynamics and pharmacokinetics
• Indications
• Contraindications
• Side effects
• Instructions for use (method and dosage)
• Overdose
• Cooperation
• Terms of sale
• Storage conditions
• Shelf life
• Cautions
• Reviews
• Price, where to buy

Composition

In tablets, the Co-Perineva contains the following elements:

• indapamide . perindopril erbumine ;
• prefabricated pellets   - Lactose monohydrate, calcium chloride hexa hydrate, Valium;
• Excipients   - Microcrystalline cellulose, colloidal silicon dioxide, magnesium stearate, sodium bicarbonate.

Product form

White round tablets, biconvex on one side a short line are etched.

Tablets Co-produced Perineva 10 tablets in a blister in a carton contains 3, 6, 9 blisters. Depending on the package, one tablet contains 0, 625 + 2 mg of active substance 1, 25 + 4 mg or 2 mg of 5 + 8.

Pharmacological action

Denies drug vasodilator, diuretic and hypotensive action.

Pharmacodynamics and pharmacokinetics

Ko Perineva is a combined preparation comprising perindopril   and indapamide .

The drug fails antihypertensive effects, effectiveness is not dependent on the age of the patient, the position of his body, is not accompanied by tachycardia. No effect on lipid metabolism, including those suffering from diabetes . When taking the drug reduced the risk of hypokalemia .

During the day, the antihypertensive effect persists.

Within a month of the drug is achieved by lowering blood pressure. In the case of cessation of treatment there is no risk of withdrawal .

Perindopril is extremely effective in the fight against hypertension   (all forms of gravity). After 4-6 hours after taking the drug develops maximum antihypertensive effect that persists throughout the day.

Perindopril is rapidly absorbed after administration of the gastrointestinal tract. The bioavailability at the level of 65-70%. After 3-4 hours after administration of the drug reaches the maximum level in the blood plasma. It undergoes metabolism in the liver, forming an active ( perindoprilat ) And five inactive metabolites. A small number of perindoprilat passes into breast milk and placenta. Excreted through the kidneys.

Perindoprilat slowed excretion in patients with cardiac and renal insufficiency and in patients older than 65 years. In patients with cirrhosis, the hepatic clearance is reduced by half, however, while not reducing the level perindoprilat.

Indapamide almost completely absorbed from the gastrointestinal tract, this process can slow down the simultaneous adoption of the food. After one hour reaches the maximum level in the blood. The liver is metabolized. Excreted through the kidneys and bowels.

Indications

The drug should be taken at essential hypertension .

Contraindications

The drug Ko Perineva contraindicated in the following cases:

• sensitivity to any element of the preparation;
• lactose intolerance ;
• refractory hyperkalemia ;
• anginevrotichesky swelling ;
• bilateral renal artery stenosis ;
• lactase deficiency ;
• hepatic failure ;
• galactose malabsorption glucose ;
• renal failure ;
• renal artery stenosis ;
• pregnancy, lactation, children under 18 years.

Precautions should take the drug in the following cases:

• connective tissue disease ( scleroderma . SLE );
• immunosuppressive therapy;
• suppression of bone marrow hematopoiesis;
• angina ;
• renovascular hypertension;
• reduction of BCC;
• hyperuricemia ;
• diabetes ;
• cerebrovascular disease.

Side effects

Use of the drug may cause the following side effects:

• thrombocytopenia . agranulocytosis . hemolytic anemia . leukopenia . aplastic anemia ;
• vertigo . paresthesia , Dizziness, headache; unstable mood, sleep disturbance; in rare cases - confusion;
• ringing in the ears, blurred vision;
• orthostatic hypotension .   Arrhythmia   ( bradycardia . atrial fibrillation . ventricular tachycardia ) myocardial infarction . angina ;
• dry cough, dyspnea, bronchospasm, rhinitis . eosinophilic pneumonia ;
• dry mouth, constipation, nausea, abdominal pain, loss of appetite, epigastric pain, vomiting, diarrhea, dyspepsia, pancreatitis . jaundice ;
• angioneurotic edema (face, lips, limbs, then, tongue, larynx), rash, hives Itching;
• muscle spasms;
• renal insufficiency;
• impotence ;
• asthenia , Increased sweating.

Instructions for use (method and dosage)

Medicine Co-Perineva take a day 1 time inside, in the morning before breakfast, drinking water.

The doses listed in the ratio indapamin / perindopril .

The first step is to take one tablet per day (0, 625/2 mg). If within one month fails to achieve control of blood pressure, the dose is increased to one tablet (1, 25/4 mg). To achieve the maximum expression of the effect, the limit should be increased to a daily dose - one tablet (2, 5/8 mg).

For elderly patients   the initial dose is one tablet (0, 625/2 mg). Drug treatment can be administered in the case of the control of blood pressure and renal function.

Patients with mild renal insufficiency   start with the lowest dose, the maximum permitted dose is 1 mg 25/4.

Overdose

Symptoms of overdose: vomiting , Nausea, muscle cramps, drowsiness , Dizziness, confusion, decreased water and electrolyte balance, oliguria , A significant reduction in pressure.

When the above symptoms should wash out the stomach, then take activated carbon Restore water and electrolyte balance. With strong pressure decrease the patient should lie on your back and raise the legs, then enter 0, 9% sodium chloride solution.

Cooperation

Do not combine the drug with the Co-Perineva ACE inhibitors   and lithium preparations As possible growth of lithium in the blood. If necessary, take the same time should be kept under the control of the level of lithium.

With the utmost care taken baclofen Which can enhance the hypotensive effect. It should control pressure, renal function, if necessary to adjust the dose.

Antipsychotics   and tricyclic antidepressants   enhance the effects of hypotension and increases the possibility of orthostatic hypotension.

Tetrakozaktit   and GCS   help to reduce the hypotensive effect.

When concomitantly with any other antihypertensives   there is the possibility of a stronger manifestation of hypotensive effect.

Perindopril

At the same time it is not recommended for use with potassium-sparing diuretics   ( spironolactone . amiloride . eplerenone . triamterene ) And potassium supplements . With their parallel application may increase potassium levels in the blood, in connection with the possible death. If necessary, the combination therapy (with hypokalemia) necessary to monitor the level of potassium and ECG parameters.

Special care is recommended to take the drug Co-Perineva conjunction with insulin   and hypoglycemic agents . Increases the risk of leukopenia   when used with cytostatic immunosuppressants . allopurinol . GCS   and procainamide . In the application of the means for general anesthesia may increase the hypotensive effect. When used in high doses thiazide   and loop diuretics   can lead to hypovolemia .

Indapamide

Drugs that cause arrhythmia (type " pirouette ") Must be taken with caution as there is a possibility of hypokalemia . The caution is recommended to take Indapamide with such drugs as a neuroleptics   ( tsiamemazin . trifluoperazine . hlopromazin   and etc.), antiarrhythmic drugs   ( amiodarone . gidrohinidin . Ibutilide . tozilad   and etc.), benzamides   ( sultopride . tiaprid . sulpiride . amisulpride ) buterofenony   ( haloperidol . droperidol ), Other drugs ( astemizole . mizolastine . sparfloxacin . Methadone . bepridil . halofantrine . terfenadine . cisapride ).

Medications that can cause the appearance of hypokalemia : tetrakozaktid . laxatives Which stimulate intestinal motility, Amphotericin B . glucocorticoids . mineralocorticoid . cardiac glycosides .

Increased risk lactic acidosis   when used with metformin . Patients receiving contrast media with high doses of iodine risk of occurrence of renal failure. Hypercalcemia It can occur when taking formulations containing the calcium salt.

Terms of sale

Sold in pharmacies by prescription.

Storage conditions

At a temperature not exceeding 30 ° C.

Shelf life

3 years.

Cautions

Do not take along with lithium preparations .

The therapy is absolutely contraindicated in patients with impaired renal function . Patients suffering hypertension May have symptoms renal failure . In this case it is necessary to stop treatment means Ko Perineva. Later, you can repeat the treatment, assigning the minimum dose, or used in monotherapy with perindopril and indapamide. Every two weeks, these patients should check the level creatinine   and Potassium in blood.

The combination Indapamide   and Perindopril   can not prevent the development of hypokalemia Especially in cases where the patient has diabetes or renal failure. The level of potassium in the blood in this case must be monitored regularly.

Reviews on Koh Perinevu

Reviews on the pill taking among their patients generally positive, but many say the manifestation of side effects, even at the lowest dose administration.

Price Koh Perinevy

The cost of the drug in Russia is on average about 350 rubles per pack of 30 pieces. and 900 rubles per 90 pieces. packaged. The average price in the Ukraine on the package 30 pcs. - 205 UAH., 90 pieces per package. - 400 UAH.