Perindopril for hypertension - instructions for the drug

Perindopril is prescribed to treat hypertension (high blood pressure) and cardiac ischemia (decreased or blocked blood supply to the heart). The medicine belongs to the ACE inhibitors. The mechanism of its action is to dilate blood vessels. This helps improve blood flow. Below is detailed information about the drug Perindopril - instructions for use, recommendations for therapy, negative effects of the drug.

What does Perindopril help with?

The medicine reduces the likelihood of recurrent heart attacks and is the only medicine proven to be effective in preventing recurrent strokes.
For older people, the use of Perindopril helps preserve memory and concentration, and prevents the development of senile dementia. After a course of treatment with Perindopril, according to medical studies, the following results were achieved:

• Normalization of blood pressure indicators – 97%;
• Elimination of palpitations – 99%;
• Reduction in the severity of venous thrombosis – 80%;
• Improved night sleep and increased vigor during the day – 97%.
• Relief from headaches – 100%.

Perindopril helps reduce and normalize blood pressure and maintains a long-term therapeutic effect.

Indications for use:

• Heart failure (chronic);
• Prevention of strokes that occur against the background of ischemia;
• Renovascular and arterial hypertension;

Perindopril is an effective drug for the treatment of arterial hypertension

• Prevention of stroke recurrence;
• Ischemia.

For patients who have had a stroke and suffer from ischemic attacks, the medicine is prescribed in combination with diuretics. This reduces the likelihood of a recurrent stroke by 75%.

Perindopril is prescribed to lower blood pressure even in patients with kidney problems and who are overweight. The medicine is well tolerated in diabetes of any type, because accelerates metabolic processes and increases sensitivity to insulin.

Indications for use

This substance is an ACE inhibitor and has vasodilating properties. Its main function is the suppression of angiotensin-converting enzyme, as a result of which blood pressure is normalized and myocardial function is stabilized.

Main indications for use:

• cardiac ischemia;
• arterial hypertension;
• chronic heart failure.

Also, drugs with this active ingredient are indicated for patients who have suffered a stroke, to reduce the possibility of its recurrence, and for chronic high blood pressure to normalize it.

Be careful! Do not use drugs containing perindopril arginine to quickly reduce blood pressure and relieve a hypertensive crisis.

Noliprel, Co-Pireneva perindopril indapamide

For many patients, taking the drug Perindopril alone is not sufficient to normalize blood pressure; therapy is supplemented with several other effective drugs. To make the work of doctors easier, pharmacists have created combination drugs with perindopril base.

indapamide analogues

Cheaper, containing indapamide and perindopril, synonymous analogues from the group of combined drugs: Prilamid tablets cost from 200 to 400 rubles, Co-Prenessa tablets - 400 rubles, Perindid - 300 rubles. The difference in price, as you can see, is noticeable.

Analogs for the combination of “perindopril plus indapamide” can also be selected from the group of combined ACE inhibitors, which include other active substances. For example, Ampril Hd tablets (ramipril + hydrochlorothiazide) cost 400 rubles, and similar Euroramipril tablets cost 200 rubles.

Analogs containing perindopril + indapamide are not particularly noted for their quality. A low price does not always guarantee the preservation of the properties of original drugs.

Price and analogues

You can buy the drug Prestarium at a price of 370 rubles, Perindopril - from 90 rubles, the average cost from different manufacturers is about 250 rubles.

When choosing analogues, a doctor may consider the following options:

1. Prilamide;
2. Bi-Prestarium;
3. Prestarium-Combi;
4. Promepril;
5. Triplix;
6. Triveram.

The drugs Prestarium and Perindopril are analogues. The choice of medication depends on the underlying disease and associated disorders.

Perindopril-Indapamide Richter

To enhance the therapeutic effect, some drugs with perindopril as an active substance are produced in combination with other antihypertensive substances. For example, Perindopril Indapamide Richter, produced by a well-known company in Poland, contains perindopril and indapamide (a diuretic).

Thanks to the combination of such components, this drug has a wider list of indications for use, which is discussed in detail in the annotation for the combined Perindopril - instructions for use

At what pressure you should pay attention to this particular medication, it is better to decide with your doctor

Analogs

We examined drugs containing arginine as the main active ingredient of perindopril. There are a small number of them on the Russian market. But there are analogues of these medications with the main active ingredient in the form of erbumine salt. They belong to the same pharmacotherapeutic group and have the same pharmacodynamics. Analogues containing erbumine include:

1. Analogues of the substance perindopril. There are also other ACE inhibitors:
   zofenopril - included in the drug Zocardis in the amount of 7.5 mg;
2. captopril - included in Blockordil, Captopril, Capoten, Angiopril, etc.;
3. lisinopril - found in the drugs Dapril, Diropress, Diroton, Irumed;
4. ramipril - drugs Amprilan, Dilaprel, Corpril, Pyramil;
5. spirapril - contained in the drug Quadropril;
6. trandolapril - included in Gopten capsules.
7. Analogs of tablets with the indapamide + perindopril complex, in the form of erbumine:
   Ko Parnavel;
8. Ko-Perineva;
9. Co-Prenessa;
10. Perindapam;
11. Perindid.
12. Analogs of tablets with the active ingredients perindopril erbumine and amlodipine:
    Amlopress;
13. Dalneva;
14. Parnavel Amlo.
15. There is only one drug with a complex of perindopril erbumine + indapamide + amlodipine - Triplixam (discussed above), which has no analogues.

Cheap analogs of Perindopril that do not contain perindopril

If substitute medications are identical both in composition and in their effect on the patient’s body, then other similar medications may contain different components, but be characterized by the same effect in treating heart failure and arterial hypertension.

For example, the drug “Lisinopril” is an analogue of “Perindopril”, which contains an active substance that is similar in action to perindopril - lisinopril. This is also a drug from the group of ACE inhibitors.

The average cost of this analogue is 200 rubles. It is also available in tablet form. You can also find the medicine “Lizinopril” in pharmacies, made in Ukraine, Germany or Israel. Buyers give preference to the drug produced in Germany.

This remedy is ideal for people suffering from obesity and diabetes, for whom it is very difficult to choose medications to lower blood pressure, since many of them have a large list of side effects that are life-threatening for such patients.

Of course, this remedy, along with its advantages, also has disadvantages: it can cause dizziness, nausea, dry cough, and diarrhea.

The drug is contraindicated for use in case of kidney and liver diseases, during pregnancy, breastfeeding, children under 18 years of age, with hereditary angioedema, and intolerance to lisinopril and other components of the drug.

When choosing analogues for the drug "Perindopril", you can also choose the drug "Enalapril". It contains a substance similar in its effect on the patient’s body to perindopril, enalapril maleate. This medicine is also an ACE inhibitor, therefore, it lowers blood pressure and at the same time reduces the load on the heart, preventing the complex consequences of hypertension.

The medicine is produced in Serbia and Macedonia. The drug has proven itself in medical practice as reliable. Release form: tablets. The cost of one package of pills ranges from 100 to 200 rubles.

May cause the following side effects: dizziness, asthenia, skin rash and itching, fatigue, drowsiness, anxiety, dry cough. Also, this drug can cause a sharp decrease in blood pressure, so its use should be accompanied by the supervision of the attending physician, since the wrong dose can cause an overdose, and therefore worsen the patient’s condition.

There are many substitutes for the drug "Perindopril". Analogues of the drug can also be selected from the group of ACE inhibitors containing the active substance captopril, similar to perindopril. This is the medicine “Captopril”, which is applicable in the treatment of arterial hypertension, coronary heart disease and heart failure.

The drug is produced in Slovenia and Ukraine. The average cost of this medicine is 300 rubles.

This medicine may also cause side effects such as blurred vision, fatigue, headaches, thrombocytopenia, decreased appetite, stomatitis, itching, tachycardia, acidosis.

Before using cheap analogues of the drug "Perindopril", you should carefully study the instructions for them. They should only be prescribed by the attending physician. Each of them has its own list of side effects and a list of contraindications that should not be underestimated.

Treatment of hypertension is not simple, each patient has his own tendency to tolerate one or another component of drugs, and it is not so easy to choose the right drug that will not cause discomfort during treatment.

Selecting an individual therapeutic agent can only be done by testing medications.

Comparison of side effects by frequency

A drug	Common side effects	Rare
Prestarium	Sleep disturbance, mild headache, drowsiness during the day, confusion, paresthesia; symptoms associated with low blood pressure; shortness of breath, cough; skin rashes, angioedema; nausea, diarrhea, vomiting	Hyponatremia, hypoglycemia, hyperkalemia; angina pectoris, arrhythmia; rhinitis, eosinophilic pneumonia; pancreatitis, dry mouth; hepatitis; photosensitivity; myalgia, arthralgia
Perindopril	Severe decrease in blood pressure; loss of appetite, nausea, vomiting; skin itching, urticaria, erythema multiforme; asthenia, fatigue, drowsiness	Pancreatitis, cholestatic jaundice; insomnia, confusion; agranulocytosis, hemolytic anemia; sexual dysfunctions, erectile dysfunction

The risk of side effects from Prestarium and Perindopril increases if the instructions for use are not followed. Important

strictly follow the course of treatment and dosage prescribed by your doctor.

Features of treatment with Perindopril

Perindopril is usually well tolerated by patients and does not cause undesirable consequences. Negative reactions occur only in 8-10% of cases.

Perindopril can cause the following disruptions in the body:

• From the gastrointestinal tract: diarrhea, indigestion, loss of appetite, dry mouth, vomiting, inflammation of the pancreas;
• From the heart and blood vessels: angina pectoris, arrhythmia;
• From the respiratory system: prolonged dry cough;
• From the side of the central nervous system: deterioration of mood, increased sweating, headache, muscle cramps, ringing in the ears, severe fatigue, dizziness;

Headaches may occur when taking Perindopril.
In rare cases, Perindopril affects a decrease in sexual function, but this is a temporary phenomenon. It has been proven that with long-term use, the drug does not reduce potency, but, on the contrary, stimulates the production of androgens and improves erectile function.

The most common side effect when taking Perindopril is a dry cough. If this phenomenon is permanent and long-lasting, the drug should be discontinued and replaced with medications of another drug group.

If side effects develop, the doctor examines the patient and, if necessary, adjusts the dosage of the medication or prescribes another drug. In each situation, an individual decision is made depending on the underlying pathology and the complexity of side effects.

Perindopril should not be taken if:

• Individual intolerance to the components of the drug;
• Pregnancy and lactation;
• The patient is under 18 years of age.

For elderly people, patients with renal failure and patients with diabetes, Perindopril is not prohibited for use. However, the drug must be taken under medical supervision.

The medicine should be used with caution in the following pathological conditions:

• Moderate renal failure, renal artery stenosis;
• Aortic and mitral stenosis;
• Having a transplanted kidney;
• Low concentration of leukocytes and platelets in blood counts;
• Severe autoimmune disorders;
• Complex pathologies of the heart and blood vessels, affecting the deterioration of blood flow in the heart;
• Violation of water and electrolyte balance.

If the dosage of the medication is violated, severe negative reactions may occur, including a decrease in blood pressure to critical levels and the development of Quincke's edema. In this case, immediate discontinuation of the drug and symptomatic therapy are required: the use of antihistamines, the administration of drugs to increase the volume of circulating blood, dialysis, and gastric lavage.

Combining any medications with Perindopril without the consent of your doctor is prohibited, because uncontrolled use can cause serious consequences for the body. Thus, psychotropic, diuretic drugs, anesthetics and muscle relaxants enhance the hypotensive effect of Perindopril and increase the risk of a sharp decrease in blood pressure.

Special instructions:

• When taking the drug, you should not drink alcohol, since alcohol enhances the hypotensive effect of Perindopril and can lead to the development of serious side effects: acute coronary circulatory failure, sudden loss of consciousness, etc.
• Before using Perindopril, you should warn your doctor about taking other medications, about any nutritional supplements, herbal decoctions and tinctures used by the patient.
• Before the course of therapy, it is recommended to undergo a liver and kidney examination, and stop taking diuretics at least three days before treatment.
• In the first days of taking Perindopril, it is better to refrain from driving and performing dangerous work, because the drug may cause drowsiness and weakness.

If you missed taking the drug for some reason, you cannot change the dosage yourself and take a double dose of the medicine. It is necessary to continue taking the drug according to the indicated therapeutic regimen.

Interaction with other drugs

When undergoing a course of treatment, which includes the use of the medication Perindopril or Amlodipine, you should completely stop using diuretics. This combination is extremely undesirable and dangerous, since diuretics significantly enhance the antihypertensive effect that the above-mentioned drug has. And therefore, the risk that this will negatively affect the kidneys increases many times over.

Doctor's opinion: “The medicine does not combine well with drugs that belong to the category of antidepressants. If these drugs are taken concomitantly, there is a high risk that the patient will develop severe hypotension. Of course, this is highly undesirable. Therefore, if it is not possible to stop taking antipsychotics, you need to think about replacing Perindopril with another drug.”

Indomethacin is allowed to be taken in parallel with the drug Perindopril. However, it is necessary to take into account the fact that it can reduce the antihypertensive effect. Consequently, there is a need to adjust the dosage of Indomethacin in order to achieve a positive effect from the course of treatment.

If the drug is prescribed to patients who have been diagnosed with a disease such as diabetes, it is necessary to reconsider the relevance of the selected dose of insulin. This need is due to the fact that during treatment with Perindopril, hypoglycemia develops in patients with diabetes mellitus. This happens because glucose tolerance increases.

Pharmacological properties

Pharmacodynamics

Perindopril is an ACE inhibitor. It is a prodrug that, after biotransformation in the human body, turns into perindoprilat (an active metabolite). The mechanism of action of the substance is presumably associated with competitive inhibition of ACE activity, as a result of which the rate of conversion of angiotensin I into a powerful vasoconstrictor, angiotensin II, decreases. Due to a decrease in the concentration of angiotensin II, plasma renin activity secondarily increases and the secretion of aldosterone directly decreases. Due to the vasodilating effect of the drug, the total peripheral vascular resistance decreases, preload and resistance in the pulmonary vessels decreases; cardiac output and resistance to stress increases.

The hypotensive effect of Perindopril develops within the first hour after taking the tablet, the maximum effect is observed after 4–8 hours, and the duration of the antihypertensive effect is 24 hours.

The drug significantly reduces the likelihood of a recurrent stroke and the risk of fatal or disabling strokes; complications of cardiovascular diseases (including heart attack); severe cognitive impairment; dementia due to stroke. The listed therapeutic benefits were observed both in patients with normal blood pressure and in patients with arterial hypertension, regardless of gender, age, absence or presence of stroke and diabetes mellitus.

Perindopril is used as monotherapy and in combination with amlodipine or indapamide.

Pharmacokinetics

Absorption of the substance is rapid: 1 hour after taking the drug orally, the maximum concentration of perindopril is detected in the blood, and after 3-4 hours - perindoprilate.

About 27% of perindopril absorbed in the gastrointestinal tract is converted into pharmacologically active perindoprilat. During metabolism, five more inactive metabolites are formed. The half-life of perindopril is 1 hour, perindoprilat - 3-4 hours.

Taking tablets with food reduces the bioavailability of the drug.

About 20% of perindoprilate binds to plasma proteins, the level of binding depends directly on the concentration of the active substance. The volume of distribution of unbound perindoprilate is approximately 0.2 l/kg.

Perindoprilate is excreted by the kidneys. The total half-life of the free fraction is 17 hours, which ensures an equilibrium systemic concentration of the substance within 4 days.

In elderly patients and persons with renal and heart failure, the elimination of perindoprilate is slowed down. For patients with renal failure, the dose of Perindopril is adjusted depending on the degree of renal dysfunction.

The elimination rate of perindoprilate in persons on dialysis is 70 ml/min.

In liver cirrhosis, the hepatic clearance of perindopril is reduced by 2 times, but the amount of perindoprilate formed remains unchanged, so dose adjustment is not required.

Composition and pharmacological action

The drug is available in tablet form. Perindopril tablets are intended for oral use only. The main active ingredient of the drug is Perindopril. Tablets may contain 4 and 8 mg of this substance. In addition, the product also contains other components that act as excipients. One of these components is lactose monohydrate. That is why this drug is never prescribed to people who are intolerant to this component.

Perindopril belongs to the category of ACE inhibitor drugs. With its help, it is possible to achieve vasoconstriction. It is believed that the drug has this effect due to the fact that it helps slow down the process of converting angiotensin into another form. The powerful vasoconstrictor effect makes the drug a leader among similar medications. That is why it is customary to include it in therapy when treating patients suffering from high blood pressure. The drug is capable of:

• reduce post- and preload;
• reduce resistance in the pulmonary vessels;
• increase cardiac endurance and minute blood volume.

In this case, the concept of endurance of the heart muscle should be understood specifically as tolerance to various types of stress. If we talk exclusively about the hypotensive effect, then it is achieved quite quickly. Already 60 minutes after taking the medication, the patient experiences a decrease in blood pressure. The effect reaches its maximum after a few hours. The main advantage of the product is considered to be the duration of the effect. After all, it lasts for 24 hours.

Mechanism of action

We can say that it is the pharmacological group of the drug that determines the main mechanism of action of the drug. Entering the body, under the influence of hepatic esterases, it is converted into an active metabolite - perindoprilat, which has the following effects:

• causes expansion of peripheral (mainly resistive) vessels and a moderate drop in blood pressure;
• reduces pre- and afterload on the heart muscle;
• corrects blood circulation in the pulmonary circulation and respiratory function;
• reduces vascular resistance of the renal arteries, improving blood flow in them.

Imported analogues of the drug

There are several analogues of Prestance on the pharmaceutical market. This:

• Amlopress from JSC Gedeon Richter;
• Dalneva from KRKA LLC.

Both drugs have the same differences from the original drug as Parnavel Amlo.

Analogues of Prestance include 2 more drugs:

• Ko-Dalneva from KRKA;
• Triplixam from Servier.

However, these medicines have a significant difference - a three-component composition. To enhance the antihypertensive effect, they additionally contain a diuretic substance, indapamide.

If we talk about drug analogues by pharmacological group (drugs containing a combination of ACE inhibitors and BMCC), then there are the following drugs:

• Coripren and Enap L Combi (contain enalapril with lercanidipine);
• Tenliza, Equator, Equacard, Eclamise (contain amlodipine with lisinopril);
• Triapine (contains felodipine and ramipril);
• Egipres (ramipril and amlodipine);
• Enanorm (enalapril and nitrendipine).

Naturally, only the attending physician can replace Prestance with one of its analogues.

Combination drugs

In severe hypertension, taking one drug often does not give the desired effect, so patients need to take 3-4 drugs at once. In this case, it is recommended to use special medications, which are a combination of perindopril with other chemicals - amlodipine (Prestans, Dalneva) and indapamide (Noliprel, Co-Perineva). Such combinations of components are well tolerated by the body, can be used in patients with concomitant diseases (diabetes, etc.) and reduce blood pressure much more effectively. In difficult cases (when pressure readings exceed 160/110 mmHg or higher), the doctor may prescribe three medications at once - indapamide, amlodipine and perindopril. The combination of these agents allows you to maintain pressure at 140/90 mmHg in 75% of patients.

Perindopril is an effective drug that, when used correctly and following precautions, will quickly reduce blood pressure and relieve the patient from the manifestations of arterial hypertension.

Adverse reactions

Even in the absence of contraindications, adverse reactions are possible, of which you should immediately notify your doctor.

The reaction is expressed in different signals from the body systems:

1. Urinary. Deterioration of kidney function, acute renal failure.
2. Respiratory system. Cough, bronchospasms.
3. Digestion. Nausea, abdominal pain, diarrhea or constipation, taste disturbance.
4. Allergic reactions. Rash, itching.
5. Nervous system. Poor sleep, headache, dizziness, blurred vision.
6. Heart and blood vessels. A sharp decrease in blood pressure, arrhythmia, angina pectoris.
7. Test indications. Decreased hemoglobin, increased urea and creatinine in the blood, increased liver enzymes and liver bilirubin.

Perindopril instructions for use dosage and method

Perindopril tablets are taken orally, before meals, once a day, preferably in the morning. The dosage is selected individually after assessing the severity of the disease and the patient’s response to the drug.

Chronic heart failure (CHF)

It is recommended to start treatment with a dose of 2 mg once a day (in the morning). After 2 weeks, you can increase the dose to 4 mg per day once, while blood pressure should be constantly monitored. Therapy for CHF with clinical symptoms is usually combined with beta-blockers, digoxin and/or potassium-sparing diuretics.

Treatment of patients with CHF, with a tendency to hyponatremia, renal failure, as well as patients who are simultaneously taking vasodilators and/or diuretics, must begin under the strict supervision of a physician.

In individuals at high risk of clinically significant hypotension, electrolyte abnormalities and hypovolemia should be corrected before starting the drug. It is also recommended to monitor serum potassium levels, blood pressure and renal function before using Perindopril and throughout the course.

Arterial hypertension

The standard starting dose for the treatment of arterial hypertension is 4 mg per day once (in the morning).

In some patients (with hyponatremia and/or hypovolemia, severe arterial hypertension, renovascular hypertension, decompensated CHF), it is recommended to reduce the initial dose to 2 mg per day once. If there is no improvement within a month of therapy, the dose can be increased to 8 mg once a day (provided the initial dose is well tolerated).

When Perindopril is added to patients taking diuretics, arterial hypotension may develop.

In this case, treatment should be carried out with caution, if possible, stopping diuretics 2-3 days before starting perindopril therapy and starting the drug with a minimum dose of 2 mg per day. In the future, depending on the dynamics of blood pressure, you can increase the dose and also resume taking the diuretic

Stable coronary heart disease

The initial dose of Perindopril is 4 mg per day once. After 2 weeks, if the drug is well tolerated and there is no impairment of renal function, the dose is increased to 8 mg per day once.

Prevention of recurrent stroke

Treatment with the drug begins with a dose of 2 mg once a day and continues for 2 weeks (before starting indapamide therapy). Then it is possible to increase the daily dose to 4 mg once. Treatment can begin 2 weeks after the stroke (or any time up to several years after the stroke).

For elderly patients, the initial daily dose of Perindopril is 2 mg. After some time, it is gradually increased to 4 mg and, if necessary, to 8 mg once a day (if previous doses are well tolerated).

In patients with renal failure, the dose of the drug is adjusted depending on the degree of renal dysfunction. With a creatinine clearance of 60 ml/min or more, the daily dose of perindopril is 4 mg, 30–60 ml/min – 2 mg per day, 15–30 ml/min – 2 mg per day every other day, less than 15 ml/min (patients on hemodialysis) – 2 mg per day on the day of dialysis (after the procedure).

Use for kidney and liver problems

If the patient already has kidney problems, when treating with perindopril arginine, their condition should be regularly monitored and the potassium level in the blood checked. Use the medicine with extreme caution when:

• renal artery stenosis;
• having only one kidney;
• chronic renal failure;
• hemodialysis.

In patients with liver cirrhosis, the hepatic clearance of perindopril is reduced by 50%, but the amount of perindoprilate formed does not decrease. So it is not recommended to change the dosage.

Release form and composition

Perindopril is available in the form of tablets and film-coated tablets in dosages of 2, 4 and 8 mg.

Description of film-coated tablets (manufactured by Izvarino Pharma LLC):

• film-coated tablets 2 mg: biconvex, round, white or almost white, a white or almost white core is visible on the cut;
• film-coated tablets 4 mg: biconvex, round, light green or green in color, a white or almost white core is visible on the cut;
• 8 mg film-coated tablets: biconvex, round, gray-green or green with a grayish tint, a white or almost white core is visible on the cut.

Film-coated tablets are packaged in blisters of 10 pcs. 1, 2, 3, 5, 6 or 9 blisters are placed in a cardboard box along with instructions for using Perindopril.

Description of tablets (manufactured by PRANAFARM LLC):

• 2 mg tablets: biconvex, round, white or almost white, without lines;
• 4 mg tablets: biconvex, round, white or almost white, scored on one side;
• 8 mg tablets: flat-cylindrical, round, white or almost white, with a chamfer and a score on one side.

Perindopril tablets produced by PRANAFARM LLC are packaged in blisters of 7 pcs. (2, 3 or 4 blisters in a cardboard box) or 10 pcs. (1, 2, 3, 4 or 5 blisters in a cardboard package).

Description of tablets (manufactured by Aurobindo Pharma Ltd.):

• 4 mg tablets: oval, white or off-white, engraved “D” on one side and engraved “5” and “8” separated by a score on the other;
• 8 mg tablets: biconvex, round, white or off-white, engraved “D” on one side and engraved “5” and “9” separated by a score on the other.

Tablets manufactured by Aurobindo Pharma Ltd. Packed in blisters of 10 pcs. Every 3 blisters are placed in a laminated foil bag along with silica gel (desiccant), and then 1 bag, along with instructions, is packed in a cardboard pack.

Perindopril tablets produced by Biokhimik OJSC are available in dosages of 2 mg, 4 mg and 8 mg. They have a flat-cylindrical shape with a chamfer, the color is white or white with a slight creamy/yellowish tint, slight marbling is allowed. Packed in blisters of 10 pcs. (1, 2 or 3 blisters in a cardboard pack) or in polymer or glass jars of 20 or 30 pcs. (1 can in a cardboard box).

Tablets produced by JSC Vertex are available only in a dosage of 4 mg. They have a flat-cylindrical round shape with a chamfer, white or almost white. Packed in blisters of 10 pcs. (1 or 3 blisters in a cardboard box), 15 pcs. (2 blisters in a cardboard box) or 30 pcs. (1 blister in a cardboard pack), as well as in polyethylene jars of 10 or 30 tablets, 1 jar in a cardboard pack.

Composition per 1 film-coated tablet:

• active ingredient: perindopril erbumine – 2, 4 or 8 mg;
• auxiliary components of the tablet core: colloidal silicon dioxide, pregelatinized corn starch, crospovidone, magnesium stearate, microcrystalline cellulose;
• film coating: Opadry II white 85F18422 (dosage 2 mg), Opadry II green 85F21738 (dosage 4 mg), Opadry II green 85F21867 (dosage 8 mg).

Composition of 1 tablet:

• active ingredient: perindopril erbumine – 2, 4 or 8 mg;
• auxiliary components: microcrystalline cellulose, magnesium stearate, lactose monohydrate, corn starch.

Russian-made analogues

The domestic pharmaceutical industry offers Russian analogues for the drug Prestance. At the moment, only one such drug is registered under the trade name Parnavel Amlo. Its production is carried out by Ozon LLC.

However, we cannot speak of complete compliance, since perindopril is included in the drug in the form of perindopril erbumine, and not perindopril arginine. In addition, the dosage of this substance is also different. The drug Parnavel Amlo contains 4 or 8 mg, while the original contains 5 or 10 mg in each tablet. The content of amlodipine is no different.

Based on this, it should be noted that independent replacement of one drug with another is not recommended. After all, the strength of the action shown may differ slightly. Therefore, in such cases, consultation with a doctor is necessary.

Drug interactions

When taking Perindopril in combination with other medications, caution should be exercised, since some of them enhance the effect of the active substance, while others can provoke the development of undesirable effects on the part of various organs and systems. Muscle relaxants, anesthetics, diuretics and psychotropic drugs enhance the hypotensive effect of taking the drug and increase the risk of a sharp decrease in blood pressure

Sympathomimetics and antacids reduce the therapeutic effect of perindoprilate, and drugs that contain potassium in the composition or contribute to its retention in the body, together with Perindopril, can lead to hyperkalemia.

Cases of overdose

It is important to consider that perindopril arginine reaches its maximum effect after 4-6 hours, although the patient experiences relief within an hour. You should not exceed the daily dosage of the medication, as this can have unpleasant consequences.

Overdose symptoms:

• a sharp decrease in pressure;
• shock;
• electrolyte imbalance;
• renal failure;
• tachycardia;
• dizziness;
• bradycardia;
• cough.

If such symptoms appear, the patient should be put to bed and doctors should be called. Perindopril is removed from the bloodstream through hemodialysis.

Analogues, synonyms, replacements

In some cases, when purchasing the original medicine is impossible for a number of reasons, patients are interested in what can replace Perindopril.

The search for an absolute analog (that is, a drug with an identical composition) for the treatment of hypertension is not always justified, because drugs with other active ingredients of similar pharmacological action are usually no less effective. The main thing is to select an analogue together with your doctor.

Experts know exactly (from practice) which is better - Perindopril or Ramipril, Perindopril or Lisinopril, and so on.

Prestarium

The antihypertensive drug from the French manufacturer Servier Laboratories Prestarium is a one-component analogue of Perindopril.
The excipients contain lactose monohydrate; the medicine is available in the form of tablets for oral administration and for resorption under the tongue. The question of which is better, Perindopril or Prestarium, can only be answered after the practical use of these medications. One thing is certain - a medicine from a French manufacturer will be several times more expensive than, say, the Russian drug Perindopril SZ.

Lisinopril

The active ingredient lisinopril in the drug of the same name, produced by a large number of European, Russian and Indian companies, is an ACE inhibitor. That is, the pharmacological effect of the drug is similar to Perindopril and its analogues and can be used in the treatment of hypertension instead of these drugs.

The auxiliary components do not contain lactose, and the drug itself is excreted unchanged from the body through the kidneys. There are no conditions for which Perindopril tablets would be powerless, but Lisinopril would cope with incredible efficiency. Therefore, discussions about the advantages of a particular remedy should be based on an individual approach to each case.

Enalapril

You should not try to find out which is better - Perindopril or Enalapril - at the pharmacy. Of course, the pharmacy worker will describe the benefits of the medicine that is available at the pharmacy outlet. If you have to choose between these two drugs, it is better to consult a doctor.

Monopril

Let's compare another pair of drugs - Monopril and Perindopril. It is still difficult to answer which drug is better. The active ingredient of Monopril is fosinopril, an ACE blocker; The composition contains lactose in anhydrous form. The list of side effects presented in the instructions for use is similar to the list under consideration for Perindopril. Most likely, it will be possible to talk about preference only after careful selection of doses and practical use of the medicine.

Perineva

The antihypertensive drug Perineva, produced by the Russian branch of the KRKA company, can confidently be called synonymous with the drug in question.
According to the instructions for use, the composition of the drug, with the exception of minor differences in excipients, is the same, and accordingly, the pharmacological properties and effectiveness are the same. Which is better - Perindopril or Perineva, as in most cases, should be shown by practical experience in the use of these drugs.

Ramipril

The active ingredient of Ramipril tablets and their direct analogues is ramipril, a precursor to the active metabolite of ramiprilat, an angiotensin-converting enzyme blocker. According to the instructions for use, the composition of the excipients of Ramipril does not differ significantly from the composition of Perindopril, but the list of indications for use is much more extensive, in particular, due to its use in nephropathy (diabetic and non-diabetic), severe proteinuria, especially accompanied by hypertension.

The question of replacing Perindopril with Ramipril should be considered after carefully studying the instructions for use of both medications and comparing them with the characteristics of the course of hypertension in the patient.

General characteristics of the drug

This medication is an angiotensin-converting enzyme inhibitor. The main component of the drug is perindopril erbumine. Additional ingredients are calcium chloride hexahydrate, MCC, magnesium stearate, colloidal silicon dioxide, crospovidone, lactose monohydrate.

Perinev tablets

Produced in the form of round and oval tablets. The pharmacological effect of the drug is hypotensive, cardioprotective, and vasodilating. The medication in question has a strong therapeutic effect due to the presence of a metabolite - perindoprilate.

The compound effectively normalizes not only diastolic, but also systolic blood pressure. It lowers in the “standing” and “lying” positions. Perineva significantly reduces the peripheral vascular resistance. This subsequently leads to a decrease in pressure.

In this case, peripheral blood flow gradually accelerates. Despite this, the heart rate does not increase. Renal blood flow gradually increases. But the glomerular filtration rate remains unchanged.

It should be noted that the maximum antihypertensive effect can be achieved approximately four or even six hours after one oral dose of the drug.
The strong hypotensive effect persists throughout the day.

After only twenty-four hours, a drug called Perineva provides eighty-seven to one hundred percent of the maximum therapeutic effect. Blood pressure gradually decreases.

Stabilization of the antihypertensive effect is observed after approximately thirty days of continuous treatment. However, the effect of therapy does not disappear for a long time.

If the course of treatment is completed and it is necessary to stop taking the drug, then there is no need to worry about the development of withdrawal syndrome. It won't come. Perindopril significantly reduces left ventricular myocardial hypertrophy.

With prolonged use, the drug in question reduces the severity of interstitial fibrosis. Perineva normalizes the myosin isoenzyme profile.

It also significantly increases the concentration of HDL. But in people who suffer from hyperuricemia, the concentration of uric acid decreases significantly.

The active substance of the drug improves the elasticity and firmness of large arteries. It also eliminates all kinds of changes in small blood vessels. The drug improves the performance of the heart muscle. At the same time, pre- and afterload are effectively reduced.

People who have chronic heart failure during treatment with a drug called Perineva experience a persistent decrease in blood pressure. A decrease in OPSS can still be observed. There is also an increase in cardiac output and cardiac index.

It is worth paying attention that immediately after administration, the active substance is instantly absorbed by the gastrointestinal tract. The highest concentration is achieved within one hour. Taking the drug while eating is accompanied by minimizing the conversion of perindopril to perindoprilat.

The instructions for the drug indicate that it should be taken for the following diseases and conditions:

• high blood pressure;
• heart failure;
• stable ischemic heart disease. A course of treatment with the drug reduces the risk of developing cardiovascular complications in people with stable coronary heart disease;
• preventing recurrent stroke. In this case, the drug in question, called Perineva, should be taken as part of combination therapy simultaneously with Indapamide. The medicine is prescribed to patients who have suffered a stroke or ischemic cerebrovascular accident.

The drug Perineva has the following contraindications for use:

• hypersensitivity to the main component of the drug;
• hereditary or idiopathic angioedema;
• It is strictly prohibited to be taken by persons under eighteen years of age. This is due to the fact that the effectiveness and safety of this drug have not yet been established;
• history of angioedema (Quincke's edema), which is associated with regular use of an ACE inhibitor;
• hereditary galactose intolerance. It is also not recommended to use Perineva if you have a Lapp lactase deficiency. Glucose-galactose malabsorption syndrome is also considered a contraindication for use.

Please note that the drug should be taken with caution by people who suffer from kidney failure.

Side effects include unbearable pain in the head, dizziness, paresthesia, sleep or mood disturbances, and confusion. Visual disturbances, noise, and ringing in the ears often occur.

Side effects

Taking the medication in question, like any other drug, does not exclude the possibility of developing unwanted reactions.
For Perindopril tablets, side effects in terms of frequency of occurrence can be presented as follows:

• often - up to 10% of cases: excessive drop in blood pressure; asthenoneurotic syndrome, dry hacking cough, difficulty breathing; tinnitus and blurred vision; dyspepsia, stool disorders, changes in taste; allergic manifestations; convulsive muscle twitching;
• rarely - up to 1%: sleep disturbance, mood swings; bronchospasm; dry mucous membranes; Quincke's edema, deterioration of kidney function, increased sweating, impotence;
• extremely rare - less than 0.1%: disorders of the cardiovascular system in the form of rhythm disturbances, chest pain such as angina pectoris, acute myocardial infarction; pneumonia with eosinophilic infiltration; rhinitis; change in blood test; disruption of the liver and pancreas; confusion, exudative erythema.

We can say that this medication is better tolerated than some other representatives of the ACE inhibitor group. For the drug Perindopril, side effects can be minimized by prescribing minimal doses.

Special instructions and children's age

Children under 18 years of age are not recommended to use the drug, since the effect of perindopril on the body has not been precisely studied.

Perindopril arginine is used with extreme caution in cases of salt-free diet, nausea, and diarrhea. In the presence of certain diseases, the drug can have the completely opposite effect:

1. With renovascular hypertension, bilateral renal artery stenosis, severe hypotension and renal failure may occur.
2. With hyponatremia and cerebrovascular diseases, there is a risk of a strong decrease in blood pressure.
3. With scleroderma, agranulocytosis and neutropenia may develop.
4. With coronary heart disease, there remains a risk of a sharp decrease in blood pressure.
5. In case of heart failure, kidney function may deteriorate.
6. During hemodialysis, using high-flow membranes, and bee venom therapy, there is a risk of anaphylactic reactions.
7. During anesthesia, it can lead to collapse.
8. In diabetes, hyperkalemia is possible.

Contraindications

Contraindications:

Hypersensitivity, history of angioedema, pregnancy, breastfeeding, childhood (safety and effectiveness have not been determined). Restrictions on use: Assessment of the risk-benefit ratio is necessary in the following cases: severe autoimmune diseases, aortic or mitral stenosis, constrictive pericarditis, hypertrophic cardiomyopathy with hemodynamic disturbances, the presence of obstructive changes that impede the outflow of blood from the heart, bilateral renal artery stenosis or single artery stenosis kidneys, presence of a transplanted kidney; obliterating atherosclerosis: arteries of the lower extremities, widespread with damage to the coronary and carotid arteries; moderate renal failure, hyperkalemia (from 5 to 5.5 mmol/l), hyponatremia or sodium restriction in the diet, dehydration, leukopenia, thrombocytopenia, general anesthesia and surgery. Use during pregnancy and breastfeeding: Contraindicated during pregnancy. Breastfeeding should be stopped during treatment.

When taken: indications

The original drug "Perindopril" is taken only as prescribed by a doctor. The drug and its analogues are recommended to be used after a comprehensive examination, which helps to determine whether the patient has allergies and contraindications to treatment with the medication. There are the following indications for the use of “Perindopril”:

• increased pressure in the arteries;
• narrowing of the lumen of the renal artery;
• chronic course of heart failure;
• therapeutic and preventive measures for myocardial infarction and stroke;
• ischemic disease.

Video on the topic

One question remains: Co Perineva or Noliprel - which is better? You can get the answer by reading the pharmacological properties of Noliprel:

Thus, Perinev's antihypertensive tablets have their own analogues. Therefore, if the pharmacy does not have these drugs, you can choose other drugs whose active ingredient is perindopril. Most often, doctors prescribe substitutes such as Noliprel, Enalapril and Vazolong.

Selecting an analogue on your own is strictly prohibited. After all, despite the same composition, medications have different additional components and different quality. Because of this, they can sometimes be less effective or cause an allergic reaction. Therefore, only a qualified doctor should replace the medication after a full examination, careful study of the medical history, and general health.

Fitolife® - innovation in the treatment of human hypertension

• Eliminates the causes of pressure disorders
• Normalizes blood pressure within 10 minutes after administration

To learn more…

Admission rules

Only the attending physician can prescribe the use of Prestance. It is prohibited to make your own decision about taking this drug, recommend its use to others, or follow the recommendations of people who are not related to medicine. Indeed, quite often, the same symptoms may require taking completely different medications.

General recommendations for taking Prestanz:

• The medicine is used in doses prescribed by the doctor.
• You should purchase the drug only in the dosage in which you need to take it, since splitting the tablets is not recommended.
• Before the first use, you should read the package insert and if you have any questions, seek clarification from your doctor or pharmacist.
• The tablet is taken in the morning with a glass of water, before breakfast.
• You should take Prestance tablets at the same time every day. This will ensure the maintenance of a constant concentration of the drug in the blood and increase the effectiveness of treatment.
• If a dose is missed, it must be taken as soon as it is remembered. If the time for taking the next dose approaches, you should not take the missed dose, as this may cause an overdose.
• You cannot stop taking the medication yourself if your condition improves. Prestance helps control blood pressure only while it is being taken. It is not able to cure hypertension. The decision to discontinue the drug or replace it with another drug can only be made by a doctor.
• During therapy with the drug, you should not consume grapefruits or juice from them.
• Perindopril, which is present in the product, can cause a rare and dangerous negative effect – angioedema. It can occur at any time during treatment and requires immediate medical attention, as it can be life-threatening.
• If any unwanted effects occur, consult a doctor.
• During long-term drug therapy, it is recommended to periodically monitor blood composition.
• Since the drug can cause dizziness, fainting and other disturbances that affect concentration, caution should be exercised when driving vehicles and performing tasks that require increased reaction speed.

Reviews from doctors and patients about the drug "Perindopril"

The pharmaceutical market is overflowing with ACE inhibitor drugs. Of these, there are a lot of drugs that replace the drug "Perindopril". Analogs and replacements, as you have already seen, can be identical both in composition and in their effect on the body. But, despite such a variety of cheap substitutes for the drug in question, many patients still prefer to be treated with the original, as evidenced by their reviews.

Of course, if the patient cannot afford the original treatment, then there is a transition to cheap combination drugs, among which doctors have identified more or less high-quality ones. Naturally, even among cheap drugs, doctors choose medicines made in Europe, among which there are practically no counterfeits.

Properties of the drug "Perindopril"

This is an effective remedy that is recommended by many experts. So, before looking for an analogue of Perindopril, let’s find out a little about what it actually is.

This is a medicine from the group of ACE inhibitors, which affects the restoration of vascular muscle tone, due to which the pressure returns to normal. Pharmacological features boil down to the fact that perindopril, decomposing to perindopilate, reduces the content in the blood of elements that make blood vessels inoperative. By expanding them, it is possible to increase the minute volume of blood and a tolerant heart mode is developed under such a load. A more detailed description is provided in the instructions for the drug.

The effect of the medicine is noticeable an hour after taking it. After four hours it reaches its maximum concentration and normalizes blood pressure for the whole day. It does not affect conscious thinking, stimulates the brain, and concentrates attention. Excreted from the body through the kidneys.

The administration is very simple, one tablet (the dose is prescribed by the doctor) is taken once a day before meals. If you take the medicine after meals, it will act slowly.

The drug is produced in Germany and Hungary. The cost of a package of tablets varies from 500 to 600 rubles.

Medicines similar to Perindopril (analogues) are not described in the instructions for use. Let's look at them a little below.

Contraindications

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Contraindications to the treatment of arterial hypertension with Perindopril tablets are as follows:

• individual intolerance to any components of the pill or hypersensitivity to them;
• children under 18 years of age;
• period of pregnancy and breastfeeding;
• time of planning to conceive a child (even at this time Perindopril can be harmful).

The drug can be used in those people who have diabetes or kidney problems due to any pathologies. You can drink it even in old age, but all these conditions require special control - you need to constantly check the relevant indicators during the treatment period.

There are also diseases for which you can take Perindopril, but this should be done with caution. Such pathologies include:

• increased content of potassium ions;
• the presence of a kidney transplant from a donor;
• dehydration;
• pathologies of connective tissue of an autoimmune nosological nature;
• exicosis;
• renal failure of any form except mild;
• atherosclerosis of the obliterating type.

To avoid overdoses, you should avoid any alcohol-containing drinks during treatment with Perindopril. It is also better not to arbitrarily increase its daily amount. Overdose manifests itself as:

• fainting;
• dizziness;
• headaches;
• weaknesses.

All these symptoms arise against the background of the fact that excess Perindopril can cause circulatory problems - the brain is insufficiently supplied with nutrients, which provokes many serious consequences. Treatment is symptomatic - gastric lavage and intake of sorbent substances are used. In particularly severe cases, hospital treatment is required, as drugs that improve blood circulation must be administered intravenously.

Prestance product

This modern drug, in addition to perindopril, contains the substance amlodipine. The latter belongs to the group of calcium channel blockers. The pharmacological effect of amlodipine is primarily that it has an antihypertensive effect by reducing vascular vasodilation and peripheral vascular resistance. Taking this drug leads to a decrease in the oxygen demand of the heart muscles, promotes the dilation of blood vessels in ischemic areas, and delays the development of angina attacks.

The use of Prestance by elderly people suffering from arterial hypertension reduces the risk of myocardial infarction. Perindopril amlodipinocolo costs 500-600 rubles for 30 tablets of 10 mg and 5 mg. This is, of course, quite expensive.

How to take Perindopril for hypertension

Perindopril is usually prescribed for a single daily dose. In the first days of therapy, daily dosages should not exceed 1 or 2 mg of the active substance. Only after 2 weeks can the dose be increased if indicated or there is no significant therapeutic effect from small concentrations of Perindopril.

Depending on the diagnosis, the following treatment regimens are usually prescribed:

• for arterial hypertension - up to 8 mg per day with a gradual increase in dose over the course of a month;
• in case of insufficient cardiac function in a congestive form, the therapeutic amount of the active substance is no more than 4 mg per day;
• for stable cardiac ischemia, the dosage starts at 4 mg per day and can be gradually increased by 2 times (2 weeks should pass between doses of 2 mg and 4 mg);
• in case of pre-stroke condition or risk of stroke - 14 days, 2 mg per day, then - 14 days, 4 mg per day;
• for renovascular type hypertension, it is enough to drink 2 mg of Perindopril per day.

It is important not to exceed the recommended dosage and be gradual when changing the concentration of the drug or discontinuing it, otherwise side effects may occur.

Alcohol compatibility

All medications do not combine well with ethanol-containing drinks.
It is especially dangerous to combine alcohol with cardiovascular drugs. It is known that alcohol negatively affects the condition of the heart and arterioles. If you drink alcohol during treatment with Prestance, this can lead to bradycardia or tachycardia and cause the development of acute heart failure. Also, such a combination provokes an increased risk of side effects.

If there is a feast ahead, there is no way to refuse to drink ethanol-containing drinks, then you need to take into account the following rules:

• drink alcohol 24-32 hours after taking the pill;
• drink ethanol-containing drinks in small quantities;
• start taking the drug 14-20 hours after drinking alcohol;
• if your health worsens, refuse the next dose of alcohol and drink more clean water over the next few hours;
• if Prestance is used as a course, then alcohol is prohibited for a period of 3 to 30 days (depending on how long the pills are taken and what instructions the treating doctor gives).

With one-time and minor consumption of alcohol, the likelihood of harming your health is minimal. But it is still better to completely eliminate alcohol during therapy with Prestance tablets.

What the instructions say about Prestarium, brief information

Captopril	from 11.00 rub. up to 169.10 rub.	hide see prices in detail
Pharmacy	Name	Price	Manufacturer
quantity per package - 20
Europharm RU	captopril 25 mg No. 20 tablet	11.00 rub.	Sintez OJSC
Pharmacy Dialogue	Captopril (50 mg tablet No. 20)	18.00 rub.	RUSSIA
Europharm RU	captopril 50 mg No. 20 tablet	18.20 rub.	Pranapharm
Pharmacy Dialogue	Captopril (50 mg tablet No. 20)	24.00 rub.	RUSSIA
quantity per package - 40
Pharmacy Dialogue	Captopril (25 mg tablet No. 40)	16.00 rub.	Belarus
Europharm RU	captopril 25 mg n40 tablet	17.00 rub.	Ozone LLC
Pharmacy Dialogue	Captopril (25 mg tablet No. 40)	17.00 rub.	RUSSIA
Europharm RU	captopril-akos 25 mg No. 40 tablet	20.00 rub.	SYNTHESIS
Lisinopril	from 16.00 rub. up to 226.00 rub.	hide see prices in detail
Pharmacy Dialogue	Lisinopril tablets 10 mg No. 20	31.00 rub.	RUSSIA
Pharmacy Dialogue	Lisinopril tablets 20 mg No. 20	33.00 rub.	RUSSIA
Pharmacy Dialogue	Lisinopril-Teva (10 mg tablet No. 20)	104.00 rub.	RUSSIA
Pharmacy Dialogue	Lisinopril-Teva (10 mg tablet No. 20)	109.00 rub.	Czech
quantity per package - 30
Pharmacy Dialogue	Lisinopril (tablet 5 mg No. 30)	16.00 rub.	RUSSIA
Pharmacy Dialogue	Lisinopril (tablet 5 mg No. 30)	19.00 rub.	RUSSIA
Pharmacy Dialogue	Lisinopril tablets 5 mg No. 30	22.00 rub.	RUSSIA
Pharmacy Dialogue	Lisinopril tablets 10 mg No. 30	22.00 rub.	RUSSIA
Indapamide	from 21.00 rub. up to 119.00 rub.	hide see prices in detail

What group of drugs does it belong to?	The drug belongs to the group of ACE inhibitors. These are chemical compounds that prevent high blood pressure and prevent complications in the functioning of the heart and blood vessels.
What is the basis of the drug, what does it look like	The description of Prestarium says that the main active ingredient is the active metabolite - perindoprilat. The medicine is produced in tablets of different dosages (2.5; 5; 10 mg), coated with a white film coating.
How does the product work?	Prestarium tablets, taken orally, gradually reduce both pressure levels by accelerating blood circulation (peripheral), but without increasing heart rate. Thanks to the vasodilator reaction, the elasticity of blood vessels is restored, which helps the normal functioning of the heart and reduces left ventricular hypertrophy. Stopping taking the pills does not lead to withdrawal symptoms.
When is it prescribed?	Indications for the use of Prestarium tablets may include: Signs of arterial hypertension; Development of chronic heart failure; The need to prevent recurrent strokes, the drug is prescribed together with a diuretic (indapamide); Coronary heart disease in a stable phase; prescribing medication for coronary artery disease reduces the risk of complications.

The tablets are taken at the initially prescribed dose for a month; if the therapy is ineffective, the question of increasing the dosage may arise.

The drug is prescribed exclusively individually, taking into account age and concomitant diseases. Particular attention is paid to kidney function and the presence of cardiovascular diseases.

They try not to treat pregnant women with ACE inhibitors unless absolutely necessary. If therapy does take place, the newborn needs to have an ultrasound to assess the condition of the skull bones and kidney function.

"Perindopril"

"Perindopril" is presented in the form of round tablets, usually white. Active ingredient: Perindopril . The medicine is recommended for high blood pressure, chronic heart failure, prevention of recurrent stroke in patients who have suffered it or for transient ischemic cerebrovascular accident.

The drug is aimed at dilating blood vessels and can increase cardiac output and exercise tolerance. It is active starting from the first hour of administration. The effect continues throughout the day.

The use of the product is prohibited in the following cases, which you should pay attention to:

1. Women's pregnancy and breastfeeding.
2. Individual sensitivity to some components of the drug.
3. The use of the product is contraindicated for children (use under eighteen years of age is prohibited).

Diabetes, kidney problems, and old age are not barriers to consumption. In many cases, the medicine is recommended for type I and type II diabetics for high blood pressure.

Reviews

Patients claim the positive effect of the drug "Perindopril" on blood pressure parameters and heart function in general. The active ingredient allows you to cope with serious pathology in a relatively short course of conservative therapy.

Patients who took the pharmaceutical drug "Perindopril" give it extremely good reviews. Indeed, in addition to the main therapeutic effects, it improves trophism and the delivery of beneficial nutrients to all peripheral tissues and organs, cleanses the macrocirculatory bed, which cannot but affect overall well-being in a positive light.

Many people suffer from problems with blood pressure and cardiovascular diseases. And often such diseases are chronic.

In this case, patients need long-term treatment, so it is very important to choose the most suitable and cost-effective drug. What is Perindopril for? This will be written about in this article.

Prestarium: patient reviews, doctors’ opinions

Expert's opinion: The treatment regimen was chosen correctly, and therefore there is a positive result, taking into account the correction on the part of the patient.

Expert's answer: If you are bothered by a cough and shortness of breath, contact your doctor. He should replace Prestarium with a similar drug, this is a side effect of the entire line of ACE inhibitors. If the symptoms of cough are not critical, there is no need to cancel it; the drug protects against threatening conditions - heart failure, heart attacks, strokes, kidney failure.

Expert's answer: It is not recommended to take clonidine constantly for hypertension; it is a single-use drug; constant use is dangerous due to a sharp increase in pressure and leads to the destruction of blood vessels. There is a threat to life, so my father should be shown to a competent cardiologist.

Expert's answer: Contact your doctor regarding increased heart rate. Perhaps he will supplement Prestarium with a beta blocker and magnesium with the addition of vitamin B6 and other medications.

Comparison table of approximate prices

Prestarium	from 400 to 600 rubles
Prestance	from 600 to 700 rubles
Perineva	from 250 to 900 rubles
Enalapril	up to 100 rubles
Lorista	from 130 to 750 rubles
Lisinopril	up to 150 rubles

Prestarium is a drug whose main potent substance is perindopril, which belongs to the group of angiotensin-converting enzyme inhibitors, and is recommended for the treatment of arterial hypertension, CHF, and coronary heart disease.

This drug is a popular medicine among hypertensive patients because it is enough to take it just once a day, and it smoothly lowers blood pressure, while rarely causing side effects.

The substance perindopril, which is part of the drug, lowers both systolic and diastolic blood pressure. Against this background, peripheral blood flow accelerates, but the pulse rate remains the same.

Analogues of Perindopril, list

Analogues of Perindopril by scope of application include drugs (list):

1. Hypernik,
2. Stoppress,
3. Noliprel,
4. Prestarium A,
5. Perindopril-Richter,
6. Perinpress,
7. Perindopril Pfizer,
8. Perindopril erbumine,
9. Perindopril tert-butylamine,
10. Perineva, Prestans,
11. Arentopres,
12. Coverex,
13. Perindid,
14. Parnavel,
15. Piristar.

Important - instructions for use of Perindopril, price and reviews do not apply to analogues and cannot be used as a guide to the use of drugs of similar composition or action. All therapeutic prescriptions must be made by a doctor. When replacing Perindopril with an analogue, it is important to consult a specialist; you may need to change the course of therapy, dosages, etc. Do not self-medicate!