Peripril

Peripril4mg

Type:Tablet

Generic Name:Perindopril Erbumine

Manufacturer:Incepta Pharmaceuticals Ltd.

Price:12.00

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Indication

Hypertension, IHD, Heart failure

Administration

Should be taken on an empty stomach. Take before meals.

Adult Dose

Oral Adult Hypertension 4-8 mg PO qDay or divided q12hr Maximum: 16 mg/day PO divided q12hr Stable Coronary Artery Disease (CAD) 4 mg PO qDay for 2 weeks, THEN increase as tolerated to 8 mg/day PO divided q12hr Reduce risk of cardiovascular mortality or MI in patients with stable CAD Heart Failure 2 mg PO qDay initially to maximum 8-16 mg PO qDay Elderly: Initially, 2 mg once daily. Dose may be increased to max 8 mg

Renal Dose

Renal impairment: CrCl (ml/min) Dosage Recommendation <15 2 mg on dialysis days. 15-30 2 mg on alternate days. 30-60 2 mg

Contraindication

History of angioedema related to previous ACE inhibitor treatment. Pregnancy (2nd/3rd trimesters).

Mode of Action

Perindopril is an ACE inhibitor, which acts by inhibiting the conversion of angiotensin I to angiotensin II, reducing the activity of the sympathetic nervous system and inhibiting enzyme kininase, which is involved in the conversion of bradykinin and other substances.

Precaution

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. Lactation: not known if distributed into breast milk; use caution

Side Effect

>10% Headache (23%),Cough (12%) 1-10% Dizziness (8%),Back pain (6%),Lower extremity pain (5%),Abnormal ECG (2%),Palpitation (1%),Depression (2%),Somnolence (1%),Menstrual disorder (1%),Edema (4%),ALT increased (2%),Sexual dysfunction (male 1%),Sleep disorder (3%),Chest pain (2%),Nausea/vomiting (2%),Flatulence (1%),Rash (2%),Hyperkalemia (1%),Tinnitus (2%) Frequency Not Defined Intestinal angioedema,Liver failure (rare),Leukopenia,Pruritus,Stroke,Syncope,Urinary retention,Vertigo,Amnesia Angioedema, More frequent in black patients (0.1%), Angioedema of lips, More frequent in black patients (0.1%), Angioedema of throat, More frequent in black patients (0.1%) Potentially Fatal: Anaphylactoid reactions, angioedema.

Interaction

May enhance hypotensive effect w/ diuretics. Additive hyperkalaemic effect w/ K supplements, K-sparing diuretics, and other drugs (e.g. ciclosporin, heparin, indometacin). May increase serum levels and toxicity of lithium. Antihypertensive effect may be reduced by aspirin or other NSAIDs. Coadministration w/ NSAIDs may also increase the risk of renal impairment. Increased risk of hypoglycaemia w/ antidiabetic agents. Rarely, nitritoid reactions occur w/ concomitant use of gold (sodium aurothiomalate). Potentially Fatal: Increased risk of hypotension, hyperkalaemia and changes in renal function (including acute renal failure) w/ aliskiren in patients w/ diabetes or renal impairment.

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