Perineva

Perineva tablets have cardioprotective and vasodilating action, and also show an antihypertensive effect.

The basis of the drug includes components: perindopril, lactose, calcium salt of hydrochloric acid, povidone (enterosorbent), pyrogenic silicon dioxide, microcrystalline cellulose, magnesium stearate.

Stabilization of blood pressure is observed after a month of treatment. Regular intake of the drug helps to reduce hypertrophic changes in the heart muscle. The appointment of long-term treatment courses can reduce the severity of interstitial pulmonary fibrosis, while normalizing the isoenzymes of fibrillar proteins, which are the main components of contractile muscles.

Clinical and pharmacological group

Perineva has antihypertensive, vasodilating and cardioprotective action.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much does Perineva cost in pharmacies? The average price is at the level of250 rubles.

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Form of issue and composition

Perineva is produced by Krka (Slovenia) in the form of tablets that are taken orally. Each tablet, regardless of the dosage of the active substance, is white in color, round in shape. In packages of 30 or 90 tablets, as well as the official instructions for use.

Perindopril (international name Perindopril) is an active substance that provides all the pharmacological actions of the drug. Included in the preparation Perineva (in Latin, INN - Perineva) in the amount of 2, 4, 8 mg. Combined Ko-Perineva forms containing Perindopril in the indicated doses and Indapamide (diuretic) in the amount of 25;, 5 or, mg.

Other Ingredients:

• silicon oxides;
• lactose;
• cellulose;
• Magnesium stearate;
• Povidone;
• calcium chloride.

Ko Perineva

It should be noted that Perineva therapy is effective only in 50% of clinical cases. To achieve a more stable result, the treatment of hypertension 1 and 2 stages is carried out by two active substances. The most effective combination is perindopril and indapaid. This combination of active ingredients is presented in Ko-Perineva tablets.

The drug is presented in three dosages:

• Perindopril, 2 mg, indapamide 25 mg;
• Perindopril, 4 mg, indapamide 5 mg;
• Perindopril, 8 mg, indapamide mg.

Ko-Perinev is prescribed as the main medication for the treatment of hypertension.

Pharmacological effect

Active substance Perineva perindopril belongs to oxopeptidase, is an ACE inhibitor or kinase. He can turn angiotensin to a vasoconstrictor and destroy the bradykinin vasodilator up to the inactive substance of the heptapeptide. This effect leads to a decrease in the level of angiotensin, the secretion of aldosterone and an increase in renin activity in the blood plasma, the system of prostaglandins.

Perindopril reduces systolic and diastolic pressure, accelerates peripheral blood flow without increasing heart beat. The maximum effect after taking the tablets comes in five hours and persists throughout the day. Stabilization of health is observed after a month of therapy, the cessation of which is not accompanied by withdrawal syndrome. Perindopril reduces myocardial hypertrophy of the left ventricle, the severity of interstitial fibrosis, the concentration of uric acid in hyperuricemia.

Indications for use

Among the main indications for the use of the drug are the following:

• arterial hypertension;
• heart failure of a chronic type;
• for the prevention of recurrent myocardial infarction;
• with stable ischemic heart disease;
• to prevent recurrent stroke, while the drug can only be used in combination therapy with indapamide drugs.

With monotherapy and complex treatment, various dosages of the drug can be prescribed taking into account the patient's condition. In some cases, despite a suitable diagnosis, the doctor may prohibit Perineva. Especially large is the risk in the elderly.

Contraindications

Complete contraindications to the use of a medicine are considered to be such states: an act;

Relative contraindications (taken with caution) are such states: ardiomyopathy;

Use in pregnancy and lactation

According to the instructions, Perineva is contraindicated during pregnancy. At the onset of pregnancy should immediately cancel the drug. The use of perindopril in the second and third trimesters of pregnancy can lead to the development of fetotoxic (hypochlorism, renal dysfunction, slowing the process of ossification of the fetal skull) and neonatal toxic (hyperkalemia, arterial hypotension, renal failure) effects.

The drug is not recommended for use in the lactation period, since there are no data on its penetration into breast milk.

Dosage and route of administration

The instructions for use indicate that Perineva tablets should be taken in the morning before breakfast, without chewing or grinding, with enough water. The medication is taken once a day, starting with a minimum dose of 2 mg, gradually increasing if necessary. The maximum daily dose should not exceed 8 mg.

1. With arterial hypertension, Perineva's medicine can be used both in monotherapy and simultaneously with other drugs that reduce blood pressure. The initial daily dose should not exceed 4 mg. If the therapy does not work within a month, the dose can be raised to 8 mg (with normal transfer of the previous dose). Before taking this medication, it is necessary to stop taking diuretics for at least 3 days, as the combined use of these drugs can lead to hypotension. Elderly patients are not recommended at the beginning of the course to take a daily dose of more than 2 mg. If necessary, with normal tolerance, it can be increased to 4 mg, and then to 8 mg.
2. In chronic heart failure, the drug should be taken exclusively under medical supervision, it should begin with a minimum dose (2 mg). Increase to 4 mg dose can be no earlier than a week.
3. As a prophylactic against repeated stroke, the dose of the drug for the beginning is 2 mg. You can start taking the drug within two weeks after suffering a stroke.
4. The recommended dose for ischemic heart disease is 4 mg. When controlling the kidney function, after two weeks, you can increase the dose twice (8 mg).

With kidney disease, the dose of the drug is administered individually, based on the diagnosis and the degree of disturbance. It is necessary to constantly monitor the patient's condition, in particular, the level of creatinine and potassium ions in the blood.

It is not necessary to adjust the dose for liver diseases.

Side effects

In general, the drug is normally tolerated by patients, but with side effects, side reactions may occur:

1. On the part of the respiratory system - cough, shortness of breath, bronchial obstruction and bronchospasm;
2. From the nervous system - dizziness and headaches, drowsiness, lethargy, emotional instability, possible development of seizures;
3. On the part of the organs of the genitourinary system - a violation of potency in men and libido in women, the development of jade, kidney failure, an increase in the level of creatinine in the blood;
4. On the part of the digestive system - pain in the epigastric region, nausea, heaviness in the stomach, dry mouth, vomiting sometimes, diarrhea or constipation, impaired liver function;
5. Allergic reactions - development of urticaria, Quincke's edema, skin rash, itchy skin.

Overdose

In an overdose, the patient may experience the following symptoms: shock, kidney failure, bradycardia, sharp depression of blood pressure, hyponatremia, dizziness, cough, hyperkalemia, tachycardia, anxiety, hyperventilation, palpitations.

With a sharp decrease in blood pressure, the patient should assume a prone position, slightly raise his legs, as well as take measures to replenish the BCC. With a bradycardia that does not respond to therapy (in particular, anthropin), it is necessary to install a pacemaker (artificial pacemaker). From the blood flow perindopril can be removed by hemodialysis.

special instructions

Before you start using the drug, read the special instructions:

1. There have been reports of cases of arterial hypotension, fainting, stroke, hyperkalemia and renal dysfunction (including acute renal insufficiency) in predisposing patients, especially with simultaneous use with medications that affect RAAS. Therefore, the double blockade of RAAS due to the combination of an ACE inhibitor with an angiotensin 2 receptor antagonist or aliskiren is not recommended.
2. In patients who are undergoing surgery with the use of general anesthesia, the drug should be canceled one day before the forthcoming surgery.
3. Against the background of treatment with Perineva, it is possible to develop a persistent, unproductive cough that stops after the abolition of therapy. This fact must be taken into account when diagnosing a cough.
4. In patients with diabetes mellitus, taking oral hypoglycemic drugs or insulin, during the first months of Perineva's therapy, it is necessary to monitor the blood glucose level.

During treatment with the drug, dizziness or excessive lowering of blood pressure may develop, which can affect a patient's ability to drive and work with other technical means.

Drug Interactions

The drug can interact with other drugs, enhancing or weakening them or their own action. This effect is also important to consider when simultaneous administration of several medications is carried out simultaneously.

Here are some examples of interactions:

1. With immunosuppressants: the development of leukopenia increases.
2. When used with neuroleptics: the hypotensive effect is enhanced.
3. When used with drugs for general anesthesia: the general antihypertensive effect increases.
4. When used with diuretics: hypovolemia may occur, or blood pressure may drop.
5. When used with potassium-sparing diuretics: the potassium content in the blood can rise - and this is very dangerous.
6. With insulin: an increase in glucose tolerance can increase, as well as a decrease in the need for insulin.
7. With baclofen: the latter increases the hypotensive effect, which can significantly change blood pressure;
8. With metformin: a renal failure of a functional type may occur. A similar effect occurs when using iodine-containing contrast agents.
9. When taking with lithium preparations: the concentration of lithium in the blood plasma can increase, and therefore it is not worth combining Ko-Perineva with these drugs.
10. With a single use with acetylsalicylic acid and other NSAIDs: hypotensive effect may decrease drug, but the risk of developing problems with the kidneys, including acute renal disease insufficiency. In the presence of existing problems with the kidneys, a single use of drugs is strictly contraindicated.

And this is only part of the possible interactions that can occur with the simultaneous use of various medications. Therefore, be sure to consult your doctor about what non-standard effects may occur if you consume several different medicines at a time.

Reviews

We picked up some reviews of people who used the drug Perineva:

1. Julia. Earlier I took the dear analogue of Perinev - Prestarium from ischemia, but now, on the recommendation of a doctor, I switched to this drug. I have never regretted - the medicine is sold at an affordable price, there is an option to buy a large package of 90 tablets and save. The drug effectively lowers the pressure, it does not hurt the heart.
2. Lyudmila. Being a hypertensive patient with experience, I tried many drugs. At the next visit to the doctor complained of swelling, and she offered to change the treatment schedule, adding a diuretic. They appointed me to Ko-Perinev. I take 1 tablet in the morning, very comfortable, I feel the effect in 3-4 hours. After about a week, I felt the results of treatment: the edema disappeared, the pressure stopped jumping. For an ambulance this medicine is not suitable, but in such cases other means are used. And so I'm very pleased with him, the pressure is almost normal. There were no side effects.
3. Elena. This medication was prescribed to me by a doctor after my heart attack. The doctor said that the pills will help normalize the condition of the heart and blood vessels, and it happened. I started to take the medicine with 2 mg per day, gradually the dosage increased to 4 mg. I see changes - the pressure "does not jump I feel great, the level of hemoglobin and creatinine is normal.

The doctors' comments about Perinev are as follows: if used correctly (this takes into account the accuracy of the diagnosis and is correct the chosen dosage) in patients there is a stable decrease in blood pressure and ischemic attacks. Nevertheless, physicians note "the reverse side of the coin" - there is a difficulty in selecting an individual dosage, so patients sometimes develop negative symptoms that threaten life.

Perineva - analogues

Analogues of Perinev's drug according to the action and indications:

• Arentopress;
• Hypernica;
• Cooverex;
• Co-benefit;
• Noliprel;
• Noliprel A;
• Noliprel A Bee Fort;
• Noliprel forte;
• Parnavell;
• Perindid;
• Perindopril;
• Perindopril arginine;
• Perindopril erbumine;
• Perindopril + Indapamide Sandoz;
• Perindopril plus Indapamide;
• Perindopril-Indapamide Richter;
• Perineva Ku-Tab;
• Perinpress;
• Piristar;
• Prestarium;
• Prestarium A;
• Stoppress.

Before using analogues, consult your doctor.

Storage conditions and shelf life

It is recommended to keep the tablets out of reach of children, avoiding direct sunlight on the package. The expiration date of the medication is indicated on the package, at the end of its tablets it is necessary to discard.

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