Perindopril/indapamide: Difference between revisions
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{{short description|Combination medication}} |
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{{Unreferenced|date=October 2006}} |
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{{Manual|date=June 2016}} |
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{{Drugbox |
{{Drugbox |
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| verifiedrevid = |
| verifiedrevid = 464199158 |
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| type |
| type = combo |
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| image = Perindopril and indapamide.svg |
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| component1 = Perindopril |
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| alt = |
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| class1 = [[ACE inhibitor]] |
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| component2 = Indapamide |
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<!-- Combo data --> |
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| class2 = [[Thiazide like]] [[diuretic]] |
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| component1 = Perindopril |
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| class1 = [[ACE inhibitor]] |
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| component2 = Indapamide |
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| class2 = [[Thiazide-like diuretic]] |
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<!-- Clinical data --> |
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| tradename = Preterax, Noliprel, Coversyl Plus |
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| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X --> |
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| pregnancy_category = |
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| routes_of_administration = [[By mouth]] |
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| ATC_prefix = C09 |
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| ATC_suffix = BA04 |
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| legal_AU = S4 |
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| legal_CA = Rx-only |
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| legal_CA_comment = <ref>{{cite web | title=Product monograph brand safety updates | website=[[Health Canada]] | date=7 July 2016 | url=https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database/label-safety-assessment-update/product-monograph-brand-safety-updates.html | access-date=3 April 2024}}</ref> |
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| legal_UK = <!-- GSL / P / POM / CD / Class A, B, C --> |
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| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V --> |
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| legal_status = Rx-only |
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<!--Identifiers--> |
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| CAS_number = 182176-83-6 |
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| PubChem = 9940214 |
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| DrugBank_Ref = {{drugbankcite|correct|drugbank}} |
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| DrugBank = |
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| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}} |
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}} |
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| ChemSpiderID = 8115834 |
| ChemSpiderID = 8115834 |
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<!--Chemical data--> |
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| InChI = 1/C19H32N2O5.C16H16ClN3O3S/c1-4-8-14(19(25)26-5-2)20-12(3)17(22)21-15-10-7-6-9-13(15)11-16(21)18(23)24;1-10-8-11-4-2-3-5-14(11)20(10)19-16(21)12-6-7-13(17)15(9-12)24(18,22)23/h12-16,20H,4-11H2,1-3H3,(H,23,24);2-7,9-10H,8H2,1H3,(H,19,21)(H2,18,22,23)/t12-,13-,14-,15-,16-;/m0./s1 |
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| InChIKey = LRRJSCKXFJTRLC-MHXJNQAMBS |
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| smiles = O=C(OCC)[C@@H](N[C@H](C(=O)N1[C@H](C(=O)O)C[C@@H]2CCCC[C@H]12)C)CCC.O=S(=O)(N)c1c(Cl)ccc(c1)C(=O)NN3c2ccccc2CC3C |
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| StdInChI_Ref = {{stdinchicite|correct|chemspider}} |
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| StdInChI = 1S/C19H32N2O5.C16H16ClN3O3S/c1-4-8-14(19(25)26-5-2)20-12(3)17(22)21-15-10-7-6-9-13(15)11-16(21)18(23)24;1-10-8-11-4-2-3-5-14(11)20(10)19-16(21)12-6-7-13(17)15(9-12)24(18,22)23/h12-16,20H,4-11H2,1-3H3,(H,23,24);2-7,9-10H,8H2,1H3,(H,19,21)(H2,18,22,23)/t12-,13-,14-,15-,16-;/m0./s1 |
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| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}} |
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| StdInChIKey = LRRJSCKXFJTRLC-MHXJNQAMSA-N |
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| CAS_number = |
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| ATC_prefix = C09 |
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| ATC_suffix = BA04 |
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| PubChem = 9940214 |
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| DrugBank = |
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| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X --> |
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| pregnancy_US = <!-- A / B / C / D / X --> |
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| pregnancy_category= |
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| legal_AU = S4 |
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| legal_CA = <!-- / Schedule I, II, III, IV, V, VI, VII, VIII --> |
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| legal_UK = <!-- GSL / P / POM / CD / Class A, B, C --> |
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| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V --> |
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| legal_status = Rx-only |
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| routes_of_administration = Oral |
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}} |
}} |
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'''Perindopril/indapamide''' (marketed as '''Preterax''', '''Coversyl Plus''' and '''Noliprel''') is a combination medication which contains [[perindopril]] (an [[ACE inhibitor]]) and [[indapamide]] (a [[thiazide-like diuretic]]) both of which are used for the treatment of [[essential hypertension]] (high blood pressure).<ref name="BeeversLip2014">{{cite book | vauthors = Lip JY, Beevers DG | veditors = Beevers DG, Lip JY, O'Brien ET |title=ABC of Hypertension | chapter = Hypertension in patients with cardiovascular disease | chapter-url = https://books.google.com/books?id=HwShBQAAQBAJ&pg=PA83|date=26 November 2014|publisher=Wiley|isbn=978-1-118-59256-4|pages=83–}}</ref> |
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'''Perindopril/indapamide''' is a combination therapy for the treatment of [[Essential hypertension]]. |
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== Medical uses == |
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==Form and Composition== |
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[[High blood pressure]] |
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Each scored tablet contains 2 mg of [[perindopril]] [[Tert-Butylamine|''tert''-butylamine]] salt and 0.625 mg of [[indapamide]]. |
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=== Administration === |
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==Indication== |
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[[Essential hypertension]]. |
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==Dosage and Administration== |
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One tablet daily, preferably to be taken in the morning and before a meal. |
One tablet daily, preferably to be taken in the morning and before a meal. |
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Elderly: Normal dosage. |
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==Pharmacological Action== |
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PRETERAX, a fixed combination of an [[ACE inhibitor]] and a chlorosulfamoyl [[diuretic]], leads to additive [[synergy]] of the [[antihypertensive]] effects of the two constituents. Its pharmacological properties are derived from those of each of the components taken separately, in addition to those due to the additive synergistic action of the two constituents, when combined, on [[blood vessels|vascular]] [[endothelium]], arteriolocapillary [[microcirculation]], and the target organs of hypertension. |
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[[Kidney failure]]: [[Creatinine clearance]] (CrCl) >30 mL/min: no dosage modification. If CrCl <30 mL/min, treatment is [[contraindicated]]. |
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Elderly patients: Normal dosage. |
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[[Renal failure]]: [[Creatinine clearance]] (CrCl) >30 mL/min: no dosage modification. CrCl <30 ml/min: treatment [[contraindicated]]. |
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== Contraindications == |
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Absolute contraindications to taking perindopril/indapamide include a known [[allergy]] to perindopril, indapamide, or [[Sulfonamide (medicine)|sulfonamides]]; history of [[Quincke's edema]] linked to previous ACE inhibitor therapy; end-stage [[Chronic kidney disease|kidney disease]]; serious [[liver]] disease; [[hyperkalemia|high levels of potassium in the blood]]; [[pregnancy]]; and [[lactation]]. |
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Relative contraindications to using this medication include combination therapy with [[lithium (medication)|lithium]], [[potassium]] salts, [[potassium-sparing diuretics]], and certain medicines which can cause [[Cardiac arrhythmia|abnormal heart rhythms]]. |
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== Side effects == |
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Side effects of perindopril/indapamide may include [[asthenia|weakness]], [[dizziness]], [[headache]], [[mood swings]] and/or [[sleep disturbances]]. Additionally, [[cramps]], [[hypotension|low blood pressure]], [[allergic reactions]], [[skin rashes]], [[gastrointestinal disorder]]s, [[dry cough]], [[erectile dysfunctions]], [[dry mouth]], and a risk of [[dehydration]] in the elderly and in people who have [[congestive heart failure]]. |
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[[Immunosuppressed]] patients. [[Hemodialysis]]: risk of anaphylactoid reaction during hemodialysis with polyacrylonitrile membranes. Liver impairment. |
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==Contraindications== |
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Absolute: Known [[allergy]] to perindopril, indapamide, or [[sulfonamides]]; history of [[Quincke's edema]] linked to previous ACE inhibitor therapy; severe renal failure; serious [[liver]] disorder; [[hyperkalemia]]; [[pregnancy]]; [[lactation]]. |
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Relative: Combination therapy with [[lithium]], [[potassium]] salts, [[potassium-sparing diuretics]], and certain medicines which can cause [[heart]] rhythm disorders. |
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Caution is recommended when prescribing perindopril/indapamide to people with [[electrolyte]] disorders, [[diabetes]], [[gout]], low blood pressure, or strict [[salt|sodium]]-free diets, heart or kidney failure, [[atherosclerosis]], [[renal artery stenosis]], and in elderly people. |
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==Side Effects== |
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[[Asthenia]], [[dizziness]], [[headache]], [[mood swings]] and/or [[sleep disturbances]], [[cramps]], [[hypotension]], [[allergic reactions]], [[skin rashes]], [[gastrointestinal]] disorders, [[dry cough]], [[dry mouth]], risk of [[dehydration]] in the elderly and in patients suffering from [[heart failure]]; changes in [[blood test]] results may occur. |
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== |
== Pharmacology == |
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Using a fixed combination of an [[ACE inhibitor]] and a chlorosulfamoyl [[diuretic]] leads to additive [[synergy]] of the [[antihypertensive]] effects of the two constituents. Its pharmacological properties are derived from those of each of the components taken separately, in addition to those due to the additive synergistic action of the two constituents, when combined, on [[blood vessels|vascular]] [[endothelium]], arteriolocapillary [[microcirculation]], and the target organs of hypertension. |
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[[Immunosuppressed]] patients. [[Hemodialysis]]: risk of anaphylactoid reaction during hemodialysis with polyacrylonitrile membranes. Liver impairment. |
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== Drug interactions == |
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==Precautions== |
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Not recommended: combinations with lithium, potassium-sparing diuretics, potassium (salts), [[antiarrhythmic drugs]] which can cause [[torsades de pointes]], [[anesthetic drugs]], [[cytostatic]]s or [[immunosuppressive agents]]. |
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Disorders of [[electrolyte]] balance, [[diabetes]], [[gout]], hypotension, or strict [[salt|sodium]]-free diets, heart or renal failure, [[atherosclerosis]], [[renal artery stenosis]], elderly. |
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== |
== References == |
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{{Reflist}} |
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Not recommended: Combinations with lithium, potassium-sparing diuretics, potassium (salts), [[antiarrhythmic drugs]] which cause [[torsade de pointes]], [[anesthetic drugs]], [[cytostatic]] or [[immunosuppressive agents]]. |
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{{ACE inhibitors}} |
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{{Antihypertensives and diuretics}} |
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{{DEFAULTSORT:Perindopril |
{{DEFAULTSORT:Perindopril Indapamide}} |
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[[Category: |
[[Category:Combination antihypertensive drugs]] |
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[[Category:Combination drugs]] |
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Latest revision as of 05:03, 3 April 2024
 | This article is written like a manual or guide. (June 2016) |
 | |
| Combination of | |
|---|---|
| Perindopril | ACE inhibitor |
| Indapamide | Thiazide-like diuretic |
| Clinical data | |
| Trade names | Preterax, Noliprel, Coversyl Plus |
| Routes of administration | By mouth |
| ATC code | |
| Legal status | |
| Legal status | |
| Identifiers | |
| CAS Number | |
| PubChem CID | |
| ChemSpider | |
| CompTox Dashboard (EPA) | |
| (verify) | |
Perindopril/indapamide (marketed as Preterax, Coversyl Plus and Noliprel) is a combination medication which contains perindopril (an ACE inhibitor) and indapamide (a thiazide-like diuretic) both of which are used for the treatment of essential hypertension (high blood pressure).[2]
Medical uses
[edit]Administration
[edit]One tablet daily, preferably to be taken in the morning and before a meal.
Elderly: Normal dosage.
Kidney failure: Creatinine clearance (CrCl) >30 mL/min: no dosage modification. If CrCl <30 mL/min, treatment is contraindicated.
Contraindications
[edit]Absolute contraindications to taking perindopril/indapamide include a known allergy to perindopril, indapamide, or sulfonamides; history of Quincke's edema linked to previous ACE inhibitor therapy; end-stage kidney disease; serious liver disease; high levels of potassium in the blood; pregnancy; and lactation.
Relative contraindications to using this medication include combination therapy with lithium, potassium salts, potassium-sparing diuretics, and certain medicines which can cause abnormal heart rhythms.
Side effects
[edit]Side effects of perindopril/indapamide may include weakness, dizziness, headache, mood swings and/or sleep disturbances. Additionally, cramps, low blood pressure, allergic reactions, skin rashes, gastrointestinal disorders, dry cough, erectile dysfunctions, dry mouth, and a risk of dehydration in the elderly and in people who have congestive heart failure.
Immunosuppressed patients. Hemodialysis: risk of anaphylactoid reaction during hemodialysis with polyacrylonitrile membranes. Liver impairment.
Caution is recommended when prescribing perindopril/indapamide to people with electrolyte disorders, diabetes, gout, low blood pressure, or strict sodium-free diets, heart or kidney failure, atherosclerosis, renal artery stenosis, and in elderly people.
Pharmacology
[edit]Using a fixed combination of an ACE inhibitor and a chlorosulfamoyl diuretic leads to additive synergy of the antihypertensive effects of the two constituents. Its pharmacological properties are derived from those of each of the components taken separately, in addition to those due to the additive synergistic action of the two constituents, when combined, on vascular endothelium, arteriolocapillary microcirculation, and the target organs of hypertension.
Drug interactions
[edit]Not recommended: combinations with lithium, potassium-sparing diuretics, potassium (salts), antiarrhythmic drugs which can cause torsades de pointes, anesthetic drugs, cytostatics or immunosuppressive agents.
References
[edit]- ^ "Product monograph brand safety updates". Health Canada. 7 July 2016. Retrieved 3 April 2024.
- ^ Lip JY, Beevers DG (26 November 2014). "Hypertension in patients with cardiovascular disease". In Beevers DG, Lip JY, O'Brien ET (eds.). ABC of Hypertension. Wiley. pp. 83–. ISBN 978-1-118-59256-4.