Perindopril/indapamide: Difference between revisions

Perindopril/indapamide
Combination of
Perindopril	ACE inhibitor
Indapamide	Thiazide-like diuretic
Clinical data
Trade names	Preterax, Noliprel, Coversyl Plus
Routes of; administration	By mouth
ATC code	C09BA04 (WHO) ;
Legal status
Legal status	AU: S4 (Prescription only); CA: ℞-only; In general: ℞ (Prescription only);
Identifiers
CAS Number	182176-83-6;
PubChem CID	9940214;
ChemSpider	8115834 ;
CompTox Dashboard (EPA)	DTXSID001027112 ;
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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).^[2]

Medical uses

High blood pressure

Administration

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

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

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

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

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

^ "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.

[1] "Product monograph brand safety updates". Health Canada. 7 July 2016. Retrieved 3 April 2024.

[BeeversLip2014-2] 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.

[1]

[2]

@@ Line 1: / Line 1: @@
+{{short description|Combination medication}}
-{{Multiple issues|
-{{Expert-subject|date=September 2015}}
 {{Manual|date=June 2016}}
-}}
 {{Drugbox
 | verifiedrevid = 464199158
-| image = Perindopril and indapamide.svg
-<!--Combo data-->
 | type = combo
+| image = Perindopril and indapamide.svg
+| alt =
+<!-- Combo data -->
 | component1 = Perindopril
 | class1 = [[ACE inhibitor]]
 | component2 = Indapamide
 | class2 = [[Thiazide-like diuretic]]
-<!--Clinical data-->
+<!-- Clinical data -->
-| tradename = Preterax, Noliprel
+| tradename = Preterax, Noliprel, Coversyl Plus
 | pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
-| pregnancy_US = <!-- A / B / C / D / X -->
 | pregnancy_category =
+| routes_of_administration = [[By mouth]]
+| ATC_prefix = C09
+| ATC_suffix = BA04
 | legal_AU = S4
-| legal_CA = <!-- / Schedule I, II, III, IV, V, VI, VII, VIII -->
+| legal_CA = Rx-only
+| 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>
 | legal_UK = <!-- GSL / P / POM / CD / Class A, B, C -->
 | legal_US = <!-- OTC / Rx-only  / Schedule I, II, III, IV, V -->
 | legal_status = Rx-only
-| routes_of_administration = Oral ([[Tablet (pharmacy)|tablets]])
 <!--Identifiers-->
-| CAS_number =
+| CAS_number = 182176-83-6
-| ATC_prefix = C09
-| ATC_suffix = BA04
 | PubChem = 9940214
 | DrugBank_Ref = {{drugbankcite|correct|drugbank}}
@@ Line 36: / Line 39: @@
 }}
-'''Perindopril/indapamide''' (marketed as '''Preterax''' 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|author1=D. Gareth Beevers|author2=Gregory Y. H. Lip|author3=Eoin T. O'Brien|title=ABC of Hypertension|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>
+'''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>
-== Form and composition ==
+== Medical uses ==
+[[High blood pressure]]
-Each scored tablet contains 2&nbsp;mg of [[perindopril]] [[Tert-Butylamine|''tert''-butylamine]] salt and 0.625&nbsp;mg of [[indapamide]].
-== Indication ==
+=== Administration ===
-[[Essential hypertension]].
-== Dosage and administration ==
 One tablet daily, preferably to be taken in the morning and before a meal.
-Elderly patients: Normal dosage.
+Elderly: Normal dosage.
 [[Kidney failure]]: [[Creatinine clearance]] (CrCl) >30 mL/min: no dosage modification. If CrCl <30 mL/min, treatment is [[contraindicated]].
-== Pharmacological action ==
-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.
 == Contraindications ==
-Absolute: 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|renal disease]]; serious [[liver]] disorder; [[hyperkalemia]]; [[pregnancy]]; [[lactation]].
+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]].
-Relative: Combination therapy with [[lithium]], [[potassium]] salts, [[potassium-sparing diuretics]], and certain medicines which can cause [[Cardiac arrhythmia|heart rhythm disorders]].
+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]].
 == Side effects ==
-[[Asthenia]], [[dizziness]], [[headache]], [[mood swings]] and/or [[sleep disturbances]], [[cramps]], [[hypotension]], [[allergic reactions]], [[skin rashes]], [[gastrointestinal disorder]]s, [[dry cough]], [[erectile dysfunctions]], [[dry mouth]], risk of [[dehydration]] in the elderly and in patients suffering from [[heart failure]], sexual dysfunctions; changes in [[blood test]] results may occur.
+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]].
-== Warnings ==
 [[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 [[salt|sodium]]-free diets, heart or kidney failure, [[atherosclerosis]], [[renal artery stenosis]], and in elderly people.
-== Precautions ==
-Disorders of [[electrolyte]] balance, [[diabetes]], [[gout]], hypotension, or strict [[salt|sodium]]-free diets, heart or renal failure, [[atherosclerosis]], [[renal artery stenosis]], elderly.
+== Pharmacology ==
+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.
 == Drug interactions ==
@@ Line 76: / Line 75: @@
 {{DEFAULTSORT:Perindopril Indapamide}}
-[[Category:Antihypertensive agents]]
+[[Category:Combination antihypertensive drugs]]
-[[Category:Combination drugs]]

v t e Antihypertensive drugs acting on the renin–angiotensin system (C09)
ACE inhibitors ("-pril")	Sulfhydryl-containing: Captopril Rentiapril Zofenopril (+nebivolol) Dicarboxylate-containing: Enalapril^# (+lercanidipine, +nitrendipine) Benazepril (+amlodipine, +pimobendan) Cilazapril Delapril (+manidipine) Imidapril Lisinopril (+amlodipine, +HCT) Moexipril Perindopril (+amlodipine, +bisoprolol, +indapamide, +amlodipine and indapamide, +bisoprolol and amlodipine, +bisoprolol, amlodipine, and indapamide) Quinapril (+HCT) Ramipril (+amlodipine, +amlodipine and HCT, +bisoprolol, +felodipine) Spirapril Temocapril Trandolapril (+verapamil) Phosphonate-containing: Ceronapril Fosinopril (+HCT) Other/ungrouped: Alacepril
AIIRAs ("-sartan")	Azilsartan Candesartan (+amlodipine, +amlodipine and HCT) Eprosartan Fimasartan Irbesartan (+amlodipine, +amlodipine and HCT, +HCT) Losartan (+amlodipine, +HCT) Olmesartan (+amlodipine, +amlodipine and HCT, +HCT) Tasosartan^§ Telmisartan (+amlodipine, +amlodipine and HCT, +HCT) Valsartan (+aliskiren, +amlodipine, +amlodipine and HCT, +HCT, +lercanidipine, +nebivolol, +sacubitril)
Renin inhibitors ("-kiren")	Aliskiren (+amlodipine, +HCT, +amlodipine and HCT) Remikiren^§
Dual ACE/NEP inhibitors	Gemopatrilat Ilepatril Omapatrilat Sampatrilat
Neprilysin inhibitors	Sacubitril (+valsartan)
Other	Sparsentan
^#WHO-EM ^‡Withdrawn from market Clinical trials: ^†Phase III ^§Never to phase III