Co-Perineva tabs 1.25mg + 4mg #90

Co-Perineva user manual

Reed more and buy Co-Perineva on this page

See also - Perineva

Composition

The tablets of Co-Perineva contain the following elements:
    indapamide, perindopril erbumine;
    semi-finished granules - lactose monohydrate, calcium chloride hexa hydrate, crospovidone;
    auxiliary substances - microcrystalline cellulose, silicon dioxide colloid, magnesium stearate, sodium hydrogen carbonate.

Form of issue

White round biconvex tablets, on the one hand, have an engraved short line.
Co-Perineva tablets are produced on 10 tablets in a blister, in a cardboard package contains 3, 6, 9 blisters. Depending on the package, one tablet contains 0.625 + 2 mg active ingredients, 1.25 + 4 mg or 2.5 + 8 mg.

pharmachologic effect

The drug refuses vasodilator, diuretic and hypotensive action.

Pharmacodynamics and pharmacokinetics

Co-Perineva is a combined preparation containing perindopril and indapamide.
The drug refuses antihypertensive effect, the effectiveness of which does not depend on the age of the patient, the position of his body, is not accompanied by tachycardia. Does not affect the metabolism of lipids, including those suffering from diabetes. When taking the drug, the risk of hypokalemia is reduced.
During the day, the antihypertensive effect persists.
After a month of taking the drug, a reduction in blood pressure is achieved. In the event of discontinuation of treatment, there is no risk of withdrawal syndrome.
Perindopril is extremely effective in fighting hypertension (all forms of severity). After 4-6 hours after taking the medicine, the maximum antihypertensive effect develops, which persists throughout the day.
Perindopril is rapidly absorbed from the digestive tract after administration. Bioavailability at the level of 65-70%. After 3-4 hours after taking the maximum level of the drug in the blood plasma is reached. Metabolism is exposed in the liver, forming an active (perindoprilat) and five inactive metabolites. A small amount of perindoprilata is absorbed into breast milk and through the placenta. It is excreted through the kidneys.
Slowed-off perindoprilata in patients with cardiac and renal insufficiency and patients older than 65 years. In patients with cirrhosis of the liver, the liver clearance is halved, but the level of perindoprilat is not reduced.
Indapamide is almost completely absorbed from the digestive tract, slowing down the process can be simultaneous eating. An hour later, the maximum level in the blood is reached. In the liver it is metabolized. It is excreted through the kidneys and intestines.

Indications for use

The drug should be taken with essential hypertension.

Contraindications

The drug Co-Perineva is contraindicated in the following cases:
    sensitivity to any element of the drug;
    lactose intolerance;
    refractory hyperkalemia;
    anginaurotic edema;
    bilateral stenosis of the renal arteries;
    deficiency of lactase;
    liver failure;
    glucose-galactose malabsorption;
    kidney failure;
    stenosis of the artery of the kidney;
    pregnancy, lactation, children under the age of 18.
With caution should take the drug in the following cases:
    connective tissue diseases (scleroderma, SLE);
    therapy with immunosuppressants;
    oppression hemopoiesis of the bone marrow;
    angina pectoris;
    Renovascular hypertension;
    decrease in BCC;
    hyperuricemia;
    diabetes;
    cerebrovascular diseases.

Side effects

The use of the drug can cause the following side effects:
    thrombocytopenia, agranulocytosis, hemolytic anemia, leukopenia, aplastic anemia;
    vertigo, paresthesia, dizziness, headache; unstable mood, sleep disturbance; in rare cases, confusion;
    tinnitus, impaired vision;
    Orthostatic hypotension, arrhythmias (bradycardia, atrial fibrillation, ventricular tachycardia), myocardial infarction, angina pectoris;
    dry cough, shortness of breath, bronchospasm, rhinitis, eosinophilic pneumonia;
    dry mouth, constipation, nausea, abdominal pain, decreased appetite, epigastric pain, vomiting, diarrhea, dyspepsia, pancreatitis, jaundice;
    angioedema (facial, lips, limbs, tongue, larynx), rash, hives, itching;
    muscle spasms;
    kidney failure;
    impotence;
    asthenia, increased sweating.

Instructions for use (Method and dosage)

Medication Co-Perineva taken a day 1 time, inside, in the morning before breakfast, washed down with water.
Doses are listed in the ratio of indapamine / perindopril.
First, take one tablet (0.625 / 2 mg) per day. If within a month it is not possible to achieve control of blood pressure, the dose is increased to one tablet (1.25 / 4 mg). To achieve the most pronounced effect, you should increase to the limit of the daily dose - one tablet (2.5 / 8 mg).
For elderly patients, the initial dose is one tablet (0.625 / 2 mg). Treatment with the drug can be prescribed in the case of control of blood pressure and kidney function.
Patients with moderate renal insufficiency begin with a minimal dose, the maximum dose allowed is 1.25 / 4 mg.

Overdose

Symptoms of overdose: vomiting, nausea, muscle cramps, drowsiness, dizziness, confusion, decreased water-electrolyte balance, oliguria, a significant decrease in pressure.
If these symptoms appear, you should wash the stomach, then take activated charcoal, restore the water-electrolyte balance. With a strong reduction in pressure, the patient should lie on his back and raise his legs, then introduce a 0.9% solution of sodium chloride.

Interaction

Do not combine the preparation of Co-Perineva with ACE inhibitors and lithium preparations, as the level of lithium in the blood can increase. If necessary, take at the same time to keep the level of lithium under control.
With extreme caution, take baclofen, which can increase the hypotensive effect. It should monitor the pressure, kidney function, if necessary adjust the dose.
Neuroleptics and tricyclic antidepressants strengthen the effect of hypotension and increase the possibility of orthostatic hypotension.
Tetrakosaktit and GCS contribute to reducing the hypotensive effect.
With simultaneous administration with any other antihypertensive drugs, there is a possibility of a stronger manifestation of the hypotensive effect.

Perindopril

At the same time, it is not recommended to use with potassium-sparing diuretics (Spironolactone, amiloride, eplerenone, triamterene) and potassium preparations. When they are used in parallel, the level of potassium in the blood can increase, so a fatal outcome is possible. If the need for joint therapy (with hypokalemia), it is necessary to observe the level of potassium and the parameters of the ECG.
With extreme caution recommend to take the drug Co-Perineva together with insulin and hypoglycemic agents. The risk of developing leukopenia increases when used with cytostatic immunosuppressants, allopurinol, GCS and procainamide. When used with agents for general anesthesia, their hypotensive effect may increase. When used in high doses, thiazide and loop diuretics can lead to hypovolemia.

Indapamide

Preparations that cause arrhythmia (pirouette type) should be taken with caution, since there is a possibility of hypokalemia. With caution recommend taking Indapamide with drugs such as antipsychotics (cyamemazine, trifluoperazine, chlorpromazine, etc.), antiarrhythmic drugs (amiodarone, hydroquinidine, ibutilide, tozilide, etc.), benzamides (sultopride, tiapride, sulpiride, amisulpride), butoperophenones (haloperidol , droperidol), other drugs (astemizole, misolastine, sparfloxacin, methadone, bepridil, halofantrine, terfenadine, cisapride).
Medicinal products that can cause hypokalemia: tetracosactide, laxatives, which stimulate intestinal motility, amphotericin B, glucocorticoids, mineralocorticoids, cardiac glycosides.
Increased risk of lactic acidosis when used with Metformin. Patients taking high-dose iodine contrast media are at risk of developing renal failure. Hypercalcemia can develop when taking drugs containing calcium salts.

Terms of sale

You can buy Co-Perineva without a prescription.

Storage conditions

At a temperature not exceeding 30 ° C.
Shelf life - 3 years.

special instructions

Do not recommend taking in parallel with lithium preparations.
Therapy is categorically contraindicated in patients with impaired renal function. Patients suffering from hypertension may have symptoms of renal failure. In this case, it is necessary to stop the treatment with Co-Perineva. Later it is possible to repeat therapy, appointing the minimum doses, or to use in monotherapy indapamide and perindopril. Every two weeks in such patients should check the level of creatinine and potassium in the blood.
The combination of indapamide and perindopril can not prevent the development of hypokalemia, especially if the patient has diabetes mellitus or kidney failure. The level of potassium in the blood in this case should be monitored regularly.

Reviews on Co-Perineva

Reviews on the tablets among the patients who received them are mostly positive, but many people note the appearance of side effects even with a minimal dose of admission.