Noliprel a tabs 2.5mg + 0.625mg #30

Noliprel instruction

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Composition

The drug Noliprel is offered in several different forms. The composition of all variations of the drug include perindopril and indapamide. Combined Noliprel tablets have 2 mg perindopril and 0.625 mg indapamide. The composition of the drug Noliprel Forte includes 4 mg of perindopril and 1.25 mg of indapamide. Noliprel A contains 2.5 mg of perindopril and 0.625 mg of indapamide. In this preparation, perindopril is bound to the amino acid arginine, which favorably affects the state of the cardiovascular system.
In the tablets Nolipret A Forte - 5 mg perindopril and 1.25 mg indapamide. In the drug Noliprel A B-forte - 10 mg perindopril and 2.5 mg indapamide.
As additional substances in the drug Noliprel is magnesium stearate, lactose monohydrate, colloidal hydrophobic silica, microcrystalline cellulose.

Form of issue

The drugs are available in the form of white tablets of oblong form, on both sides of the risk pills. They fit into a cardboard package of 14 and 30 pcs. in blisters.

pharmachologic effect

Noliprel is a combined remedy that contains perindopril (an angiotensin-converting factor inhibitor) and indapamide (a diuretic that enters the sulfonamide group).
The pharmacological action of a drug is determined by a combination of certain effects of these components. In this combination, both components mutually enhance the action. Noliprel is an antihypertensive drug that effectively reduces both diastolic and systolic pressure. The degree of severity of the effect depends on the dose. After taking the drug, there is no rapid heart beat. The clinical effect is observed 1 month after the treatment was started. Antihypertensive effects persist for one day. After the therapy is suspended, the patient does not have withdrawal symptoms. In the course of treatment, the severity of left ventricular hypertrophy decreases, the degree of general atrial and post cardiac loading decreases. Large vessels become more elastic, the walls of small vessels are restored. The metabolic processes that occur in the body, the drug has no effect.
Perindopril reduces the level of secretion of aldosterone, which increases the activity of renin in the blood. Arterial pressure decreases in people with different levels of renin activity. Under the influence of this component, the vessels expand.
When taking the drug reduces the likelihood of hypokalemia. The mechanism of action of indapamide is similar to thiazide diuretics: urinary excretion and urinary excretion of sodium, chlorine ions will increase.
Hyperreactivity of blood vessels decreases with adrenaline. The amount of lipids in the blood does not change.

Pharmacokinetics and pharmacodynamics

The pharmacokinetics of perindopril and indapamide when applied in a complex is the same as for separate application. After ingestion, rapid adsorption of perindopril occurs. The level of bioavailability is 65-70%. About 20% of the total absorbed perindopril is later converted to perindoprilat (active metabolite). The maximum concentration of perindoprilat in plasma is observed after 3-4 hours. With blood proteins bind less than 30%, depending on the concentration in the blood plasma. The half-life is 25 hours. Through the placental barrier, the substance penetrates. Perindoprilat from the body is excreted through the kidneys. Its half-life is 3-5 hours. There is a slower introduction of perindoprilat in the elderly, as well as in patients with heart failure and kidney failure.
Indapamide is completely and relatively quickly absorbed from the digestive tract. The maximum concentration of the substance in the plasma is noted one hour after oral administration.
With plasma proteins, the substance binds to 79%. Half-life is 19 hours. The substance is released in the form of inactive metabolites by the kidneys (approximately 70%) and the intestine (about 22%). In people with kidney failure, there is no change in the pharmacokinetics of the substance.

Indications for use Noliprel

There are such indications for the use of the drug:
    essential hypertension;
    the need to reduce the risk of manifestations of microvascular complications in people with kidney, vessel and heart diseases, which at the same time suffer from arterial hypertension, as well as type 2 diabetes.

Contraindications

Contraindications to the use of all varieties of Noliprel are such diseases and conditions:
    high sensitivity to the components of the drug or the presence of allergic reactions to its components;
    renal failure, in which the creatinine clearance is less than 30 ml / min;
    hepatic insufficiency, in which there is a tendency to encephalopathy;
    combining with drugs that extend the QT interval, as well as with antiarrhythmic drugs;
    hypokalemia;
    stenosis of the renal arteries;
    lactase deficiency, glucose galactose malabsorption syndrome, galactosemia;
    angioedema in history;
    pregnancy, lactation;
    age to eighteen years.
Also, do not take the drug at one time with potassium preparations, potassium-sparing diuretics, if the patient has hyperkalemia.
In the absence of sufficient information it is not recommended to use tablets to treat people who are on hemodialysis, as well as patients with decompensated heart failure.
Cautiously assigned to people with systemic connective tissue diseases, to those who take antidepressants, with oppression of bone marrow hematopoiesis. Also, the treatment of patients with angina pectoris, renovascular hypertension, cerebrovascular diseases, hyperuricemia, and lability of blood pressure is conducted with caution.

Side effects

    In the functions of the cardiovascular system: pronounced hypotension, orthostatic collapse, in rare cases: arrhythmia, stroke, myocardial infarction.
    In the functions of the genitourinary system: impairment of kidney function, proteinuria in people with glomerular nephropathy, in rare cases - acute renal failure. There may be a decrease in potency.
    In the functions of the central and peripheral NA: severe fatigue, dizziness, headache, asthenia, unstable mood, hearing, vision, appetite, convulsions, in some cases stupor.
    In the functions of the respiratory system: cough, shortness of breath, bronchospasm, discharge from the nose.
    In the functions of the gastrointestinal tract: dyspepsia, abdominal pain, pancreatitis, cholestasis, increased activity of transaminases, hyperbilirubinemia.
    In the functions of the blood system: on the background of hemodialysis or after kidney transplantation, patients may develop anemia, in rare cases - thrombocytopenia, pancytopenia, agranulocytosis, hemolytic anemia.
    Allergic manifestations: skin itching, rash, swelling, urticaria.
    In patients with hepatic insufficiency, hepatic encephalopathy can develop. People with a disturbed water-electrolyte balance may exhibit hyponatremia, hypovolemia, hypokalemia, dehydration.

Instructions for use Noliprel (Method and dosage)

Noliprel tablets are preferably taken in the morning. The medicine is prescribed one tablet a day. Instruction for Noliprel Fort provides a similar treatment regimen. Noliprel A and Noliprel AB Forte are prescribed to patients 1 tablet per day. If the creatinine clearance is equal to or exceeds 30 ml / min in patients, then there is no need to reduce the dose. If the clearance equals or exceeds 60 ml per day, then the treatment should carefully monitor the level of potassium and creatinine in the blood.
If necessary, after a few months of treatment, the doctor may increase the dose, appointing Noliprel A Forte or another version of this medication instead of Noliprel.

Overdose

When the medicine is overdosed, there is a strong decrease in pressure, nausea, vomiting, dizziness, unsteady mood, symptoms of kidney failure, electrolyte imbalance. In this case, you should immediately lead to a normal water-electrolyte balance, rinse the stomach, take enterosorbents. Noliprel metabolites can be removed by dialysis. If necessary, intravenous saline is administered.

Interaction

Do not take Noliprel at one time with lithium preparations. If it is impossible to cancel one of the drugs, you should clearly control the lithium content in the blood.
With simultaneous treatment with potassium-sparing diuretics or drugs with potassium, the concentration of potassium in the blood can increase. This combination is recommended only for hypokalemia.
When combining indapamide with vincamine, bepridilom, sultopride, halofantrine, as well as with simultaneous intravenous administration of erythromycin, arrhythmia and bradycardia may occur.
Sometimes with simultaneous treatment with insulin and Noliprelum may develop hypoglycemia.
When taking non-steroidal anti-inflammatory drugs, the hypotensive properties of Noliprel are suppressed. In the case of dehydration, this combination of drugs can cause kidney damage or kidney failure.
When treating with Noliprelum and neuroleptics or tricyclic antidepressants, orthostatic hypotension may develop.
In view of the delay in the body of water and electrolytes with simultaneous treatment with Noliprel and mineralocorticoids, glucocorticosteroids, stimulant laxatives, tetracosactide, amphotericin B, hypotensive effect decreases and the likelihood of hypokalemia increases.
In view of the possibility of hypokalemia, the risk of toxic effects of cardiac glycosides increases.
When combined with metformin, lactic acidosis may develop.
Before using iodine-containing X-ray contrast preparations with Noliprel it is necessary to conduct adequate hydration of the organism.
Simultaneous application of calcium salts can provoke hypercalcemia.
Simultaneous treatment with cyclosporine may increase the level of creatinine in the blood.

Terms of sale

To buy Noliprel the prescription is not needed.

Storage conditions

Store at a temperature not exceeding 30 ° C, you need to protect the medicine from children's access.
Shelf life 3 years.

special instructions

People who have been prescribed Noliprel treatment need adequate adequate dehydration to prevent a sharp drop in pressure.
People with heart failure can simultaneously treat with beta-blockers.
In the treatment with Noliprel, a positive reaction is observed when performing the doping test.
In the first weeks of treatment, it is important to carefully drive vehicles or work with precise mechanisms in the treatment of Noliprel.
If there is a marked decrease in pressure during treatment, it may be necessary to administer 0.9% sodium chloride intravenously.
Treatment of patients with circulatory insufficiency in the brain or with coronary heart disease should start with small doses of Noliprel.
In people who have very high levels of uric acid in their blood, the risk of developing gout increases with the treatment with varieties of Noliprel.

Children

The drug is not prescribed for the treatment of children under 18 years of age, since there is no precise data on the efficacy and safety of such treatment.

With alcohol

Do not take alcohol during therapy with Noliprel.

In pregnancy and lactation

Pregnant women and mothers during breastfeeding Noliprel are contraindicated. Systematic treatment of these drugs can lead to the development of anomalies and diseases in the fetus, as well as lead to the death of the fetus. If a woman learns about pregnancy during treatment, there is no need to interrupt pregnancy, but the patient should be aware of the possible consequences. In the case of increased blood pressure, another antihypertensive therapy is prescribed. If a woman took this medication in the second and third trimesters, ultrasound of the fetus should be performed to assess the condition of his skull and the functioning of the kidneys.
Newborns whose mothers took the drug may suffer from arterial hypotension, so they need to ensure constant monitoring of specialists.
When breastfeeding, the drug is contraindicated, so lactation for the duration of therapy should be discontinued or another drug should be selected.

Reviews about Noliprel

Reviews on the forums about Noliprel, as well as about the drugs Noliprel A, Noliprel A Forte, Noliprel AB Forte show that this drug effectively lowers blood pressure. The drug maintains normal blood pressure, allowing to reduce the likelihood of development of strokes and myocardial infarction.
Reviews for Noliprel Fort also often contain information that this medication and other variants of it can produce a positive result when other drugs are ineffective. Sometimes patients note the development of some side effects, in particular, dry cough, headache, but they are not very intense.
Doctors also note the positive impact of drugs, but always note that the drug should be taken strictly according to instructions and taking into account the recommendations of a specialist. In particular, the drug should be taken regularly, and not only during the period of intense BP surges.