Dorover 4mg Domesco medicine for hypertension, congestive heart failure (1 blister x 30 tablets)

Perindopril is an inhibitor inhibitor (inherity of the converting enzyme, CEI), which converts angiotensin I into angiotensin II is a vasoconstrictor. Angiotensin II also stimulates the adrenal shells of Aldosteron secretion. The result is:

Perindopril's hypotension is also shown in patients with low or normal renin levels.

Perindopril is acting through active metabolites as Perindoprilat. Other metabolites are not active.

Characteristics of anti -hypertension activity

In arterial hypertension:

In the treatment of heart failure:

Of the three studies of heart failure, hypotension takes place slowly and suddenly with Perindopril, compared to other drugs in the same pharmacological class.

Hemodynamic mechanism in heart failure

Perindopril reduces heart activity:

pharmacokinetics

Perindopril is quickly absorbed by oral. The absorption amount is 65 to 70% of the drug.

Perindopril is hydrolyzed into Perindoprilat, which is a specific inhibitor for angiotensin conversion yeast. The amount of perindoprilat formed varies with food. The peak concentration of plasma Perindoprilate is achieved after 3 to 4 hours. The ratio of binding with plasma proteins is less than 30%, but depends on the concentration.

When using Perindopril at a single daily dose, stable state reaches an average after about 4 days. The semi -cumulative cycle is about 24 hours.

Higher plasma Perindoprilat concentration in patients whose clearance is less than 60 ml/min, regardless of kidney failure or high age.

In patients with heart failure, Perindoprilat elimination is also slower.

Perindoprilat's relic of the relic of Perindoprilat is 70 ml/min. Perindopril's kinetics change in cirrhosis patients: The liver clearance of the original molecule is half reduced. However, the amount of Perindoprilat formed does not decrease, so no dose adjustment.

Angiotensin conversion inhibitors can pass through the placenta.

Start treatment at a dose of 2mg, oral in the morning. The maintenance treatment dose is from 2mg to 4mg, 1 time/day. For patients at risk, should start treatment at a dose of 1mg, 1 time in the morning.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

Handling: gastric lavage and immediately setting an intravenous line to transmit isothermic salt solution. Perindopril has the competent fertilizer (70 ml/minute).

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when forgetting a dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Rare: Evana (edema) on the face, head, lips, tongue, bar and/or larynx.

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Caution when using

Cases of heart failure, loss of salt water: The risk of hypotension and/or kidney failure.

In hypertension that has been treated for diuretics in advance, it is necessary to stop diuretics at least 3 days before starting Perindopril, then re -use if needed. If it is not possible to stop, should start treatment at a dose of 2mg.

In kidney hypertension, it is advisable to start treating at a low dose of 2mg.

CREATININ CREATIIN ATTRACTIVE ATTRACTIVE ATTERS AND INTERESTING AND IN THE FIRST MONTH.

In congestive heart failure with diuretic, diuretic should be reduced a few days before starting Perindopril.

On risk groups, especially people with severe congestion heart failure (degree IV), the elderly, patients who initially have too low blood pressure or renal function, or patients who are taking high doses of dosage, must start using low -dose 1mg, under the monitor of the doctor.

Anaphylactic reactions (lip edema and tongue with shortness of breath and hypotension) have been recorded while hemolysis with high absorbent membranes (polyacrylonitril) on patients treated with enzyme inhibitors. This coordination should be avoided.

Need to adjust the dose of Perindopril according to the degree of renal failure. In these patients, they must periodically check potassium and creatinin.

Caution and monitoring of kidney function when treating patients with hypertension due to kidney blood vessels.

There is no research in children, so Perindopril is contraindicated for children. In the case of great surgical anesthesia or medication can cause lower pressure, Perindopril can cause hypotension, which must be cured by increasing blood volume.

The ability to drive and operate machinery

because the drug can cause headaches, temperament and/or sleep disorders, so be cautious when used for patients who are operating train or machinery.

pregnancy and lactation

Pregnancy

There is no toxicity research data for mothers and fetuses. On the patient is treated with enzyme inhibitors, in some cases, the growth of the uterus, premature or existence of arterioscleros is recorded. Some rare cases of non -reverse neonatoma have been informed, after the mother is treated with diuretics. Do not use for pregnant people.

Breastfeeding period

There is no human data. Do not use for nursing mothers.

Medicinal interaction

Non -steroid anti -inflammatory drugs, corticosteroids, tetracosactid: Reducing the effect of lowering blood pressure (due to nonsteroidal anti -inflammatory drugs that inhibit prostaglandine, vasodilation and phenylbutazone effects are salt - water).

Some patients have used diuretic before, especially when newly treated, hypotension effects can become excessive when starting to use Perindopril.

Collaborate with neuroleptics and imipramine antidepressants will increase the risk of vertical hypotension.

Insulin (insulin, hypoglycemia): As well as other angiotensin conversion enzyme inhibitors, Perindopril increases the hypoglycemic effect of these drugs.

Combining Perindopril with potassium salts and with potassium diuretics at risk of increased potassium - blood and kidney failure. Do not coordinate drugs that cause potassium - blood with transferred enzyme inhibitors. However, in case it is necessary, it should be used carefully and must regularly evaluate potassium - blood.

Lithi: increased blood lithium.