Perindastad 4mg Stella medicine for hypertension (1 blister x 30 tablets)

Dosage form Box of 1 blister x 30 tablets
Specifications Perindopril Erbumin

Ingredient

Composition information	Content
Perindopril Erbumin	4mg

Uses

indications

Perindastad 4 drugs are indicated in the following cases:

Treatment of hypertension.

Treatment of heart failure symptoms.

Stable coronary artery disease: Reduce the risk of cardiovascular events in patients with a history of myocardial infarction and/ or regenerate circulation.

Pharmacokology

Perindopril is an angiotensin I converting enzyme inhibitor into Angiotensin II (ACE) converting or kinase, an expeptidase that allows the turn of angiotensini into Angiotensin II vasodilatoma as well as bradykinin vasodilation into an inactive heptapidide heptide.

ACE inhibition reduces angiotensin II concentration in plasma, leading to increased lenin activity in plasma (due to negative reverse feedback in reverse release) and reduction of aldosteron secretion, because ACE is inactivating Bradykinin, ACE inhibitors also increase the activity of the Kallikrein-oil system

It is possible that this mechanism contributes to the effect of lowering the blood pressure of ACE inhibitors and is partly responsible for a few side effects (such as cough). Perindopril works through the active metabolites of Perindoprilat. Other metabolites without ACE inhibitors in in vitro.

Dynamic pharmacokinetics

perindopril acts as a precursor of the type of activity Diacid Perindoprilat. After drinking, Perindopril was quickly absorbed with a pretty 65 - 75%birth.

The drug is widely metabolized, mainly in the liver, Perindoprilate and non -activity metabolites include glucuronides. Food reduces Perindopril's conversion to Perindoprilat. Perindoprilat's plasma concentration is achieved after 3-4 hours of drinking Perindopril. Perindoprilat is associated with plasma protein about 10 - 20%.

Perindopril is excreted mainly in the urine in a constant form, Perindoprilat and other specialized substances. The excretion of Perindopriat through two stages with the sale time is about 5 hours and the sale time is 25 - 30 hours or longer, the last disposal time is present in the form of closely associated with Angiotensin moving yeast. Elimination through perindopalat decreases when renal failure. Both Perindopril and Perindoprilat are excluded by the fertilizers.

Before taking Perindastad 4mg Stella medicine for hypertension (1 blister x 30 tablets)

How to use

use by oral. Drink in the morning before meals.

Dosage

Hypertension

Perindopril is used single or combined with other anti -hypertension drugs.

Starting dose recommended: 4 mg x 1 time/day, drink in the morning. Can increase the dose up to 8 mg x 1 time/day after a month of treatment

Elderly patients: The starting dose of 2 mg may increase to 4 mg after a month of continued treatment, then if necessary, it can increase to 8 mg depending on the kidney function.

Symptoms of heart failure

recommended starting dose: 2 mg oral in the morning. This dose may increase by 2 mg in the period of less than 2 weeks to 4 mg x 1 time/ day if tolerated.

Stable coronary artery disease

The starting dose of 4 mg x 1 time/day for 2 weeks, then increase to 8 mg x 1 time/day, depending on the kidney function provided that the 4 mg dose is well tolerated.

Elderly patients: The starting dose of 2 mg x 1 time/day for 1 week, then 4 mg x 1 time/day at the next week, before increasing the dose to 8 mg x 1 time/day depending on the kidney function.

Adjust the dose in patients with renal failure

Roadinine clearance from 30 - 60 ml/minute: 2 mg/day.

Creatinine clearance from 15 - 30 ml/minute: 2 mg, used daily.

Patients with hemolysis (Perindoprilat clearance coefficient is 70 ml/min.

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?

Symptoms:

The most common sign is hypotension.

Treatment

Should stop taking ACE inhibitors and monitor patients.

should be supportive treatment and symptomatic treatment. Perindopril overdose treatment by infusion of physiological saline intravenous solution. Perindopril can be excluded by blood decomposition with a clearance of 52 ml/minute for Perindopril and 67 ml/minute for Perindoprilat.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Perindastad 4, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Neurological. Headache, visual disorders and/ or sleep, depression, when the treatment is not fully controlled.

digestive: digestive disorders are not very specific and there has been notice of taste disorders, dizziness and cramps.

Skin: A few cases of local rash have been notified.

Respiratory: Sometimes there are symptoms of cough, generally not very uncomfortable, just a dry cough, irritation.

Uncommon, 1/1000

Some signs of no specificity: helpless, dry mouth.

Blood: It is possible to see hemoglobin mitigating at the beginning of treatment.

Biochemistry: Hyassium - blood, usually fleeting. It can be seen that hyper urea and blood creatinine, and recovered from treatment.

Rare, ADR

Evaluation (on the face, head, lips, tongue, bar and/or larynx).

Instructions on how to handle ADR

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.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Perindastad 4 contraindications in the following cases:

Hypersensitivity to Perindopril, other ACE inhibitors or any ingredients in the formula.

History of veins related to the previous ACE inhibitors.

Pregnant and lactating women.

Caution when used

Heart effect: Symptoms of hypotension may occur. Patients with special risks include people who reduce volume or limit salt, prolonged diuretic, diarrhea, diarrhea or vomiting, significant hypotension may occur in patients with congestive heart failure - the ability of myocardial infarction or stroke in people with anemia or ischemic disease.

Effects on the kidneys: The memory of the Renin-Anotensin-Aldosteron system can cause kidney failure and rarely damage to the body and/ or death in sensitive patients (renal functional people depend on the activity of the RAA system as in patients with severe congestive heart failure).

A decrease in renal function, manifested by slight increase or transient bun and geatinine in serum, may occur after treatment with ACE inhibitors, especially in patients with hypertension with kidney stenosis on the one side or both sides, previous kidney failure or simultaneous treatment with diuretics. Dosage reduction should be reduced, in some cases of stopping treatment with Perindopril and or diuretics if necessary.

Effects on potassium concentrations: Hyarassic hyperkalemia may occur, especially in patients with renal impairment or diabetes and in patients taking drugs that can increase the concentration of potassium in serum (such as potassium diuretics, potassium supplements, salt -containing substances containing potassium).

cough: dry and persistent cough, stop completely after stopping the drug.

Anesthesia surgery: Self -blood pressure may occur in patients undergoing surgery or during anesthesia with drugs that cause hypotension. Hemorrhage drops in these patients can be adjusted by increasing volume.

The ability to drive and operate machinery

Perindopril does not directly affect the ability to drive and operate machinery but some cases of hypotension occur in some patients, especially when starting treatment or use in combination with other lower blood pressure drugs.

Pregnancy

Perindopril is contraindicated for pregnant women.

The period of breastfeeding

Small amount of Perindopril is excreted into breast milk. Perindopril is contraindicated to nursing women.

Interactive drug

Diuretics: Sometimes excessive hypotension occurs in patients who are taking diuretics when they start treatment with Peindopril. The phenomenon of hypotension can be minimized by diuretics or extra salt before or at the beginning of treatment with Perindopril.

Potassium diuretics, potassium supplements or potassium salts: Perindopril may increase the concentration of potassium in serum due to the ability to reduce the production of aldosteron.

Lithi: Lithi concentration in serum increases and symptoms of lithium poisoning have been reported in patients using simultaneously with ACE inhibitors. Be cautious when using these drugs and regularly monitor lithium concentration in serum.

Non -steroid anti -inflammatory drugs, corticosteroids, tetracosacid: reducing the effect of perindopril.

Neurology and antidepressants like imipramin used with Perindopril: Increases the hypotension.

Insulin (insulin, oral drugs): Perindopril increases the hypoglycemic effect of these drugs.

Storage

In closed packaging, dry place, avoid moisture. The temperature does not exceed 30 ° C.

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