Perindopril + indapamide


Generic Medicine Info
Contraindications
Hypersensitivity to perindopril, indapamide or sulfonamide-related drugs. History of angioedema due to previous ACE inhibitor treatment, hereditary or idiopathic angioedema, unilateral or bilateral renal artery stenosis, hypokalaemia, hepatic encephalopathy. Patient with extracorporeal treatments leading to contact of blood with negatively charged surfaces. Severe hepatic and moderate to severe renal impairment (depending on fixed-dose combination). Pregnancy and lactation. Concomitant use with aliskiren in patients with diabetes mellitus or moderate to severe renal impairment (GFR <60 mL/min/1.73 m2). Concomitant use with or within 36 hours after the last dose of sacubitril/valsartan.
Special Precautions
Patient with CV disease (e.g. ischaemic heart disease, heart failure, long QT syndrome), cerebrovascular disease, acute cardiac decompensation, hypertrophic cardiomyopathy with outflow tract obstruction, aortic or mitral valve stenosis, prediabetes or diabetes mellitus, dehydrated states, volume depletion, metabolic acidosis, collagen vascular disease (e.g. SLE), cirrhosis; history of gout, penicillin allergy. Patient undergoing major surgery, LDL apheresis with dextran sulfate, and desensitisation treatment with hymenoptera venom. Not recommended for use in patients with primary aldosteronism. Black race. Renal and hepatic impairment. Elderly. Patient Counselling Avoid exposure to direct sunlight and UV light; apply sunscreen when going outdoors. Monitoring Parameters Monitor blood pressure, serum electrolytes (e.g. Na, K, Ca) and creatinine, BUN; hepatic function at baseline and as clinically indicated; uric acid, blood glucose, urea (in patients at risk of hyperkalaemia); CBC with differential (in patient with collagen vascular disease or renal impairment). Assess pregnancy status.
Adverse Reactions
Significant: Cough, hypotension, syncope, photosensitivity, ocular effects (e.g. acute transient myopia, acute angle-closure glaucoma), CNS depression, dysgeusia, SLE exacerbation or activation, dermatologic reactions (e.g. maculopapular pruritic rashes, lichenoid eruptions, psoriasis, pemphigus like rash, rosacea, Stevens-Johnson syndrome), electrolyte disturbances (e.g. hyperkalaemia, hypokalaemia, hypochloraemia, hyponatraemia, hypophosphataemia, hypercalcaemia), increased liver enzymes and serum bilirubin, hepatic encephalopathy, renal function deterioration (e.g. increased BUN and serum creatinine, oliguria, acute renal failure, progressive azotaemia, proteinuria), hyperuricaemia, haematologic effects (e.g. neutropenia with myeloid hypoplasia, agranulocytosis, anaemia, thrombocytopenia). Ear and labyrinth disorders: Vertigo, tinnitus. Eye disorders: Visual impairment. Gastrointestinal disorders: Nausea, vomiting, diarrhoea, abdominal pain, constipation, dyspepsia, dry mouth. General disorders and administration site conditions: Asthenia. Metabolism and nutrition disorders: Anorexia. Musculoskeletal and connective tissue disorders: Muscle cramps. Nervous system disorders: Dizziness, headache, paraesthesia. Respiratory, thoracic and mediastinal disorders: Dyspnoea. Skin and subcutaneous tissue disorders: Maculopapular rash, pruritus.
Potentially Fatal: Angioedema with laryngeal oedema, arrhythmias. Rarely, cholestatic jaundice that may progress to fulminant hepatic necrosis; hypersensitivity reactions (e.g. anaphylactic/anaphylactoid reactions).
Drug Interactions
Enhanced antihypertensive effect with other antihypertensive agents, vasodilators, baclofen and TCAs. Perindopril: Increased risk of lithium toxicity. May diminish antihypertensive effect with NSAIDs and sympathomimetic drugs. Increased risk of adverse effects with angiotensin-receptor blockers and estramustine. May enhance the hypotensive effect of anaesthetics. Increased risk of hyperkalaemia with ciclosporin, heparin, trimethoprim, co-trimoxazole, K-sparing diuretics, K supplements and K-containing salt substitutes. May potentiate hypoglycaemia with insulin and oral hypoglycaemic agents. May increase risk of angioedema with racecadotril, mammalian target of rapamycin (mTOR) inhibitors (e.g. sirolimus, everolimus, temsirolimus) and gliptins (e.g. linagliptin, vildagliptin). May increase risk of leucopenia with allopurinol, immunosuppressants, corticosteroids, or procainamide. May cause nitritoid reactions with Na aurothiomalate. Indapamide: Increased risk of hypokalaemia with IV amphotericin B, glucocorticoids, systemic mineralocorticoids, stimulant laxatives, drugs that induce torsades de pointes such as antiarrhythmics (e.g. quinidine, disopyramide, amiodarone, dofetilide), neuroleptics (e.g. chlorpromazine, thioridazine, trifluoperazine, pimozide), benzamides (e.g. amisulpride, sultopride, tiapride), bepridil, cisapride, erythromycin, halofantrine, mizolastine, moxifloxacin, pentamidine, vincamine, methadone, astemizole, and terfenadine. May potentiate toxic effects of cardiac glycosides (e.g. digitalis). May increase the incidence of allopurinol hypersensitivity.
ATC Classification
C03BA11 - indapamide ; Belongs to the class of low-ceiling sulfonamide diuretics.
C09AA04 - perindopril ; Belongs to the class of ACE inhibitors. Used in the treatment of cardiovascular disease.
Disclaimer: This information is independently developed by CIMS based on perindopril + indapamide from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
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