Bi-Preterax

Bi-Preterax

perindopril + indapamide

Manufacturer:

Servier

Distributor:

Zuellig
Concise Prescribing Info
Contents
Per tab Perindopril 4 mg, indapamide 1.25 mg
Indications/Uses
Essential HTN (not indicated for initial therapy).
Dosage/Direction for Use
1 tab/day as single dose. Elderly Treatment should be initiated after considering BP response & renal function. Renal impairment Usual medical follow-up will include frequent monitoring of creatinine & K.
Administration
Should be taken on an empty stomach: Preferably taken in the morning.
Contraindications
Hypersensitivity to any other ACE inhibitors or sulfonamides. Dialysis patients; untreated decompensated heart failure. Perindopril: History of angioedema (Quincke's edema) associated w/ previous ACE inhibitor therapy; hereditary/idiopathic angioedema; concomitant use w/ aliskiren-containing products in patients w/ DM or renal impairment (GFR >60 mL/min/1.73 m2); concomitant use w/ sacubitril/valsartan; extracorporeal treatments leading to contact of blood w/ negatively charged surfaces; significant bilateral renal artery stenosis or stenosis of the artery to a single functioning therapy. Pregnancy (2nd & 3rd trimesters). Indapamide: Severe renal/hepatic impairment; hepatic encephalopathy; hypokalemia. Do not use w/ non-antiarrhythmic agents causing Torsades de pointes. Lactation.
Special Precautions
Concomitant use w/ lithium. Risk of sudden hypotension in the presence of pre-existing Na depletion in individuals w/ renal artery stenosis. Regularly monitor plasma electrolytes & K levels. Galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. May impair ability to drive or operate machinery. Renal impairment. Perindopril: Dual blockade of renin-angiotensin-aldosterone system. Concomitant use w/ K-sparing drugs, K supplements or K-containing salts. Neutropenia/agranulocytosis/thrombocytopenia/anemia. Angioedema. Anaphylactoid reactions during desensitization & LDL apheresis. Hemodialysis. Cough. Risk of arterial hypotension &/or renal insufficiency. Atherosclerosis. Renovascular HTN. Cardiac failure/severe cardiac insufficiency (grade IV). Diabetics. Possibility of higher prevalence of low-renin states in Black hypertensive patients. Discontinue 1 day prior to surgery. Aortic or mitral valve stenosis/hypertrophic cardiomyopathy. Discontinue in patients who develop jaundice or marked elevations of hepatic enzymes. Hyperkalemia. Elderly. Childn & adolescents. Indapamide: Hepatic encephalopathy. Photosensitivity. Hyponatremia w/ hypovolemia. K depletion w/ hypokalemia. May reduce urinary excretion of Ca & cause a mild & transient increase in plasma Ca levels. Monitor blood glucose in diabetic patients. Increased tendency to gout attacks in hyperuricemic patients. May cause +ve reaction in doping tests. Acute myopia & secondary angle-closure glaucoma.
Adverse Reactions
Perindopril: Dizziness, headache, paresthesia, dysgeusia; visual impairment; vertigo, tinnitus; hypotension & related effects; cough, dyspnea; abdominal pain, constipation, diarrhea, dyspepsia, nausea, vomiting; pruritus, rash; muscle cramps; asthenia. Indapamide: Hypersensitivity (mainly dermatological in subjects w/ a predisposition to allergic & asthmatic reactions); maculopapular rash.
Drug Interactions
Avoid w/: Lithium, aliskiren in diabetic or impaired renal patients, K-sparing diuretics (triamterene, amiloride), K salts, estramustine, other antihypertensives [ACE inhibitors & angiotensin receptor blockers (ARB)]. Special care w/: Other antihypertensives including ARB, aliskiren or diuretics; K-sparing drugs for heart failure (eplerenone & spironolactone at doses 12.5-50 mg/day); racecadotril; mTor inhibitors eg, sirolimus, everolimus, temsirolimus; anesth; iodinated contrast agent; moxifloxacin, sparfloxacin; methadone; procainamide; allopurinol; mizolastine, terfenadine or astemizole, corticosteroids; immunosuppresants (eg, ciclosporin, tacrolimus); erythromycin by inj; halofantrine; pentamidine; injectable gold; vincamine; bepridil; quinidine, hydroquinidine, disopyramide, amiodarone, sotalol; cisapride, diphemanil; digoxin or other cardiac glycosides; baclofen; antidiabetics eg, insulin, metformin or gliptins; Ca including Ca supplements; stimulant laxatives (eg, senna); NSAIDs (ibuprofen) or high dose salicylates (eg, aspirin); amphotericin B by inj; TCAs, neuroleptics (eg, amisulpride, sulpiride, sultopride, tiapride, haloperidol, droperidol); tetracosactide; trimethoprim; vasodilators including nitrates; heparin; medicines used for treatment of hypotension, shock or asthma (eg, ephedrine, noradrenaline or adrenaline).
ATC Classification
C09BA04 - perindopril and diuretics ; Belongs to the class of ACE inhibitors in combination with diuretics. Used in the treatment of cardiovascular disease.
Presentation/Packing
Form
Bi-Preterax tab
Packing/Price
30's (P1,956.92/pack)
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