perindopril + indapamide




Concise Prescribing Info
Perindopril 2 mg, indapamide 0.625 mg
Dosage/Direction for Use
1 tab/day as single dose. If BP is not controlled after 1 mth of treatment, the dose can be doubled. Elderly 1 tab/day. Moderate renal impairment (CrCl 30-60 mL/min) Max: 1 tab/day.
Should be taken on an empty stomach: Preferably taken in the morning.
Hypersensitivity. Dialysis patients. Untreated decompensated heart failure. Perindopril: History of angioedema associated w/ previous ACE inhibitor therapy. Hereditary or idiopathic angioedema. Concomitant use w/ aliskiren-containing products in patients w/ DM or renal impairment (GFR <60 mL/min/1.73 m2); sacubitril/valsartan. Extracorporeal treatments leading to contact to blood w/ negatively charged surfaces. Significant bilateral renal artery stenosis. Pregnancy (2nd & 3rd trimesters). Indapamide: Hepatic encephalopathy. Hypokalemia. Combination w/ non-antiarrhythmic agents causing Torsades de pointes. Severe renal & hepatic impairment. Lactation.
Special Precautions
Concomitant use w/ lithium. Risk of sudden hypotension in the presence of preexisting Na depletion in individuals w/ renal artery stenosis. Regularly monitor plasma electrolytes & K levels. Galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Renal impairment. May impair ability to drive or operate machinery. Perindopril: Dual blockade of renin-angiotensin-aldosterone system. Concomitant use w/ K-sparing drugs, K supplements or K-containing salts; mTOR inhibitors (eg, sirolimus, everolimus, temsirolimus). Neutropenia/agranulocytosis/thrombocytopenia/anemia. Patients w/ collagen vascular disease, immunosuppresant therapy, treatment w/ allopurinol or procainamide, or in combination of these complicating factors, especially if there is preexisting impaired renal function. Periodic monitoring of WBC. 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 than in non-Black 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); maculopapular rash.
Drug Interactions
Avoid w/: Lithium, aliskiren in diabetic or impaired renal patients, K-sparing diuretics (eg, triamterene, amiloride), K salts, estramustine, other antihypertensives (ACE inhibitors & angiotensin receptor blockers). 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); IV erythromycin; halofantrine; pentamidine; IV gold; vincamine; bepridil; antiarrythmics; cisapride, diphemanil; digoxin or other cardiac glycosides; baclofen; antidiabetics eg, insulin, metformin or gliptins; Ca including Ca supplements; stimulant laxatives eg, senna; NSAIDs or high dose salicylates; amphotericin B inj; CNS drugs; tetracosactide; trimethoprim; vasodilators including nitrates; medicines used for hypotension, shock or asthma eg, ephedrine, noradrenaline or adrenaline; sacubitril, valsartan.
ATC Classification
C09BA04 - perindopril and diuretics ; Belongs to the class of ACE inhibitors in combination with diuretics. Used in the treatment of cardiovascular disease.
Preterax tab
30's (P1,682.81/box)
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