Perindopril + Indapamide

Indications

Perindopril + Indapamide is used for: Hypertension, IHD, Heart failure,

Adult Dose

Oral Hypertension Adult: Per tab contains perindopril 4 mg and indapamide 1.25 mg: 1 tab once daily in the morning.

Child Dose

Renal Dose

Renal impairment: CrCl (ml/min) Dosage Recommendation <30 Avoid use. 30-60 Dose adjustment may be needed.

Administration

Contra Indications

Hypersensitivity. Severe renal impairment (CrCl <30 ml/min), hypokalaemia, severe hepatic impairment or hepatic encephalopathy, history of angioedema associated with treatment with an ACE inhibitor, children. Dialysis patients or patients with untreated decompensated heart failure. Hereditary/idiopathic angioneurotic oedema. Pregnancy and lactation.

Precautions

Impaired renal function, risk of hypotension and electrolyte imbalance. Regular monitoring of renal function and plasma levels of potassium are recommended. Blood glucose levels should be monitored in diabetic patients especially in those with low serum potassium levels. Increased risk of neutropenia/agranulocytosis in immunosuppressed patients. Treatment should be discontinued immediately if there is angioneurotic oedema of the face, extremities, lips, tongue, glottis and/or larynx.

Pregnancy-Lactation

Interactions

Increased risk of lithium toxicity. May cause and potentiate orthostatic hypotension when used with alcohol, barbiturates, neuroleptics, narcotics or other antihypertensives. Increased risk of acute renal insufficiency in dehydrated patients when used with systemic NSAIDs or high dose salicylates. May increase risk of hypoglycaemia in patients on concurrent treatment with hypoglycaemic sulfonamides/insulin. Concurrent use with baclofen may potentiate antihypertensive effect. May reduce antihypertensive effect when used with corticosteroids or tetracosactide. Increased risk of hyperkalaemia when used with potassium-sparing diuretics or potassium supplements. May increase hypotensive effect of certain anaesthetic drugs. Increased risk of leucopenia when used with allopurinol, immunosuppressants, procainamide or systemic corticosteoids. Additive hypotensive effect when used with other antihypertensives.

Adverse Effects

Side effects of Perindopril + Indapamide : Dry cough, headache, bradycardia, dizziness, asthenia, hypokalaemia and orthostatic hypotension. GI effects such as constipation, dry mouth, nausea, epigastric pain, anorexia, abdominal pain and taste disturbance.

Mechanism of Action

Perindopril is an ACE inhibitor, which acts by inhibiting the conversion of angiotensin I to angiotensin II, reducing the activity of the sympathetic nervous system and inhibiting enzyme kininase, which is involved in the conversion of bradykinin and other substances. Indapamide is a sulfonamide derivative with an indole ring. It inhibits the reabsorption of sodium in the cortical dilution segment, thus increasing urinary output, resulting in an antihypertensive effect.