Perindopril + Indapamide

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Generic Name of Perindopril + Indapamide - Learn More

Perindopril + Indapamide

Perindopril + Indapamide Precaution - What You Need to Know

Before starting Perindopril + Indapamide, patients must consult their healthcare provider to ensure that the combination is suitable for their health needs. There are several key precautions associated with this medication:

- Kidney Function: Both Perindopril (an ACE inhibitor) and Indapamide (a diuretic) are eliminated through the kidneys. Patients with renal impairment should be monitored closely, as this combination can affect kidney function. Dosage adjustments may be necessary for individuals with kidney disease.
- Electrolyte Imbalance: Indapamide can cause electrolyte imbalances, particularly low potassium (hypokalemia) and low sodium (hyponatremia). Regular blood tests to monitor electrolyte levels are essential, especially in patients on long-term therapy.
- Pregnancy and Breastfeeding: Perindopril is contraindicated during pregnancy, particularly in the second and third trimesters, due to the risk of harm to the fetus. The combination should not be used in breastfeeding mothers, as both drugs may pass into breast milk.
- Hypotension: This combination medication can lower blood pressure, especially when treatment is initiated. Patients with low blood pressure or those who are dehydrated (due to excessive sweating, vomiting, or diarrhea) should be monitored closely.
- Liver Disease: Patients with severe liver disease should be treated cautiously, as Indapamide is metabolized in the liver, and this combination can worsen liver function.
- Diabetes: Care should be taken in diabetic patients, as Indapamide may affect blood sugar control, and Perindopril can influence kidney function, which is crucial for diabetics.

Perindopril + Indapamide Indication - Uses and Benefits

The combination of Perindopril (an ACE inhibitor) and Indapamide (a thiazide-like diuretic) is used for the management of several conditions:

- Hypertension (High Blood Pressure): This combination is primarily indicated for the treatment of hypertension. It works by lowering blood pressure through complementary mechanisms: Perindopril relaxes blood vessels (by inhibiting the ACE enzyme), while Indapamide reduces fluid retention (by acting as a diuretic).
- Heart Failure: It can also be prescribed for the management of congestive heart failure, particularly in patients with hypertension or a history of heart failure.
- Chronic Kidney Disease (CKD): In patients with CKD, the combination may be used to reduce the progression of kidney damage, especially if hypertension is a contributing factor.

Perindopril + Indapamide Contraindications - Important Warnings

There are several contraindications for using Perindopril + Indapamide:

- Hypersensitivity: Patients who have an allergy or hypersensitivity to either Perindopril, Indapamide, or any components of the medication should avoid its use.
- Pregnancy: As mentioned earlier, Perindopril is contraindicated during pregnancy due to the risk of harm to the fetus, especially during the second and third trimesters.
- Renal Artery Stenosis: The combination should not be used in patients with bilateral renal artery stenosis or unilateral renal artery stenosis, as the medications may further reduce renal function.
- Severe Hypokalemia or Hyponatremia: Since Indapamide can lower potassium and sodium levels, this combination should not be used in patients with severe hypokalemia or hyponatremia.
- Severe Liver Disease: As Indapamide is metabolized in the liver, it should not be used in patients with severe hepatic impairment or cirrhosis.
- Severe Hypotension: Patients with severe hypotension or those who are dehydrated should not use this combination, as it can cause further drops in blood pressure.

Perindopril + Indapamide Side Effects - What to Expect

Common and serious side effects may occur with Perindopril + Indapamide. Patients should be advised to report any adverse effects to their healthcare provider:

- Common Side Effects:
- Dizziness or lightheadedness, especially when standing up quickly.
- Fatigue or tiredness.
- Headache.
- Cough (common with ACE inhibitors like Perindopril).
- Electrolyte imbalances, such as low potassium (hypokalemia) or low sodium (hyponatremia).
- Nausea or stomach upset.

- Serious Side Effects:
- Severe hypotension: A significant drop in blood pressure, leading to fainting, dizziness, or shock.
- Angioedema (swelling of the face, lips, tongue, or throat), which can lead to difficulty breathing and requires immediate medical attention.
- Kidney problems: Symptoms of kidney dysfunction include swelling of the legs, feet, or hands, changes in urine output, or fatigue.
- Severe electrolyte disturbances: Hypokalemia (low potassium) can lead to muscle cramps, weakness, and heart arrhythmias, while hyponatremia (low sodium) can cause confusion, seizures, or fatigue.
- Liver issues: Jaundice (yellowing of the skin or eyes) and elevated liver enzymes.

Perindopril + Indapamide Pregnancy Category ID - Safety Information

19

Perindopril + Indapamide Mode of Action - How It Works

The combination of Perindopril and Indapamide works through complementary mechanisms to reduce blood pressure and improve heart function:

- Perindopril: As an ACE inhibitor, Perindopril blocks the conversion of angiotensin I to angiotensin II, a peptide that normally causes blood vessels to constrict. By inhibiting this conversion, Perindopril relaxes the blood vessels, which helps lower blood pressure and reduces the workload on the heart. Additionally, Perindopril helps in reducing proteinuria (protein in the urine), which can be beneficial for patients with chronic kidney disease.
- Indapamide: Indapamide is a thiazide-like diuretic that promotes the excretion of sodium and water through the kidneys. It reduces fluid volume in the body, which helps to lower blood pressure. By increasing urine output, Indapamide also helps decrease swelling and water retention, which is useful in conditions such as heart failure.

Together, this combination provides synergistic effects to lower blood pressure, prevent fluid retention, and reduce strain on the heart and kidneys.

Perindopril + Indapamide Drug Interactions - What to Avoid

There are several drug interactions to be aware of when using Perindopril + Indapamide:

- Other Antihypertensives: Concurrent use with other antihypertensive agents (such as beta-blockers, calcium channel blockers, or other ACE inhibitors) may lead to excessive lowering of blood pressure. Close monitoring is necessary when used together.
- Potassium Supplements or Potassium-Sparing Diuretics: Indapamide can lower potassium levels, but when combined with potassium supplements or other potassium-sparing diuretics (such as spironolactone), the risk of hyperkalemia (high potassium) can increase, which can be dangerous.
- Lithium: The combination of ACE inhibitors (like Perindopril) and lithium can increase the concentration of lithium in the blood, raising the risk of lithium toxicity. Frequent monitoring of lithium levels is recommended.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): The use of NSAIDs alongside this combination may reduce the antihypertensive effect of Perindopril and increase the risk of kidney damage. Caution is advised when these drugs are taken together.
- Diuretics: When combined with other diuretics, there is an increased risk of dehydration and electrolyte imbalance, especially hypokalemia. Close monitoring is advised.
- Rasagiline: Co-administration with certain monoamine oxidase inhibitors like rasagiline may increase the risk of severe side effects.

Perindopril + Indapamide Adult Dose - Recommended Dosage

- The recommended starting dose for Perindopril + Indapamide is typically a combination tablet containing Perindopril 5 mg and Indapamide 1.25 mg once daily.
- Depending on the response, the dose may be increased to 10 mg of Perindopril and 2.5 mg of Indapamide per day.
- Elderly patients or those with kidney issues may require a lower starting dose or slower dose escalation.

Perindopril + Indapamide Child Dose - Dosage for Children

The combination of Perindopril + Indapamide is not typically prescribed for pediatric patients. Safety and efficacy have not been established in children, and the potential risks associated with this combination in younger individuals are not well-studied.

Perindopril + Indapamide Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, the dose of Perindopril + Indapamide may need to be adjusted. For patients with creatinine clearance less than 30 mL/min, the combination is generally not recommended, as both medications are eliminated by the kidneys. For those with moderate renal impairment (creatinine clearance between 30-60 mL/min), careful monitoring of kidney function and electrolytes is essential.