Prestarium and pills dispersible 5mg №30

Indications and usage

Arterial hypertension;
Chronic heart failure;
Prevention of recurrent stroke (combination therapy with indapamide) in patients who have had a stroke or transient cerebral circulation in ischemic type;
Stable coronary artery disease: reduced risk of cardiovascular complications in patients with stable coronary artery disease.

Contraindications

Angioedema in history;
Pregnancy;
Breast-feeding;
Childhood;
Hypersensitivity to the drug and to other ACE inhibitors.
The drug is contraindicated for use in pregnancy.
If necessary, the appointment of the drug during lactation should decide on the termination of breastfeeding.

Pharmacological action - hypotensive, vasodilating, cardioprotective, natriuretic.

After a single dose of 4–8 mg, blood pressure decreases after 4–6 hours. It has a prolonged hypotensive effect that continues with repeated daily intakes for 24 hours. The antihypertensive effect depends on the dose (in the range of 2–8 mg).At a dose of 2 mg, it inhibits ACE by 80% at the peak of action and by 60% after 24 hours, with an increase in dose to 8 mg, its inhibitory activity increases to 95% and 75%, respectively. In patients with a positive response to treatment, blood pressure is normalized within 1 month and remains within the normal range during treatment. Termination of therapy is not accompanied by the development of withdrawal syndrome. In patients with chronic heart failure, statistically reliably reduces the severity of clinical symptoms and increases exercise tolerance. Does not cause fluctuations in blood pressure after the first dose and during long-term therapy. With a six-month intake in patients with chronic heart failure, the permeability of the large, medium and small bronchi improves (the increase in patency in the small bronchi is more pronounced in patients who smoke). On the background of portal gastropathy reduces the vulnerability and bleeding of the gastric mucosa with the disappearance of erosions and ulcers. Prolonged therapy is not accompanied by a change in renal function. Increases HDL, lowers uric acid (in patients with hyperuricemia).

In vitro and in vivo studies revealed no signs of mutagenicity, with long-term use in mice and rats, carcinogenic properties, as well as signs of embryotoxicity and teratogenic effects in rats, mice, rabbits and monkeys. In high doses, it has a toxic effect on the maternal organism and the organism of the fetus in rodents and rabbits, it penetrates into the breast milk of rats.

When ingestion is rapidly absorbed from the gastrointestinal tract. Bioavailability is 65–95%, decreasing by 35% with a simultaneous meal. The concentration reaches a maximum in plasma after 1 h (perindoprilat after 3-4 h) and drops to 33–34% Cmax by the end of the day. Penetrates the BBB. In the liver, 17–20% is converted into perindoprilat, the remaining amount is converted into 5 inactive metabolites. Communication with plasma proteins is less than 30% and depends on concentration, the volume of distribution - 0.2 l / kg, T1 / 2 - 1.5–3 h. Slowly dissociates from the association with ACE (“effective” T1 / 2 - 25– 30 h), not cumulated, excreted by the kidneys (70%). With repeated use, equilibrium concentrations are reached after 4 days. Against the background of impaired renal function, chronic heart and kidney failure, in elderly patients, the elimination of all metabolites is reduced (correction of the dosing regimen is necessary).

Adverse reactions

On the part of the respiratory system: possible dry cough.
On the part of the digestive system: dyspepsia, dry mouth, taste disorders.
From the side of the central nervous system: headache, sleep and / or mood disorders, dizziness; in some cases - seizures.
On the part of the hematopoietic system: a decrease in the level of hemoglobin (especially at the beginning of treatment); rarely, a decrease in the number of red blood cells and / or platelets.
On the part of the kidneys: increased creatinine and uric acid (reversible).
Allergic reactions: angioedema, skin rash, itching, erythema.
Other: sexual disorders.

Assign inside, 1 tab. 1 time / day, preferably in the morning, before meals.
The pill should be put on the tongue and after it disintegrates on the surface of the tongue, swallow it with saliva.
When choosing a dose, it is necessary to take into account the peculiarities of the clinical situation and the degree of reduction in blood pressure during the treatment.

Storage conditions

Special storage conditions are not required.
Keep out of the reach of children.