"Ko-Perineva": an analogue. "Ko-Perineva": instructions for use, feedback

Arterial hypertension currently suffers a fairly wide strata of the population of different social principles, wealth, level of education. Nor can it be said that this disease reaches only elderly people, as was, say, in the last century. Modern life is rapid, global challenges, high technologies, the desire to do as much as possible today, to do even more tomorrow, do not allow the body to fully relax. In conditions of constant stress and work at the limit of physical possibilities, hypertension develops . Who of modern people pays attention to the fact that often the headache? It hurts a day, two, a week, a month, and when, finally, a person turns to a doctor, it becomes clear that hypertension is already taking place.

Modern medicine is ready to offer hypertensive patients a lot of drugs to stabilize blood pressure, one of which is Ko-Perineva. Instructions for use contain full information about the possibilities, contraindications and side effects.

Composition and form of release

The main active ingredients of the drug are indapamide and perindopril erbumin. In addition, the tablets additionally present a semi-finished product of granules (in the form of crospovidone, lactose monohydrate and calcium chloride hexahydrate) and a number of auxiliary substances.

The form of the drug is round biconvex tablets of white color. Are offered in several dosages. The buyer can purchase medicines in pharmacies with a dose of active substances 0.625 +2 mg, respectively, 1.25 + 4 or 2.5 + 8 mg.

In general, I must say that the French doctors developed and successfully use the drug "Noliprel A", and its Russian counterpart - "Ko-Perineva."

Pharmacodynamics

Perindopril is an ACE inhibitor, it promotes vasodilatation, which reduces blood pressure and, consequently, reduces the burden of the heart. After 4-6 hours after taking the medication the maximum effect develops, which can be maintained throughout the day. Indapamide belongs to the group of diuretics diuretics. In addition, this substance can improve the elasticity of the vascular walls, which also contributes to lowering blood pressure.

How far is not any of its analogues, Ko-Perineva does not affect the processes of fat and carbohydrate metabolism. In addition, the presence of indapamide does not cause much harm to the water-salt balance of the body, which can not be said about other diuretic medicines. Treatment with this combined remedy (Ko-Perineva) does not promote the development of tachycardia, the condition of the heart muscle stabilizes, and its ability to transfer loads improves.

Who should refrain from the application?

The drug is very effective for the treatment of hypertension, but it also has a list of contraindications. "Ko-Perineva", analogues having the same active ingredients, can not be taken with hypersensitivity to any components of the drug. Also, no medication is prescribed for those who suffer from intolerance or lactose deficiency, glucose-galactose malabsorption, stenoses of the renal arteries, hepatic or renal insufficiency. Contraindication for the use of "Ko-Perineva" is the presence in the patient of refractory hyperkalemia (excess potassium in the body), a predisposition to the development of angioneurotic edema (the body's reaction to the influence of chemical-biological factors, is very often allergic).

Do not appoint "Ko-Perineva" and those patients who suffer from azotemia (in the blood above the permissible limits contain nitrogen metabolites that must be excreted by the kidneys) and anuria (urine does not enter the bladder). The effectiveness and safety of Ko-Perineva have not been established (similar drugs can be used in the presence of clinical trials) for patients under 18 years of age, pregnant and lactating women. Therefore, for these groups of people, medication is prohibited.

Possible side effects

Most often, as negative effects that the medication itself or the cheap counterpart of "Ko-Perineva" - the pill "Perindopril plus Indapamide" - can provoke certain side effects from different organs and systems of the body. The most frequent reactions from the side of the central nervous system are headaches, dizziness, weakness, and sensitivity disorders. From the senses you can hear about noise in the ears, violation of visual perception. The pronounced decrease in blood pressure is a possible reaction of the cardiovascular system.

A dry, irritating, unproductive cough signals a respiratory reaction. A fairly large list of abnormalities can be observed from the gastrointestinal tract. Here, regarding the reaction to the Ko-Perineva remedy (analogs), patients' comments refer to nausea, vomiting, diarrhea, frequent constipation, abdominal pain and epigastric region, changes in taste sensations, and a decrease in appetite. The musculoskeletal system can remind oneself of seizures.

There are various side effects in the form of skin rashes of varying intensity, itching, swelling of the face, mucous membranes of the mouth, tongue of the upper palate or larynx.

Dosing regimen

Dosage of the medication (any analogue of "Ko-Perineva" can be taken according to another scheme) - 1 tablet within 24 hours. It is best to do this in the morning, before breakfast, washing down with water. Most often the scheme is developed from the calculation of the ratio "indapamide / perindopril". First, the patient is given a tablet with a dosage of 0.625 / 2 mg. If, after a month, to achieve control over BP failed, the dose is increased to one tablet at a dose of 1.25 / 4 mg. To achieve an effective result, the dosage can be increased to a maximum daily dose of 2.5 / 8 mg.

Older patients start treatment with one tablet at a dosage of 0.625 / 2 mg. Therapy begins and is carried out under the constant control of blood pressure and the functioning of the kidneys.

If the patient suffers from a moderate degree of renal failure, the therapy also starts at a dosage of 0.625 / 2 mg, but the maximum allowable dose per day should not exceed 1.25 / 4 mg.

Exceeding the permissible dose: symptomatology, treatment

Symptoms of an overdose of a medicament are the presence of nausea, vomiting, the development of muscle cramps. Possible drowsiness, dizziness, confusion, oliguria (a decrease in the volume of urine released by the kidneys), a decrease in the water-electrolyte balance, a drop in blood pressure. Any analogue of "Ko-Perineva" can have another symptomatology in case of an overdose.

To eliminate the consequences, it is recommended to wash the stomach and take absorbent drugs. It is also necessary to restore the water-electrolyte balance. If there is a strong fall in blood pressure, the patient needs to lie on his back and raise his legs. The attending physician may consider it necessary to introduce a 0.9% solution of sodium chloride. There is information about the effectiveness of hemodialysis.

Pregnant and lactating women

"Ko-Perineva" instructions for use forbids pregnant women and nursing mothers. The use of this medication during the period of bearing a child can provoke the development of fetoplacental ischemia, and, as a consequence, increase the risk of slowing the development of the fetus. If it is a question of nursing mum, it should be borne in mind that indapamide is excreted in breast milk. If nevertheless application of Ko-Perineva during lactation is an urgent necessity, it will be necessary to refuse breastfeeding.

Special instructions

It is inadmissible to use Ko-Perineva in parallel with any lithium preparations. In case of violations in the functioning of the kidneys, the medication should also not be taken. If a patient with a diagnosis of arterial hypertension has received symptoms of renal insufficiency after using Ko-Perineva, treatment should be stopped immediately. A little later you can try to resume taking the medication in minimum doses or go to monotherapy with the use of indapamide and perindopril. In such patients every 2 weeks you need to monitor the level of potassium and creatine in the blood.

In patients with diabetes mellitus or renal insufficiency, "Ko-Perineva" (analogs as well) can provoke the development of hypokalemia. Therefore, such people need constant monitoring of the level of potassium in the blood.

Interaction with other substances

Do not use perindopril together with potassium-sparing diuretics and potassium preparations. Also, with great care, the medication itself (and any analogue of the drug Ko-Perineva) is prescribed together with insulin and other hypoglycemic agents. Joint use of a drug with cytostatic immunosuppressants can cause leukopenia. When using the drug and medications for general anesthesia, there is a possibility of increasing the hypotensive effect.

Indapamide-containing medications are administered with caution in parallel with neuroleptics and antiarrhythmic drugs, benzamides, and bootrophenones. Also, "Ko-Pirenev" is not assigned together with drugs that can provoke the development of hypokalemia, with laxatives that stimulate the work of the intestine.

The use of contrast substances with a high content of iodine can be an impetus to the development of renal failure.

Medication-analogues

The most common analogue of Ko-Perineva, known and widely known to consumers, is Noliprel A. Dosage (ratio "perindopril / indapamid" from the original manufacturer "Servier" France) can be 2.5 / 0.625 mg, 10 / 2.5 mg, 5 / 1.25 mg. Also this drug is produced in Russia ("Serdix") in the same dosage as the original.

Another known analogous drug is Perindopril plus Indapamide from a Russian manufacturer. For the above ratio, dosages of 1.25 / 4 mg, 2.5 / 0.008 mg, 0.625 / 0.002 mg, 8 / 2.5 mg are possible.

Price range

Dosage and the number of tablets in the package are the main factors influencing the price of the Ko-Perineva medication. The instruction (analogues may differ slightly in dosage) describes possible variants of the ratios of the two main components - perindopril and indapamide. For example, 30 tablets with a ratio of 0.625 / 2 mg will cost the buyer 350 rubles. The drug with a dosage of 1.25 / 4 mg will cost 390-440 rubles. The largest ratio of 2.5 / 8 mg - from 470 to 510 rubles for 30 tablets. Naturally, packages of 90 tablets will cost buyers a much larger amount.

The French original "Noliprel A" will cost consumers much more.

Consumer opinion

Medication "Ko-Perineva" instructions for use, reviews of patients in most cases described as a modern and very effective drug for normalizing blood pressure. The drug is convenient to use: took one tablet in the morning, and is free until the next day. In addition, at the cost of "Ko-Perineva" is available to a wide range of consumers with different financial capabilities, which can not be said about "Noliprele A" from the French manufacturer.

However, negative feedback, which is most often associated with the manifestation of side effects in the form of headaches, edema of the face and extremities, reactions from the gastrointestinal tract, is not uncommon. In such cases, you must stop treatment and seek medical advice. After examining and assessing the situation, the specialist will decide whether to resume taking Co-Perineva with reduced dosage, or it is better to pay attention to other medicines with similar characteristics and expected results of treatment.