Perindopril, Indapamide and Amlodipine

ACE Inhibitor · ACE inhibitor/Calcium antagonist/Diuretic

Indications

Substitution therapy for treatment of essential hypertension, in patients already controlled with perindopril/indapamide fixed dose combination and amlodipine, taken at the same dose level.

Dosage

Adults: One tablet per day as a single dose, preferably to be taken in the morning and before a meal. Children: Not recommended.

Adverse Effects

Dizziness, headache, paresthesia, vertigo, somnolence, visual disturbances, tinnitus, palpitations, flushing, hypotension (and effects related to hypotension), cough, dyspnoea, GI disorders (abdominal pain, constipation, diarrhoea, dysgeusia, nausea, dyspepsia, vomiting), pruritus, rash, maculopapular rashes, muscle cramps, ankle swelling, asthaenia, oedema & fatigue.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Dialysis patients; patients with untreated decompensated heart failure; severe renal impairment (creatinine clearance below 30 mL/min); moderate renal impairment (creatinine clearance below 60 mL/min); history of angioedema (Quincke's oedema) associated with previous ACE inhibitor therapy; hereditary/idiopathic angioedema; hepatic encephalopathy; severe hepatic impairment; hypokalaemia; severe hypotension; shock, including cardiogenic shock; obstruction of the outflow-tract of the left ventricle (e.g. high grade aortic stenosis); haemodynamically unstable heart failure after acute myocardial infarction; concomitant use with aliskiren in patients with diabetes mellitus or renal impairment (GFR <60 mL/min/1.73 meter square). Precautions: Haemodialysis patients. Photosensitivity…

Interactions

Aliskiren, K salts, K-sparing diuretics, ACE inhibitors, angiotensin-II receptors antagonists, NSAIDs, heparins, immunosuppressant agents e.g. ciclosporin or tacrolimus, trimethoprim, dantrolene (infusion), estramustine, baclofen, imipramine-like antidepressants (tricyclics), neuroleptics, non-K-sparing diuretics, nitroglycerin, other nitrates, other vasodilators, thiazide or loop diuretics, metformin, class IA antiarrhythmic agents (e.g. quinidine, hydroquinidine, disopyramide), class III antiarrhythmic agents (e.g. amiodarone, dofetilide, ibutilide, bretylium, sotalol).

Pharmacokinetics

PERINDOPRIL: Onset of action: Peak effect: 1-2 hrs. Metabolism: Hepatic. Bioavailability: Approx. 75%. Half-life elimination: 1.5-3 hrs. Time to peak: Chronic therapy: Approx. 1 hr. Excretion: Urine. INDAPAMIDE: Absorption: Rapid and complete. Metabolism: Extensively hepatic. Bioavailability: 93%. Half-life elimination: Biphasic: 14 and 25 hrs. Time to peak: 2 hrs. Excretion: Urine (Approx.70%). Faeces (23%). AMLODIPINE: Onset of action: Antihypertensive effect: Significant reductions in blood pressure at 24-48 hrs after first dose. Duration: Antihypertensive effect: At least 24 hrs. Discontinuation after 6-7 wks of treatment: Duration extends to at least 72 hrs. Absorption: Well absorbed. Metabolism: Hepatic. Bioavailability: 64%-90%. Half-life elimination: Terminal (biphasic): 30-50 hrs. Time to peak, plasma: 6-12 hrs. Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.