Generic
Indapamide + Perindopril Erbumine
17 brands available in the market
At a glance
Indapamide + Perindopril Erbumine combination is used for the treatment of essential hypertension where blood pressure is not adequately controlled on perindopril alone.
Description
Indapamide + Perindopril Erbumine is a combination medicine that helps control high blood pressure. Perindopril is an ACE inhibitor that blocks conversion of angiotensin I to angiotensin II, causing vasodilation and decreased aldosterone secretion. Indapamide is a thiazide-like diuretic that inhibits sodium reabsorption in the distal tubule, increasing urine output. This combination effectively lowers blood pressure.
Indications
- Essential hypertension (where blood pressure is not adequately controlled on perindopril alone)
Therapeutic class
Combined antihypertensive preparations
Pharmacological class
ACE Inhibitor + Thiazide-like Diuretic
Pharmacology
Perindopril is a nonsulphydryl ACE inhibitor that is rapidly hydrolysed to perindoprilat, its principal active metabolite. ACE catalyses the conversion of angiotensin I to the vasoconstrictor angiotensin II. Inhibition of ACE activity leads to decreased levels of angiotensin II, resulting in decreased vasoconstriction and decreased aldosterone secretion. Indapamide is a sulphonamide derivative with an indole ring that inhibits sodium reabsorption in the cortical diluting segment, increasing urinary excretion of sodium and chlorides.
Mechanism of action
Perindopril inhibits ACE to prevent angiotensin II formation and relax blood vessels; Indapamide inhibits sodium reabsorption in the distal tubule to remove excess water and lower blood pressure.
Dosage
Adult Dose (Oral):
- 1-2 tablets daily in the morning (before a meal)
- In case of renal insufficiency, start with an adequate dose
Renal Dose: CrCl <30 mL/min: Avoid use; CrCl 30-60: Dose adjustment may be needed
Administration
Take on empty stomach (morning before a meal); swallow whole; do not chew, crush or break; take in the morning to avoid nighttime urination.
Missed dose
If you miss a dose, take it as soon as possible; if it is almost time for your next dose, skip the missed dose and go back to regular schedule; do not double the dose.
Side effects
Common Side Effects:
- Nausea
- Diarrhea
- Stomach pain
- Constipation
- Vomiting
- Headache
- Vertigo
- Dizziness
- Altered vision
- Numbness
- Ringing in ear
- Breathlessness
- Indigestion
- Allergic reaction
- Skin rash
- Itching
- Cramps
- Fatigue
Others: Persistent dry cough, angioedema, rash, dyspepsia, sleep disturbance, asthenia, dry mouth, hypotension
Precautions & warnings
Precautions:
- Indapamide + Perindopril may affect your ability to drive (dizziness, weakness)
- Inform doctor about cough or throat irritation that doesn't go away
- May cause dehydration; drink plenty of fluids; inform doctor if extreme thirst, muscle weakness or very dry mouth develops
- If dizziness occurs, rise slowly from sitting or lying position
- Not safe during pregnancy (may cause birth defects or fetal death)
- Caution in renal impairment, renal artery stenosis, heart failure, gout, diabetes, liver cirrhosis, elderly, atherosclerosis, idiopathic or hereditary angioedema
Contraindications
Contraindications:
- Hypersensitivity
- Severe renal impairment (CrCl <30 mL/min)
- Hypokalemia
- Severe hepatic impairment or hepatic encephalopathy
- History of angioedema with ACE inhibitor
- Children
- Dialysis patients or patients with untreated decompensated heart failure
- Hereditary/idiopathic angioneurotic edema
- Pregnancy and lactation
Drug interactions
Drug Interactions:
- Additive effect with other antihypertensives and diuretics
- Antipsychotic drugs may potentiate hypotensive effects
- NSAIDs may reduce antihypertensive effect
- ARB and Potassium-sparing diuretics may cause hyperkalemia
Food interactions
Food Interactions: Indapamide + Perindopril may cause excessive drowsiness with alcohol.
Use in pregnancy
Use in Pregnancy: Unsafe during pregnancy; definite evidence of risk to developing baby; not recommended during pregnancy.
Use in lactation
Use in Lactation: Probably safe; limited data suggests drug does not represent significant risk to baby; mothers taking Indapamide + Perindopril should not breastfeed.
Pediatric use
Safety and efficacy in pediatric patients have not been established.
Geriatric use
Dose adjustment may be needed in elderly patients based on renal function.
Renal / hepatic impairment
Renal Impairment: Caution in renal impairment; CrCl <30: Avoid use; CrCl 30-60: Dose adjustment may be needed; start with adequate dose in renal insufficiency.
Hepatic Impairment: Caution in liver disease; dose adjustment may be needed; contraindicated in severe hepatic impairment or hepatic encephalopathy.
Overdose effects
Overdose: Hypotension, nausea, vomiting, cramps, dizziness, sleepiness, mental confusion, oliguria (may progress to anuria), salt and water disturbances (low sodium, low potassium); gastric lavage or activated charcoal; monitor and maintain fluid and electrolyte balance.
Storage conditions
Keep below 30°C temperature, away from light & moisture; keep out of reach of children.
Chemical structure
Indapamide + Perindopril Erbumine