التركيب :
تحتوي كل مضغوطة من بريفرسيل على 4 ملغ بيريندوبريل إربومين .
الخواص :
الحركية الدوائية :
الإستطبابات :
يوصف بريفرسيل في علاج ارتفاع الضغط الشرياني ( يمكن إعطاؤه بمفرده أو بالمشاركة مع أصناف أخرى من خافضات الضغط خاصة مع المدرات الثيازيدية ) و في علاج قصور القلب الاحتقاني .
مضادات الإستطباب :
التحذيرات / الاحتياطات :
التداخلات الدوائية :
التأثيرات الجانبية :
الجرعة و طريقة الاستعمال :
التعبئة :
علبة تحوي 20 مضغوطة بريفرسيل / 4 ملغ .
علبة تحوي 30 مضغوطة بريفرسيل / 4 ملغ .
PREVERSIL
Composition:
Each Preversil tablet contains 4 mg Perindopril Erbumine.
Properties:
- Perindopril Erbumine is a pro-drug that metabolized in vivo by hydrolysis of the ester group to form perindoprilat which inhibits ACE (Angiotensin Converting Enzyme). It’s the mechanism through which this drug lowers blood pressure.
- ACE catalyzes conversion of angiotensin I to angiotensin II. Angiotensin II is a potent peripheral vasoconstrictor which stimulates aldosterone secretion by the adrenal cortex, and provides negative feedback on renin secretion.
- So the inhibition of ACE results in decreased plasma angiotensin II, leading to decreased vasoconstriction, increased plasma renin activity and decreased aldosterone secretion.
- While the principal mechanism of perindopril in blood pressure reduction is believed to be through the renin, angiotensin, aldosterone system, ACE inhibitors have some effect even in apparent low-renin hypertension.
Pharmacokinetics:
- Oral administration of Preversil results in its rapid absorption with peak plasma concentrations at approximately 1 hour. The absolute bioavailability of perindopril is 75%.
- Mean total body clearance of perindopril is 219-362 ml/min, and its mean renal clearance is 23,3-28.6 ml/min.
- Only 4-12% of the perindopril administered dose recovered unchanged in the urine.
- Hepatic esterase appears to be responsible for the hydrolysis of perindopril.
- The clearance of perindoprilat is almost exclusively renal.
- Plasma concentrations of both perindopril and perindoprilat in elderly patients (over the age of 70) are twice those observed in younger patients.
Indications:
Preversil is indicated for the treatment of patients with essential hypertension, it may be used alone or given with other classes of anti-hypertensives especially thiazide diuretics. It is also recommended in the treatment of congestive heart failure.
Contraindications:
This drug must not be used in the following circumstances:
- Patients with hypersensitivity to permdopril or to any other ACE inhibitors.
- In patients with congestive heart failure.
- pregnancy or breast feeding.
- In children.
- If in any doubt, ASK your physician.
Precautions/ Warning:
· Impaired renal function and hepatic insufficiency.
· Congestive heart failure.
- Angioedema involving the face, extremities, lips, tongue and/or larynx has been reported in patients treated with ACE inhibitors.
- It can cause symptomatic hypotension in some patients.
- Treatment with ACE inhibitors may lead to agranulocytosis and neutropenia in rare cases.
- Elevations of serum potassium have been observed in some patients.
Drug Interactions:
- Diuretics: diuretics increase the hypotension effect of Preversil.
- Food interactions: if Preversil is administered with food, the extent of biotransformation of perindopril to perindoprilat is reduced, so it’s administered generally in a fasting state.
Side Effects:
- Gastrointestinal disorder, dizziness, cramps, localized rashes.
- Non productive cough may sometimes occur.
- If these problems persist, inform your physician.
Dosage & Administration:
- In patients with essential hypertension the recommended initial dose is 4 mg once a day. The dosage may be titrated upward until blood pressure is controlled or to a maximum of 16 mg per day once or divided into two doses.
- The recommended dose is 4-8 mg/day.
- In elderly patients: the initial dosage is 4 mg daily in one or in two divided doses it may be titrated upward to a maximum of 8 mg/day.
- In concomitant diuretics:
· If treatment with Preversil alone was not adequate a diuretic can be added.
· If patients currently being treated with a diuretic, symptomatic hypotension can occur following the initial dose of Preversil, that case the diuretic should be discontinued 2 to 3 days prior to Preversil therapy. If the diuretic can not be discontinued an initial dose of 2-4 mg Preversil daily in one or in two divided doses is used with careful medical supervision for several hours, then the dosage is titrated as described above.
- In patients with impaired renal function: the initial dosage should be 2 mg/day and it should not exceed 8 mg/day.
Presentation:
Box contains 20 tablets of Preversil / 4 mg.
Box contains 30 tablets of Preversil / 4 mg.