تحتوي كل مضغوطة من بريفرسيل على 4 ملغ بيريندوبريل إربومين .
الحركية الدوائية :
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 :
علبة تحوي 20 مضغوطة بريفرسيل / 4 ملغ .
علبة تحوي 30 مضغوطة بريفرسيل / 4 ملغ .
Each Preversil tablet contains 4 mg Perindopril Erbumine.
- 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.
- 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.
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.
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.
· 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.
- 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.
- 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.
Box contains 20 tablets of Preversil / 4 mg.
Box contains 30 tablets of Preversil / 4 mg.
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