Perindopril + Indapamide

Generic Name

Perindopril-Indapamide

Other Names

• Perineva
• Preterax
• Coversyl Plus
• BiPreterax

Drug Class

• ACE Inhibitor
• Thiazide-like Diuretic

Chemical Formula

C19H32N2O5.C16H16ClN3O3S

Molecular Weight

395.53 g/mol (perindopril) + 365.83 g/mol (indapamide)

Mechanism of Action

• Perindopril: ACE Inhibitor - blocks the conversion of angiotensin I to angiotensin II
• Indapamide: Thiazide-like Diuretic - inhibits sodium reabsorption in the distal convoluted tubule

Indications

• Hypertension
• Heart Failure

Common Dosage Forms

• Tablet

Typical Dosage

• Perindopril 2-8mg + Indapamide 0.625-2.5mg once daily

Pediatric Dosage

• Not established

Geriatric Dosage

• Dose adjustment may be required in the elderly

Side Effects

• Hypotension
• Hyperkalemia
• Hypokalemia
• Dizziness
• Headache
• Fatigue
• Cough

Contraindications

• History of angioedema related to previous ACE inhibitor therapy
• Severe renal impairment (CrCl<30 mL/min)
• Anuria
• Hypersensitivity to sulfonamides

Pregnancy Category

• Category D - Risk of fetal harm, especially in the second and third trimesters

Lactation Safety

• Limited data, caution advised. Not recommended during breastfeeding.

Drug Interactions

• Potassium-sparing diuretics
• Potassium supplements
• NSAIDs may reduce the antihypertensive effects

Overdose Symptoms

• Hypotension
• Electrolyte disturbances

Antidote for Overdose

• Supportive measures, possible vasopressors for severe hypotension

Storage Conditions

• Store in a cool, dry place at room temperature (15-30°C)

Pharmacokinetics

• Absorption: Well absorbed from the GI tract
• Distribution: Perindopril: Protein binding - 20-30%, Indapamide: Protein binding - 79%
• Metabolism: Perindopril: Hepatic, Indapamide: Hepatic
• Excretion: Perindopril: Renal, Indapamide: Renal

Precautions

• Renal impairment
• Hepatic impairment
• Hyperkalemia
• Hypovolemia
• Electrolyte disturbances

Warnings

• First-dose hypotension
• Renal impairment monitoring
• Hyperkalemia risk