Hypertension is a real threat to human life, especially for patients of retirement age. This disease can cause complications such as coronary heart disease, heart attack, stroke and other diseases of the cardiovascular system. Patient inaction can lead to death. Therefore, when making a diagnosis of hypertension, it is worth immediately starting treatment.

The pharmaceutical market is full of drugs of different levels of impact on the human body. One of the commonly prescribed medicines is Prestarium.

Drug packaging

Prestarium: composition, form of entry into the pharmaceutical market, manufacturer

Release form of the drug

Prestarium is a synthesis of an angiotensin inhibitor (second generation enzyme). Prestarium INN -. Has a vasoconstrictive effect. The drug was created in France. The sale is carried out strictly according to the prescription of the attending doctor.

Available in tablet form:

• 2 mg - white color, round. In a pack of 14 or 30 tablets.
• 4 mg - light green, elongated oval in the form of a capsule. In a pack of 14 or 30 tablets.
• 8 mg - green color, round. There are 30 tablets in a pack.

How much does Prestarium cost?

The medication can be purchased at Russian pharmacies at a price ranging from 440 rubles to 600 rubles per pack. The cost depends on the volume and the company of the manufacturer.

Prestarium: what helps

The drug Prestarium provides significant assistance in reducing high blood pressure, improves the performance of the heart muscle and prevents the occurrence of heart attacks and strokes.

The properties of the drug manifest themselves within the first hour after use. The maximum efficiency is noticeable after 4, 8 hours of reception. The substance that induces the action continues its effect on the body for 24 hours.

Prestarium also helps relieve the symptoms of the following diseases:

• Arterial hypertension. The drug carries out a rapid decrease in blood pressure both in the standing position and in the supine position, by reducing vascular resistance. The frequency of contraction of the heart muscle remains at the same level, the level of hypertrophy of the left ventricle of the heart decreases. Prestarium is not addictive and is not accompanied by a "withdrawal" syndrome. Blood pressure returns to normal after the first month of admission. Simultaneous intake of diuretics enhances the antihypertensive effect on the patient's body.
• Heart failure in a chronic course. Taking the medication is characterized by a gradual normalization of the work of the heart muscle by reducing the level of load, as well as an increase in the cardiac index.
• Ischemia. The passage of a full course of treatment for coronary artery disease is characterized by a decrease in general symptoms and the level of risk of complications.
• Violations of the efficiency of the brain in relation to blood supply.

The medication may be prescribed for prophylactic purposes. The sooner precautions are taken to combat high blood pressure, the less dangerous complications can occur. You can avoid the onset of a second stroke and improve the patient's well-being.

Prestarium: instructions for use

Prestarium is prescribed for oral administration once a day. The medicine is drunk on an empty stomach before breakfast. If the patient forgot to take the medication, then it is allowed to take it at lunchtime or in the evening.

When the first symptoms of the disease are detected, it is necessary to consult a doctor to clarify the diagnosis and dosage of the medication. The dose of Prestarium depends on the diagnosis:

• Arterial hypertension (stably elevated blood pressure from 140/90). At the initial stage, a dose of no more than 4 mg of the drug per day is prescribed. If, with a similar dosage, the patient's symptoms disappear, and the state of health "goes uphill", then the course of treatment continues in the same perspective. If there is no result and the pressure is still kept at 140/90 and above, side effects are not present, then the dose can be increased by 2 times. At the initial stage of taking the medication, there may be a rapid decrease in blood pressure, which causes symptoms such as drowsiness and weakness. The first 1-3 calendar days Prestarium can be taken at bedtime so that the body has time to adapt. After a month, the dosage can be increased to 10 mg per day, but only with the recommendation of a doctor.
• Heart failure (a violation of the working capacity of the heart due to which there is an insufficient supply of blood to the tissues and organs of the human body). Initially, a dosage of 2 mg per day is prescribed. After visiting the doctor and analyzing the effectiveness of taking the medication, the rate can be increased. If Prestarium does not cause negative side reactions, but the effectiveness of the intake remains at a low level and the pressure does not decrease, then the dosage is doubled.
• Prevention of recurrent stroke (sudden interruption of blood supply to the brain, which causes paralysis). Treatment begins with the minimum dosage of Prestarium. Therapy can be carried out no earlier than 2 weeks after a stroke.
• Reducing the risk of vascular and heart disease. If coronary heart disease is detected, Prestarium can be taken up to 5 mg per day. Therapy is usually delayed up to 2 weeks, then the dose may be increased. It is necessary to carefully approach the issue of health and pay attention to the condition of the kidneys.

The early period of taking the drug Prestarium does not have a cumulative effect of a biologically active substance. In retirement age, the excretion of the drug from the body is slowed down, as well as in patients with renal insufficiency. Therefore, dose adjustment is necessary.

A change in dosage for liver diseases (cirrhosis) is not required.

Prestarium: contraindications and side effects

An incorrectly prescribed dosage of the drug Prestarium, as well as the individual characteristics of the human body, can cause side ailments:

• Rapid drop in blood pressure;
• The occurrence of a dry cough, bronchospasm;
• Nausea;
• blurred vision;
• dizziness, weakness;
• Increase in the amount of creatine in urine and blood;
• Allergic manifestations in the form of itching of the skin.

Taking Prestarium above the specified norm leads to an overdose. It is characterized by the development of renal failure, bradycardia and the occurrence of stupor, delayed reaction. Increasing the dose on your own can lead to negative consequences.

Taking the medication is accompanied by some prohibitions:

• Driving vehicles and working at height, as the drug reduces attentiveness and the effect of "stupor" may occur;
• Individual sensitivity to ingredients;
• Pregnancy and the period of breastfeeding (lactation);
• Age up to 18 years;
• Indigestion of lactose, its lack.

The drug can be taken orally, but with a preliminary consultation of a physician and its careful control with:

• Connective tissue diseases (lupus);
• Combination with immunosuppressants, diuretics, preparations containing potassium;
• With concomitant diarrhea or vomiting, poisoning;
• Hyperkalemia;
• The effect of anesthesia on the body;
• Retirement age;
• kidney transplant;
• A patient related to the Negroid race.

Prestarium: storage conditions

Prestarium must be kept out of the reach of children. The temperature in the room should be at least 30°C. The term for the use of the drug is 2 years from the creation of the drug.

Prestarium: pros and cons

Advantages of the drug

The positive aspects of medicines include:

• Convenient reception: 1 time per day at the same time interval (in the morning);
• Adequate cost;
• Good tolerability of the drug, including the category of people of retirement age.

The negative aspects of the drug include:

• The presence of side ailments;
• Acquisition of a medicine strictly according to the prescription;
• The drug is effective when taken together with other drugs for hypertension;
• Prohibition of admission for such categories of people as pregnant women, nursing mothers and children under 18 years of age.

Prestarium: combination with other medicines

Prestarium can be used to treat hypertension as an independent drug, and can be combined with diuretics. In this case, control by the attending doctor is necessary.

The simultaneous use of Prestarium and ACE inhibitors is not recommended, since Prestarium increases the effectiveness and effect of vasodilator drugs.

Some of the drugs taken together with Prestarium can cause hyperkalemia. This is fraught with cardiac arrest. These drugs include: ibuprofen, heparin, immunosuppressants, etc. In patients diagnosed with diabetes mellitus, Prestarium can cause a decrease in blood sugar due to the combined use of the medication and insulin. The result can be hypoglycemia and coma.

Prestarium: analogues

The pharmaceutical market is overflowing with medicines of various types and prices. In almost every drug, you can find a "double" (analogue-synonym) and drugs that are similar in degree of effect, but different in chemical composition.

Analogues of Prestarium include: Acetyl, Coversil, Stoppress, Parnavel, Perineva, Hypernik and others. The most effective choice can only be made by the attending doctor, as he will take into account the general history and the degree of neglect of vascular and heart disease.

Acetyl Coversil Stoppress Parnavel Perineva

Prestarium or Perineva, which is better

Perineva is the main and most common analogue of Prestarium. The main difference between medicines is the substance that induces the effect. Prestarium has perindopril arginine, and Perineva has perindopril erbumine. Due to this, the dosage of Perinev (4 mg) corresponds to the dose of Prestarium (5 mg) and 8 mg (Perinev) corresponds to 10 mg (Prestarium).

Perineva remains a more advantageous option for patients due to its low cost. Prices in pharmacies start at 270 rubles per pack, and Prestarium from 440 rubles. It should be borne in mind that the lowest dosage of Perineva corresponds to a slightly higher dose of Prestarium.

What's better?

Prestarium: reviews of patients and doctors

Patients who have tried Prestarium therapy on themselves leave favorable reviews. Patients note good tolerance, mild side effects, as well as ease of administration (1 time per day at the same time interval). However, some patients report the low effectiveness of monotherapy with the drug in terms of lowering blood pressure and consider this medication to be “weak”. With the joint use of Prestarium and other medicines that reduce blood pressure, the effectiveness is higher. Among the most common side ailments are cough, swelling of the throat and tongue, dizziness and general weakness.

Since the 1990s, studies have been conducted on the effect of perindopril (the substance that induces action in Prestarium) on the human body. About 50,000 people took part in the experiment. The result of the test was the conclusion that the drug lowers blood pressure, helps to improve a person's well-being by getting rid of the symptoms of diseases (hypertension, ischemia, heart failure).

Prestarium is recommended for all people at risk of cardiovascular disease, both as a method of treatment and as a preventive measure. Studies have shown a reduction in the risk of recurrent stroke, prevention of atherosclerosis. Side ailments manifest themselves rarely and in a mild form. People of retirement age, as well as those who have had a stroke, tolerate the course of treatment favorably.

Prestarium and alcohol compatibility

Prestarium and alcohol

Treatment for symptoms of diseases of the heart and blood vessels takes more than one month. Therefore, many patients have a question: is it possible to take alcohol in combination with Prestarium? The combination of alcoholic beverages with the use of Prestarium is not recommended. The reasons are the following possible consequences.

Which are used for a long period of time, and do not lose their relevance for a single gram, because they constantly farm. companies come up with more and more new drugs that are directly related to the ACE inhibitor group.

One of the typical examples of such drugs is a unique, modern and safe drug called Prestarium, which can be used both for complex treatment and for monotherapy. The optimal management tactics can only be selected by the attending physician.

Description of the drug

Prestarium is a universal, highly effective drug intended for the planned treatment of essential hypertension and CHF. It will also successfully help with coronary artery disease (in any of its cases - starting with angina pectoris of 1 degree and ending with the prevention of recurrence of AMI), but in the latter case, the appointment is carried out together with a saluretic agent. Therapy using any ACE inhibitor, even modern and relatively safe, must necessarily be purely individual, because the prolongation of the course, the optimal dose is selected in accordance with the personal characteristics of the patient, the characteristics of his state of health, his age category, history data and the results of the examination. Before prescribing this pharmaceutical preparation, it is necessary to determine the functional activity of the renal apparatus.

Prestarium has become a popular drug also because it is quite enough to take it once a day, so that the drug smoothly reduces SBP and DBP, and at the same time does not cause negative side effects. Conducted scientific studies reliably show that against the background of the systematic use of Prestarium, vascular tone is rehabilitated, they become much more elastic. By its effect, the drug also gradually reduces the pre- and afterload on cardiomyocytes. Accordingly, when implementing the complex effect of Prestarium, it quickly approaches the normal mark.

There is another positive property of this drug - even if the patient decides to stop taking Prestarium for one reason or another, the withdrawal syndrome does not develop. A few words about the pharmacokinetics - after oral administration, Perindopril is rapidly absorbed into the bloodstream, being reabsorbed in the gastrointestinal tract. The maximum concentration is noted one hour after ingestion. The excretion of the pharmaceutical preparation is slowed down in the elderly, as well as in patients with chronic renal failure and chronic heart failure.

Compatibility in combinations

Prestarium significantly increases the severity of the hypoglycemic action of the hormone insulin and sulfonylurea drugs. Tricyclic antidepressants, antipsychotic drugs (neuroleptics), saluretics significantly potentiate the hypotensive effect and greatly increase the possible risk of manifesting orthostatic hypotension (there is a so-called additive effect). Glucocorticosteroids, NSAIDs significantly reduce the severity of the hypotensive effect (there is a pronounced retention of water and electrolytes dissolved in it). Potassium-sparing diuretics, potassium preparations significantly increase the risk of developing hyperkalemia symptoms.

With a combined appointment with lithium preparations, there is a possibility of slowing down its excretion from the body. Diuretics, drugs intended for general anesthesia, and muscle relaxants increase the risk of persistent hypotension. The risk can be minimized by stopping saluretics a few days before starting Prestarium monotherapy. Antacids reduce the bioavailability of ACE inhibitors. Alcohol increases the hypotensive effect of these pharmaceuticals.

Release form and composition

Prescription form of release - tab. 5 mg and 10 mg each, they are packed in polypropylene bottles, 30 pcs. The bottle is equipped with a dispenser and a stopper, which includes a gel that absorbs moisture. Each bottle is in a carton box with first opening control - this is a mandatory condition of the manufacturer.

Regarding storage conditions - there are no special remarks regarding this issue.

In terms of composition, the biochemically active substance in this case is perindopril arginine. In addition, the tablet also contains adjuvants - the so-called excipients that are necessary to stabilize the prescription form, but they do not realize any clinical effect.
Important note: in 0.05 g of perindopril arginine, the amount of perindopril is 3.395 mg.

Morphological characteristics of the table. Prestarium - they are white, rounded, with existing engraving.

Instructions for use

The main approaches to the appointment and indications for the use of this drug are dictated by the peculiarities of its properties. The appointment of Prestarium is shown in situations where there is a need:

• Reduce SBP and DBP.
• Accelerate peripheral blood flow, but do it in such a way that the pulse rate does not increase.

Taking into account the fact that this pharmaceutical product implements a rather pronounced vasodilating effect, and also helps to restore the elasticity of the main arteries and blood vessels of the hematomicrocirculatory bed, and also improves the state of the structure of the vascular wall of small arteries, it makes sense to use it for various trophic disorders that very often manifest themselves in a variety of conditions. pathologies of a cardiogenic nature.

Perindopril effectively normalizes the work of the heart, reducing preload and afterload on cardiomyocytes, and also reduces pathological LVH.

Accordingly, based on the features listed above, it is easy to guess that the indications for the use of Prestarium will be as follows:

• GB or secondary;
• prevention of relapse of stroke by ischemic or hemorrhagic type;

The dosage regimen in each case is selected by the attending physician purely individually, in the vast majority of cases.

Prestarium is taken 1 time per day, usually in the morning. With GB, the starting dose is 2.5-5 mg per day. In the first days of taking blood pressure, it may decrease excessively, especially in patients who take saluretics. Accordingly, this causes undesirable symptoms - asthenovegetative disorders, among which weakness, fatigue, and drowsiness dominate. For the first 1-3 days, it makes sense to take the medicine at night, until the body gets used to it.

A month later, if necessary, it is permissible to increase the dose of the drug to max. permissible - 10 mg per day, but it is possible to increase the dose of Prestarium only if it is well tolerated.

In the treatment of CHF, treatment starts with a dose of 2.5 mg per day. After two weeks, it is increased to 5 mg per day, if the patient tolerates the treatment well. At the same time, blood pressure indicators and renal functions are systematically monitored, and the content of potassium in the blood is periodically measured.

In patients with a relatively stable course of coronary artery disease, it is recommended to develop therapy with a dose of 5 mg per day. After 2 weeks the dose may be increased accordingly up to 10 mg per day.

Elderly patients begin treatment with 2.5 mg per day, and then the doctor adjusts their dose individually.

Side effects

As a rule, Prestarium is usually well tolerated. Please note that if the dosage is chosen correctly, then serious problems are unlikely to occur. As a rule, one has to deal with a dry cough, which clearly requires the abolition of this drug with its subsequent replacement with an angiotensin-II receptor blocker (aka sartan). If blood pressure is lowered through measures, then dizziness is quite possible, as well as cranialgia and blurred vision. In some situations, constipation, various enanthemas and exanthemas, paresthesias and taste disorders are noted.

Contraindications

There are a number of conditions, the presence of which in a patient leads to the fact that the use of Perindopril becomes impossible a priori. These include:

1. Individual intolerance to ACE inhibitors, which actually belongs to a drug called Perindopril.
2. Pregnancy, and regardless of the gestational age.
3. Lactation.
4. Children's age up to 18 years.
5. Individual lactose intolerance (this condition is provoked by a primary deficiency of the lactase enzyme).

All other contraindications are purely relative - in other words, if they are present, the drug must be taken with extreme caution. These disorders include the following disorders:

1. Double sided.
2. The absence of a fully functioning one kidney.
3. Renal insufficiency.
4. Severe systemic diseases (deep pathologies) of the connective tissue (such as SLE, scleroderma).
5. Ongoing immunosuppressive therapy.
6. Decrease in BCC, and regardless of the root cause of the violations.
7. KhNK IV f.c.

There are some drugs that, when taken in combination with Prestarium, can excessively increase the molar concentration of potassium in the blood - this is very dangerous, since the condition is fraught with cardiac arrest.

Accordingly, it is not necessary to combine in one therapeutic combination:

1. Aliskiren;
2. Potassium-sparing saluretics;
3. - in fact, just like all other NSAIDs.

It is unreasonable to combine Prestarium with other representatives of the pharmaceutical group of ACE inhibitors and sartans in one hypertensive patient, because their “application point” has too much in common.

In patients with type 1 or type 2 diabetes, Perindopril can significantly potentiate the action of insulin and sugar-lowering tablets. This results in an increased risk of hypoglycemia.

How to drink with hypertension

Prestarium is an effective drug, the systematic use of which reduces blood pressure, and significantly. Accordingly, in order to prevent an overdose, the patient must definitely consult with his attending physician in order to prevent an overdose and the development of a huge number of adverse reactions in the form of a dangerous side effect.

In turn, after the examination, the therapist, if necessary, will write out a referral for further additional examination, to a narrow specialist, which may be a cardiologist, neuropathologist, etc. Prestarium from and with CHF is prescribed quite often. The drug is intended for complex therapy of cardiac pathologies.

The drug is strongly recommended to be taken by patients who have previously suffered a stroke, since it serves as an excellent prevention of a recurrent attack. Due to the fact that Perindopril, like all other ACE inhibitors, is characterized by an accumulation effect, it will be enough to take it once a day to obtain an effective result, which is very convenient for the patient.

Like most other hypotonic drugs, this drug has a positive effect on blood vessels, expanding them. After the appointment of Prestarium, blood circulation returns to normal, the brain receives the amount of oxygen it needs, thanks to which it is possible not only to quickly reduce blood pressure, but also restore the previous activity of cognitive functions. The intake of this drug is highly recommended for patients who have previously had essential hypertension, but crises do not occur due to the high efficiency of the body's adaptive systems.

Those hypertensive patients whose values ​​are respectively 160/100 mm Hg. Art. or higher, it is strongly recommended to prescribe 2-3 drugs for hypertension at once - because one single drug will not be enough to lower blood pressure to the level of the physiological norm. Even if a modern, effective and safe Perindopril is used, it will not cope in monotherapy with or 3 degrees / stages. Moreover, it is worth making an allowance for the fact that such patients have a very high cardiovascular risk of manifesting cardiac complications.

It is not difficult to guess that such patients, in order to increase the effectiveness of therapy, will be recommended combined treatment - 2-3 drugs for pressure, which it makes sense to use simultaneously.

Most likely, the doctor will advise the “malicious” hypertension to take some combination drug:

• perindopril + indapamide (commercial names - Noliprel,);
• perindopril + amlodipine (commercial names - Dalneva).

Patients who develop the so-called mild essential headache are often prescribed Prestarium. To him, the doctor, if necessary, can add statins, aspirin, magnesium-B6 and some other drugs, the action of which will positively affect the state and functioning of the cardiac system.

The pharmaceutical product in question has a rather impressive range of advantages, but it also has numerous contraindications, and even if all the rules of use are followed, it may well cause unwanted side effects.

As a rule, practicing doctors prescribe a standard dosage of drugs for absolutely all patients with essential hypertension. The reason for increasing the recommended doses may be the low effectiveness of the therapy in individual cases.

In some situations, Prestarium from pressure cannot be used at all by definition, and taking into account the fact that there are no both relative and absolute contraindications to its appointment. For example, if it is necessary to bring the indicators of SBP and DBP to the physiological norm as soon as possible against the background of a hypertensive crisis. The thing is that even with all its effectiveness, the result of using Prestarium as a drug for emergency care for primary or secondary arterial hypertension leaves much to be desired, to put it mildly, the best, because the action realized by it will begin to appear only a few hours after how the patient takes the pill.

Accordingly, you will not find real reviews anywhere regarding the fact that Prestarium should be in the first aid kit as a first aid kit.

Analogues of Prestarium A tablets

The main analogue of Prestarium, which is not inferior in effectiveness to the original drug, is Perinev's tablets. They are produced by the European company KRKA, but the plant is located in Russia. Perineva is approximately 1.5 times cheaper than Prestarium. Tab. Perinev's biochemically active substance is perindopril erbumine, and in Prestarium - perindopril arginine.
It is important to emphasize that their relative doses are somewhat different: 4 mg of perindopril erbumine is approximately a multiple of 5 mg of perindopril arginine; accordingly, 8 mg of perindopril erbumine will be identical in its effectiveness to 10 mg of arginine salt.

There are some other analogues of Prestarium, however, for one reason or another, these drugs are now very difficult to find on the modern market:

1. Parnavel;
2. Vero-Perindopril;
3. Perindopril Richter;
4. Perindopril "Northern Star".

Terms and conditions of storage

It is allowed to store this drug only in a place inaccessible to children, provided that it is protected from direct sunlight. The shelf life of this pharmaceutical product is 3 years. In no case should Perindopril be used after the expiry date indicated on the package. There are no conditions regarding temperature and humidity.

Instructions for use:

Prestarium is a drug for the treatment of high blood pressure.

pharmachologic effect

Prestarium reduces pressure, narrows arterial vessels, restores the elasticity of large arteries.

Patients with chronic cardiovascular insufficiency note that during treatment, metabolic processes in the heart are restored.

There are reviews of Prestarium, confirming that it reduces afterload and preload on the heart, pressure when filling the right and left ventricles, increases exercise tolerance, and reduces the heart rate.

With prolonged use, Prestarium reduces the severity of left ventricular hypertrophy.

The hypotensive effect of the drug after taking the average starting dose develops after 4-6 hours, and persists for another day. After a month of using Prestarium, the pressure stabilizes, and this condition is observed for a long time.

The withdrawal syndrome after the termination of treatment does not develop.

The active substance of Prestarium is perindopril arginine.

Release form

Prestarium is available in tablets.

Indications for the use of Prestarium

According to the instructions, Prestarium is prescribed for hypertension, chronic heart failure, stable ischemia.

Good reviews about Prestarium, which is used to prevent the occurrence of a recurrent stroke in patients who have already had a previous stroke, or who suffer from transient ischemic cerebral circulatory disorders. In this case, Prestarium is prescribed simultaneously with indapamide.

According to the indicated indications, Prestarium analogues can be taken only after consultation with a cardiologist.

Prestarium instructions: how to use

Take Prestarium once a day, in the morning, before meals.

With hypertension, patients at the beginning of treatment are prescribed Prestarium at a dosage of 5 mg. If after a month the pressure does not return to normal, the dose can be increased to 10 mg.

In order to prevent a sharp decrease in pressure, diuretics should be stopped three days before the start of treatment, if they were prescribed. In the absence of such an opportunity, Prestarium therapy begins with a dosage of 2.5 mg, kidney function, and the level of potassium in the blood are monitored. If necessary, on the recommendation of a doctor, after a while the dose is increased.

Elderly patients are also prescribed 2.5 mg of Prestarium at the beginning of treatment and gradually adjust the dosage to 10 mg.

In heart failure, the drug is often prescribed simultaneously with beta-blockers, digoxin. Permissible initial dose - 2.5 mg. Up to 5 mg, the dosage is increased after 2 weeks.

If a patient suffering from heart failure has a tendency to develop hypotension, during treatment, kidney function, blood pressure, and potassium content in the blood are monitored.

To prevent recurrent stroke, patients who have been diagnosed with cerebrovascular disease in the past are prescribed Prestarium at a dosage of 2.5 mg. The drug is taken for two weeks, after which the patient is prescribed indapamide. According to the instructions, Prestarium is started to be taken at any time after the first stroke, even after a few years.

For the prevention of cardiovascular complications in stable ischemia, the drug is taken for two weeks at 5 mg per day. After two weeks, the dosage is increased to 10 mg.

Elderly patients take 2.5 mg of Prestarium for 7 days, after which they switch to 5 mg, and after another week, with a normal kidney condition, they begin to take 10 mg once a day.

For patients with impaired renal function, the treatment regimen is adjusted. In case of violation of the liver, judging by the reviews, Prestarium can be taken according to the standard scheme without health consequences.

Side effects of Prestarium

The use of Prestarium can cause deterioration of kidney function, the development of acute renal failure, the appearance of cough, bronchospasm, rhinitis, eosinophilic pneumonia, breathing problems, dry mouth, pancreatitis, cholestatic jaundice, nausea, diarrhea, abdominal pain, constipation, rash and itching on the skin, erythema multiforme, taste disturbance, loss of appetite.

There are reviews of Prestarium confirming that the drug can cause confusion, asthenia, convulsions, visual disturbances, sleep disturbance, sexual function, dizziness, excessive sweating, tinnitus, arrhythmia, heart attack or stroke, angina pectoris, severe pressure drop, mood deterioration .

In addition, against the background of treatment with Prestarium and analogues of the drug, neutropenia, thrombocytopenia, pancytopenia, agranulocytosis, hyperkalemia, increased activity of liver enzymes, leukopenia, decreased hemoglobin, hematocrit can be observed.

Contraindications

According to the instructions, Prestarium is contraindicated for galactosemia, galactose or glucose malabsorption, hypersensitivity to perindopril, ACE inhibitors, during pregnancy, lactation, with a history of angioedema.

With caution, Prestarium and drug analogues should be taken by patients who, due to hemodialysis, diuretics, adherence to a salt-free diet or vomiting, diarrhea, have a reduced blood volume, as well as those diagnosed with angina pectoris, hyponatremia, cerebrovascular pathology, bilateral arterial stenosis kidneys, renovascular hypertension.

Patients under 18 years of age, patients with scleroderma, lupus erythematosus, hyperkalemia, aortic valve stenosis, obstructive hypertrophic cardiomyopathy, and those who take immunosuppressants take Prestarium under supervision.

Analogues

Analogues of Prestarium are: Perineva, Parnavel, Perindopril-Richter, Perindopril, Perindopril-SZ.

Prestarium is a hypotensive, vasodilatory drug that inhibits ACE, which leads to a decrease in blood pressure by reducing vasoconstriction.

Additionally, Prestarium restores elasticity in large arteries and vessels, stimulates the secretion of aldosterone. Significantly reduces the formation of subendocardial collagen, a metabolic process in cardiac myocytes.

The drug does not lead to metabolic disorders and does not affect the lipid profile. The action of perindopril arginine is produced through its active metabolite, perindoprilat. Other metabolites did not show ACE inhibition activity in clinical testing.

Prestarium 5mg and 10mg photo

During treatment with Prestarium, there is a significant improvement in the therapeutic symptoms of heart failure, there is an increase in exercise tolerance (according to the bicycle ergometric test).

Indications for use Prestarium

Why is Prestarium prescribed? The drug is indicated in the case of arterial hypertension of various etiologies and chronic heart failure (CHF). The same goes for indications:

1. prevention of recurrent stroke in patients with a history of cerebrovascular disease (as part of complex therapy with indapamide);
2. reducing the risk of CVS complications in patients with stable coronary artery disease.

The dosage of the drug depends on the therapeutic purpose and the patient's condition.

How long can I take Prestarium? According to the instructions for use, the standard course of treatment is 1-2 months. In any case, the appointment of tablets and the duration of treatment should be determined by a specialist.

Instructions for use Prestarium, dosage

Prestarium is taken orally, in the morning before meals (recommended time) with a sufficient amount of water, without chewing or crushing.
The dosage depends on the therapeutic purpose and should be established by the attending physician, taking into account the diagnostic data of the patient.

Treatment of essential hypertension:

Prestarium is an effective drug for the treatment of arterial hypertension of any severity. Against the background of the application, there is a decrease in systolic and diastolic blood pressure in the supine and standing positions.

This effect occurs after 4-6 hours from the moment of administration, and the effect is fixed within 24 hours. With a successful therapeutic effect, Prestarium stabilizes pressure within a month and lasts for a long time.

The initial therapeutic dose is 4 mg once a day. If within 28-33 days the effect has not been achieved, the dose may be increased to 8 mg 1 time per day (maximum).

In patients with renovascular arterial hypertension the recommended starting dose is 2 mg once a day. Further correction of the dosage according to blood pressure indicators is possible.
In elderly patients, treatment should begin with a dose of 2 mg / day, and, if necessary, gradually increase up to a maximum of 8 mg per day.

Symptomatic heart failure
The active substance of Prestarium tablets normalizes the work of the heart, reducing preload and afterload. Patients have a decrease in filling in the right and left ventricles, an increase in cardiac output, a decrease in total peripheral vascular contraction, and an increase in cardiac index.

Patients with heart failure when taking Prestarium concomitantly with a potassium-excreting diuretic and / or digoxin and / or a β-adrenergic blocker are recommended to start treatment under close medical supervision and with an initial dose of 2.5 mg.

After 2 weeks, subject to good tolerance, the dose is increased to 5 mg 1 time per day (as needed).

Patients with severe heart failure should begin treatment with Prestarium under medical supervision with extreme caution.

Chronic cardiovascular insufficiency.
The initial daily dose is 2 mg Prestarium. The maintenance average dose is 2-4 mg / day.
In case of SS insufficiency IV degree, an excessive decrease in blood pressure in the elderly, it is necessary to use the drug under constant medical supervision at a dose of 1 mg / day.

Stable coronary heart disease (CHD)
During the international multicenter study EUROPA, lasting 4 years, the effect of perindopril was studied in patients with stable coronary artery disease. The result of therapy with Prestarium was a significant reduction in the relative risk of developing predefined complications.

With stable coronary artery disease - the initial dosage is 5 mg, then the dose is increased after two weeks to 10 mg Prestarium (taking into account the patient's condition).

If signs of unstable angina pectoris are noticed during the first month of treatment, the risk / benefit ratio must be carefully weighed before deciding whether to continue treatment.

Prevention of recurrent stroke
Therapy is carried out in combination with the diuretic indapamide. The initial dosage is 2.5 mg. After 14 days, the dosage of the drug is increased to 1 tablet Prestarium 5 mg (before they started taking indapamide).

Application features

Simultaneous therapy with thiazide diuretics enhances the antihypertensive effect.

Before starting the use of Prestarium and during administration, it is necessary to monitor blood pressure, kidney function and potassium levels in the blood plasma.

The risk of developing arterial hypotension, renal failure while taking the drug increases with a significant loss of sodium and water ions (a strict salt-free diet is contraindicated).

When prescribing ACE inhibitors to patients receiving diuretic therapy, there may be a sharp drop in blood pressure. For prevention, it is recommended to stop taking diuretics 2-3 days before the start of therapy or prescribe the drug in lower doses - 2 mg 1 time per day.

Side effects Prestarium

Possible side effects of Prestarium:

• nausea, vomiting, dry mouth,
• dry cough,
• insomnia, dizziness, headache,
• hypohemoglobinemia, thrombocytopenia,
• skin rash, angioedema, itching and redness of the skin,
• potency disorders.

According to cardiologists, the cause of many side effects of the drug was a violation of the instructions for the use of Prestarium by patients, including non-compliance with the regimen of taking the drug and dosage. The incidence of some side effects is comparable to that of placebolo and cannot be accurately attributed to Prestarium therapy.

Contraindications:

It is forbidden to use Prestarium for conditions and pathologies:

• allergy to perindopril or other components of the drug,
• the patient's age is up to 18 years,
• pregnancy (especially II-III trimester), breastfeeding,
• angioedema,
• severe autoimmune systemic connective tissue diseases,
• diabetes,
• stenosis of the artery of a single kidney,
• inhibition of bone marrow hematopoiesis.

Interactions:

The drug has a complex chain of interactions with other drugs. If you are taking other medications or treatments, be sure to tell your doctor!

Analogues of Prextarium

Since perindopril has shown itself to be an effective substance in the treatment of hypertension and other heart diseases, there are enough Prestarium analogues based on it. Here are some of them, the most available in Russian pharmacies:

• Arentopres
• Hypernik (Russian analogue)
• coversum
• Coversil
• Perindopril
• Perineva
• Perinpress
• Stoppress

Important - instructions for use from Prestarium tablets, price and reviews do not apply to analogues and cannot be used as a guide or instruction. In any case, if it is necessary to replace the drug with an analogue, it is necessary to consult the attending physician (possibly changing the dosage, other side effects, etc.).

Storage conditions:
Prestarium should be stored for no more than 2 years at a temperature not exceeding 30 ° C. Released by prescription.