After oral administration perindopril is rapidly absorbed from the gastrointestinal tract trenbolone enanthate 200 and reaches its maximum plasma concentration within 1 hour.
20% of the amount absorbed is converted into perindopril perindoprilat (active metabolite).
Taking the drug during a meal accompanied by a decrease in the conversion of perindopril perindoprilat, respectively, decreases the bioavailability of the drug. The volume of distribution of unbound perindoprilat is 0.2 l / kg. Communication with a minor plasma proteins, perindoprilat relationship with ACE less than 30%, but depends on its concentration.
Perindoprilat excreted by the kidneys. T1 / 2 unbound fraction is about 3-5 hours. Not accumulates. Elderly patients, patients with renal and chronic heart failure elimination perindoprilat slowed. Perindoprilat removed by hemodialysis (rate 70 ml / min., 1.17 ml / sec.) And peritoneal dialysis.
Patients with cirrhosis of the liver “liver” perindopril clearance varies, the total quantity of perindoprilat formed does not change and correct dosing regimen is not required .
- Arterial hypertension;
- chronic heart failure;
- prevention of recurrent stroke (in the complex therapy with indapamide) in patients with cerebrovascular disease in history (stroke or transient cerebral ischemic attack);
- stable coronary heart disease (CHD): reducing the risk of cardiovascular events in patients with previous myocardial infarction and / or coronary revascularization.
- Hypersensitivity to perindopril or any other components of the drug, as well as to other ACE inhibitors;
- angioedema in history trenbolone enanthate 200 (hereditary, idiopathic or due to angioedema receiving ACE inhibitors);
- age of 18 years (effectiveness and safety have been established);
- hereditary galactose intolerance, Lapp lactase deficiency or malabsorption syndrome glucose-galactose.Precautions: renovascular hypertension, bilateral renal artery stenosis, renal artery stenosis only – risk of severe hypotension and renal failure; CHF decompensation, hypotension; chronic renal insufficiency (creatinine clearance (CC) of less than 60 ml / min); significant hypovolemia and hyponatremia (due to salt-free diet and / or previous therapy with diuretics, dialysis, vomiting, diarrhea), cerebrovascular disease (including cerebrovascular insufficiency, coronary heart disease, coronary insufficiency) – the risk of excessive reduction of blood pressure; stenosis of the aortic or mitral valve, hypertrophic obstructive cardiomyopathy, hemodialysis using vysokoprotochnyh nitron polyacrylic membrane – the risk of anaphylactoid reactions; condition after kidney transplantation – is no clinical experience;apheresis procedure to low density lipoprotein (LDL), simultaneous desensitizing therapy allergens (eg, poison Hymenoptera) – The risk of anaphylactoid reactions; connective tissue disease (including systemic lupus erythematosus (SLE), scleroderma), inhibition of bone marrow hematopoiesis in patients receiving immunosuppressants, allopurinol or procainamide – the risk of agranulocytosis and neutropenia; congenital deficiency of glucose-6-phosphate dehydrogenase – isolated cases of hemolytic anemia; in blacks – the risk of anaphylactoid reactions; surgery (general anesthesia) – the risk of excessive reduction of blood pressure; diabetes (control of blood glucose concentration); hyperkalemia; elderly age.Pregnancy and lactation
In pregnancy, the use of the drug is contraindicated. Do not use in the I trimester of pregnancy, so when pregnancy is confirmed Perineva drug should be abolished as soon as possible. The drug is contraindicated in the II – III trimesters of trenbolone enanthate 200 pregnancy, since the application of II – III trimesters of pregnancy can cause foetotoxic effects (decreased renal function, oligohydramnios, retardation of ossification of the fetal skull bones) and neonatal toxic effects (renal failure, hypotension, hyperkalemia). If, however, used the drug in the II – III trimesters of pregnancy, it is necessary to conduct ultrasound of the kidneys and the bones of the skull of the fetus.
Use of the drug Perineva breast-feeding is not recommended due to lack of data on the possibility of its penetration into breast milk. If necessary, use during lactation breastfeeding stop.