Hypersensitivity to perindopril and other components of the drug or other ACE inhibitors, angioedema in history against a background of ACE inhibitor therapy, trenbolone enanthate for salehereditary or idiopathic angioedema, pregnancy, lactation, age 18 years (effectiveness and safety have been established).
aortic stenosis, hypertrophic obstructive cardiomyopathy, cerebrovascular diseases (including cerebrovascular insufficiency, coronary heart disease, coronary insufficiency – a risk of excessive blood pressure lowering and concomitant ischemia.
Severe autoimmune systemic diseases of connective tissue (incl . systemic lupus erythematosus, scleroderma), inhibition of bone marrow hematopoiesis in patients receiving immunosuppressive drugs (increasing the likelihood of developing neutropenia).
renovascular hypertension, a bilateral renal artery stenosis, stenosis of the artery only kidney condition after kidney transplantation (risk of renal dysfunction and agranulocytosis), chronic renal failure (especially accompanied by hyperkalemia), hyperkalemia, diet sodium restriction, a condition associated with decreased blood volume (including diarrhea, vomiting, diuretics), diabetes, advanced age, surgery (general anesthesia).
Dosing and Administration
Inside, in the morning before eating.
The initial dose for treating hypertension is 4 mg / day, if necessary (1 month), the dose may be increased to 8 mg / day in one step.
In the appointment of ACE inhibitors in patients receiving diuretic therapy, there may be a decrease in the sharp decline in blood pressure, which is recommended for the prevention stop taking diuretics 2-3 days before the expected trenbolone enanthate for sale start of therapy Perlikorom or prescribe a drug at lower doses -. 2 1 mg once daily
in patients with renovascular hypertension, the initial dose is 1 mg 2 times a day. If necessary, the subsequent dose may be increased.
In elderly patients, therapy should be initiated with a dose of 2 mg per day, and thereafter, if necessary, to gradually increase it up to a maximum dose of 8 mg per day.
Treatment of patients with heart failure in combination with a nekaliysberegayuschim diuretic and / or digoxin. advisable to start under close medical supervision, Perlikor administered in an initial dose of 1 mg 2 times a day, in the morning.
In the future, after 1-2 weeks of therapy, the dose may be increased to 4 mg 1 time per day.
In patients with impaired renal function , the dose should be adjusted according to the degree of renal failure: depending on the creatinine clearance. When CC 30-60 ml / min – 1 mg 2 times a day; with CC 15-30 ml / min – 2 mg every other day; patients on hemodialysis (creatinine clearance less than 15 ml / min.) – 2 mg daily dialysis
. When QC more than 60 ml / min 4 mg per day of
the appointment Perlikora patients with hepatic impairment, dose change is required.
Side effect On the part of the cardiovascular system : often – an excessive fall in blood pressure and related symptoms, rarely – arrhythmias, angina, myocardial infarction and stroke. From the mochevydelitelnoy system : decrease in renal function, acute renal failure. On the part of the respiratory system : often – “dry” cough, shortness of breath; rarely – bronchospasm, rhinorrhea. From the digestive system : often – nausea, vomiting, abdominal pain, change in taste, diarrhea or constipation, dry mouth, decreased appetite, cholestatic jaundice, pancreatitis. On the part of the central nervous system : often – headache , asthenia, fatigue, dizziness, ringing in the ears, blurred vision, muscle cramps, paresthesias; rarely – depressed mood, insomnia; rarely-sputannostsoznaniya. Allergic reactions : often – skin rash, itching; rarely – urticaria, angioedema; rarely – exudative erythema multiforme. Laboratory tests : often – hypercreatininemia, proteinuria, hyperkalemia; hyperuricemia; rarely (with prolonged use at high doses) – neutropenia, leukopenia, gipogemoglobinemiya, thrombocytopenia, decreased hematocrit; very rarely – agranulocytosis, pancytopenia, increased activity of “liver” enzymes, hyperbilirubinemia, haemolytic anemia (compared to trenbolone enanthate for sale glucose-6-phosphate dehydrogenase deficiency). Other : increased sweating, sexual dysfunction.
Overdose Symptoms : marked reduction of blood pressure, shock, stupor, bradycardia, electrolyte disturbances (hyperkalemia, hyponatremia), renal failure. Treatment : gastric lavage, the restoration of fluid and electrolyte status, intravenous administration of 0.9% sodium chloride solution. In the case of pronounced reduction in blood pressure of the patient should be placed horizontally, lifted his legs up.Effective hemodialysis (not use highly permeable membrane nitron polyacrylic). With the development of bradycardia – atropine, trenbolone enanthate for sale may require production of an artificial pacemaker. buy legal anabolic steroids online
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