Prestance tabs 10mg + 10mg #30

Instruction for Prestance

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Biochemical composition and form of production

Prestance is produced in the form of tablets with a biconvex surface. Their form depends on the concentration of two active ingredients: perindopril and amlodipine:
    oval tablets - 5/5;
    triangular tablets - 10/5;
    cylindrical tablets - 10/10;
    triangular tablets - 10/5.
Additionally, the composition of the drug includes: silicon oxide, fine cellulose powder, food stabilizer E572, milk sugar. The tablets are packaged in plastic bottles with a dispenser. The cardboard box contains 30 tablets and instructions for the use of the anti-ischemic agent.

Therapeutic properties

The cardiological preparation contains two active components that have different pharmacological properties. Perindopril has a pronounced antianginal effect by inhibiting the enzymes that convert angiotensin I to vasoconstrictor angiotensin II. Its metabolites accelerate the breakdown of bradycardin to inactive peptide compounds.
Prestance inhibits ACE, which leads to an increase in the activity of the kallikrein-kinin system. Due to this, the tone of smooth muscle fibers in arterial and venous vessels decreases, as a result of which the severity of hypertension decreases. When using tablets, peripheral blood circulation is normalized and diastolic and systolic blood pressure decreases. Despite the intensification of blood circulation in the kidneys, the glomerular filtration rate does not change.
Perindopril has a pronounced vasodilating and antihypertensive activity. It increases the elasticity of the vascular walls, lowers blood pressure and improves the trophism of ischemic tissues in the heart. The therapeutic effect continues for 24 hours after taking the pills.
Amlodipine belongs to calcium channel inhibitors from the subgroup of dihydropyridine derivatives. It prevents the penetration of calcium ions into cardiomyocytes, due to which muscle fibers relax. The active metabolite stimulates the expansion of peripheral arterioles and coronary vessels, which leads to a decrease in pre- and afterload on the heart muscle.
The cardiac drug practically does not affect the tone of the sinus node and AV conductivity. By reducing platelet aggregation, the tablets accelerate the excretion of sodium by the kidneys. In this regard, the period of hypotensive and anti-ischemic action of Prestance increases.

Indications for use

The antianginal agent is used in polytherapy of the following forms of cardiopathology:
    insufficiency of the coronary vessels;
    stable (tense) angina pectoris;
    myocardial insufficiency;
    transient disorders of cerebral circulation;
    arterial hypertension (symptomatic and essential).
The combined anti-ischemic drug is used to prevent recurrent stroke and angina attacks in patients with controlled hypertension.

Dosing regimen

It is advisable to take Prestance tablets in the morning on an empty stomach 20-30 minutes before breakfast. To reduce the likelihood of irritation of the esophageal mucosa, it is advisable to drink 200 ml of drinking water with tablets. The dosage regimen largely depends on the clinical indications and the severity of the symptoms of heart failure.
Adults are prescribed 1 tablet of cardiopreparation per day. If necessary, it is combined with cardiac glycosides, but only on the recommendation of a cardiologist. The duration of pharmacotherapy ranges from 15 to 60 days.

Special instructions

According to the instructions for use of the anti-ischemic agent, patients after 65 years of age with glomerular filtration disorders are prescribed a minimum amount of perindopril. This is due to a natural increase in its half-life and the risk of developing intoxication. During treatment, it is necessary to monitor blood creatinine levels and serum potassium concentration.
With moderate severity of liver failure, the cardiopreparation is used with caution. Patients with hepatic cirrhosis and fibrotic lesions of the parenchyma are not prescribed tablets, which is due to the impossibility of inactivation of metabolites by hepatic enzymes.
Antihypertensive medication is not prescribed for children and adolescents under the age of 18. Adequate studies of the safety of the use of perindopril and amlodipine for this category of patients have not been conducted. It is believed that the combination of these substances can negatively affect the functioning of the endocrine system and, as a result, the physical and mental development of children.

Gestation and lactation

It is forbidden to use Prestance by women during gestation and breastfeeding. Perindopril can provoke malformations in the development of a child in the second and third trimesters of pregnancy: kidney failure, oligohydramnios, deformation of the skull bones, etc.
Amlodipine can be excreted in breast milk and can interfere with the baby's digestive system. When prescribing an antihypertensive agent during lactation, the issue of transferring the infant to formula feeding should be resolved.

Alcohol compatibility

Ethanol-containing drinks stimulate the hypotensive effect of the cardio drug, which is fraught with a critical decrease in blood pressure and hypoxia of brain tissue.

Interaction with medications

It is undesirable to combine Prestance with potassium-sparing diuretics and potassium preparations due to the risk of hyperkalemia. Limitations also apply to lithium-based medication. Perindopril increases the plasma concentration of lithium, which is fraught with intoxication and necrotization of the renal pelvis.
Due to the possible development of side effects (angioedema, drug poisoning, hypotension), it is not recommended to combine anti-ischemic tablets with:
    non-narcotic analgesics;
    tricyclic antidepressants;
    sympathomimetics;
    corticosteroids;
    alpha blockers;
    antipsychotics;
    immunosuppressants;
    potent anesthetics;
    inducers of CYP3 A4;
    peripheral vasodilators.
It is advisable to consult with a cardiologist before taking any over-the-counter medications. Some of the above groups of medicines can affect myocardial conduction, lead to cardiac arrest and death.

Overdose

Currently, there are no data on cases of cardio drug overdose. It is believed that taking overdoses of Prestance leads to the occurrence of pathological symptoms characteristic of an overdose of amlodipine and perindopril:
    tachycardia;
    bradycardia;
    peripheral vasodilation;
    hyperemia of the face;
    cardiogenic shock;
    temperature increase;
    hypotension;
    electrolyte disturbances;
    kidney failure.
Gastric lavage and intake of sorbents helps to relieve the patient's well-being. Intravenous administration of dopamine and sodium gluconate is possible to maintain heart function.

Side effects

Against the background of prolonged use of antihypertensive pills, patients may develop the following side effects:
    pancytopenia;
    anemia;
    lability of body weight;
    hyperbilirubinemia;
    headache;
    violation of sleep and wakefulness;
    confusion of consciousness;
    peripheral neuropathy;
    palpitations;
    spasms of the bronchi;
    stool disorders;
    cytolytic hepatitis;
    myalgia.
In patients with impaired glomerular filtration and septic inflammation of the ureter, nocturia, frequent urination, cystitis, etc. can be diagnosed. But most often, patients complain of nausea, dyspeptic symptoms, dry mouth and heartburn.

Contraindications for Prestance

An anti-ischemic drug is not used in cardiotherapy in the presence of the following diseases and pathological conditions:
    hypersensitivity to amlodipine and perindopril;
    obstruction of the bronchi;
    stenosis of the coronary arteries;
    hereditary angioedema;
    kidney failure;
    myocardial insufficiency against the background of myocardial infarction.
Pills Prestance are used with caution for hypertrophic cardiomyopathy, diabetes mellitus, agranulocytosis and cardiovascular diseases.

Storage conditions

Stored at room temperature out of the reach of children for 24 months from the date of release.

Terms of sell

You can buy Prestance without a prescription.