Prexim
Generic Name
Perindopril Arginine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| prexim 200 mg capsule | ৳ 35.00 | ৳ 140.00 |
| prexim 400 mg capsule | ৳ 50.00 | ৳ 350.00 |
| prexim 100 mg suspension | ৳ 120.00 | N/A |
Description
Overview of the medicine
Prexim (Perindopril Arginine) is an ACE inhibitor used to treat high blood pressure (hypertension), stable coronary artery disease, and heart failure. It helps to relax blood vessels, making it easier for the heart to pump blood.
Uses & Indications
Dosage
Adults
For hypertension: Initial dose 5 mg once daily, adjusted based on response, maximum 10 mg daily. For heart failure: Initial dose 2.5 mg once daily, maintenance 5-10 mg daily. For stable coronary artery disease: Initial 5 mg once daily for two weeks, then 10 mg once daily.
Elderly
Start with a lower initial dose (e.g., 2.5 mg once daily) and adjust carefully.
Renal_impairment
Dosage adjustment is necessary based on creatinine clearance. For CrCl < 60 mL/min, lower doses are recommended.
How to Take
Take orally once daily, preferably in the morning before a meal to ensure consistent absorption.
Mechanism of Action
Perindopril inhibits the angiotensin-converting enzyme (ACE), preventing the conversion of angiotensin I to angiotensin II. This leads to decreased vasoconstriction, reduced aldosterone secretion, and lower blood pressure. It also reduces cardiac preload and afterload.
Pharmacokinetics
Onset
Onset of antihypertensive effect within 1 hour, peak effect within 3-7 hours.
Excretion
Perindoprilat is primarily eliminated by renal excretion. About 4-12% of the dose is excreted as perindoprilat in urine.
Half life
Perindopril: 1 hour. Perindoprilat: approximately 17 hours (effective half-life).
Absorption
Rapidly absorbed from the gastrointestinal tract and rapidly hydrolyzed to perindoprilat (the active metabolite). Bioavailability is about 65-70%.
Metabolism
Perindopril is a prodrug and is extensively metabolized in the liver by esterases to its active metabolite perindoprilat and other inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to perindopril or any other ACE inhibitor
- History of angioedema associated with previous ACE inhibitor therapy
- Hereditary or idiopathic angioedema
- Pregnancy (especially second and third trimesters)
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment
Drug Interactions
NSAIDs
Reduced antihypertensive effect and increased risk of renal impairment.
Lithium
Increased serum lithium levels and lithium toxicity.
Diuretics
Increased risk of hypotension.
Antidiabetic agents
Increased risk of hypoglycemia.
Potassium-sparing diuretics, potassium supplements
Increased risk of hyperkalemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, shock, bradycardia, electrolyte disturbances, and renal failure. Treatment involves symptomatic and supportive measures, including intravenous saline infusion and hemodialysis if severe.
Pregnancy & Lactation
Contraindicated during pregnancy, especially in the second and third trimesters due to potential fetal toxicity. Not recommended during breastfeeding as it may pass into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from manufacturing date, check specific packaging for exact expiry.
Availability
Pharmacies nationwide
Approval Status
Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established the efficacy and safety of perindopril in hypertension, heart failure, and stable coronary artery disease, including the EUROPA and ADVANCE trials.
Lab Monitoring
- Serum creatinine and potassium levels should be monitored periodically, especially at the start of treatment and in patients with renal impairment.
- Blood pressure should be monitored regularly.
Doctor Notes
- Assess renal function and electrolytes before initiating and periodically during therapy.
- Counsel patients on the risk of angioedema and to seek immediate medical attention if it occurs.
- Avoid concomitant use with potassium-sparing diuretics or potassium supplements unless serum potassium is closely monitored.
Patient Guidelines
- Take the medicine at the same time each day.
- Do not stop taking Prexim without consulting your doctor, even if you feel well.
- Report any symptoms like swelling of the face, lips, tongue, or throat (angioedema) immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Prexim may cause dizziness or fatigue, especially at the start of treatment or when changing dosage. Patients should be cautious when driving or operating machinery until they know how they react to the medication.
Lifestyle Advice
- Maintain a healthy diet low in sodium.
- Engage in regular physical activity.
- Avoid smoking and limit alcohol intake.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.