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Indapamide + Perindopril Arginine: Brands, Price & Uses in Bangladesh
Indapamide + Perindopril Arginine is a fixed-dose combination of a thiazide-like diuretic (indapamide) and an angiotensin-converting enzyme (ACE) inhibitor (perindopril arginine) and more.
About Indapamide + Perindopril Arginine
Indications of Indapamide + Perindopril Arginine
Indapamide + Perindopril Arginine is a fixed-dose combination of a thiazide-like diuretic (indapamide) and an angiotensin-converting enzyme (ACE) inhibitor (perindopril arginine), indicated for the treatment of essential hypertension.
Established Uses
- Hypertension not adequately controlled on monotherapy: Indapamide + Perindopril Arginine is indicated in patients whose blood pressure is not adequately controlled with either indapamide or perindopril arginine alone.
- Substitution (replacement) therapy: Indapamide + Perindopril Arginine may be used as substitution therapy in patients already adequately controlled on the individual components (perindopril arginine and indapamide) given concurrently at the same doses, for the convenience of a single daily tablet.
Not First-Line Initial Therapy
Indapamide + Perindopril Arginine is generally not used as first-line initial therapy for hypertension; it is intended for patients who require combination treatment after the individual components have been trialed or titrated separately, consistent with standard hypertension management guidelines.
Dosage & Administration of Indapamide + Perindopril Arginine
The dose of Indapamide + Perindopril Arginine should be individualized based on prior response to the individual components. It is administered once daily, generally in the morning, before a meal.
| Indication/Situation | Recommended Dose |
|---|---|
| Hypertension inadequately controlled on monotherapy | Start with the lowest available combined strength of Indapamide + Perindopril Arginine (e.g., perindopril arginine 2.5 mg/indapamide 0.625 mg) once daily; may be increased after 3–4 weeks if blood pressure control is insufficient, up to the maximum available combined strength. |
| Substitution therapy (already controlled on individual components) | Switch to the Indapamide + Perindopril Arginine tablet strength matching the doses of perindopril arginine and indapamide the patient is already taking separately, once daily. |
| Elderly patients | Start at the lowest strength; titrate cautiously with monitoring of renal function and blood pressure. |
| Renal impairment | Use with caution in mild-to-moderate impairment with dose adjustment/monitoring; contraindicated in severe renal impairment (see Contraindications). |
| Pediatric patients | Not recommended; safety and efficacy not established (see Pediatric Use). |
If a dose of Indapamide + Perindopril Arginine is missed, it should be taken as soon as remembered unless it is close to the next scheduled dose, in which case the missed dose should be skipped; doses should not be doubled.
Side Effects of Indapamide + Perindopril Arginine
Indapamide + Perindopril Arginine is generally well tolerated, but may cause the following adverse effects:
Common
- Dry, persistent cough (a characteristic class effect of the ACE inhibitor component)
- Dizziness, headache
- Hypotension, including symptomatic orthostatic hypotension (especially after the first dose or a dose increase)
- Asthenia (weakness/fatigue)
- Paresthesia
- Gastrointestinal disturbances (nausea, constipation, abdominal pain, dry mouth)
- Muscle cramps
- Electrolyte disturbances: hypokalemia, hyponatremia (from the indapamide component), or hyperkalemia (from the perindopril arginine component)
Less Common / Serious
- Angioedema (rare but potentially life-threatening; see Precautions and Warnings)
- Renal impairment or increase in serum creatinine
- Elevated blood uric acid, precipitation of gout
- Rash and other hypersensitivity skin reactions; rare photosensitivity reactions
- Blood dyscrasias (leukopenia, neutropenia, agranulocytosis, thrombocytopenia) — rare
- Impaired glucose tolerance
Patients taking Indapamide + Perindopril Arginine who experience swelling of the face, lips, tongue, or throat, or difficulty breathing, should seek emergency medical care immediately.
Contraindications of Indapamide + Perindopril Arginine
Indapamide + Perindopril Arginine is contraindicated in the following situations:
- Known hypersensitivity to perindopril, indapamide, any other ACE inhibitor, or any sulfonamide-derived drug.
- History of angioedema associated with previous ACE inhibitor therapy, or hereditary/idiopathic angioedema.
- Pregnancy (see Pregnancy and Lactation).
- Severe renal impairment (including anuria) or patients undergoing dialysis.
- Severe hepatic impairment or hepatic encephalopathy.
- Concomitant use with aliskiren-containing products in patients with diabetes mellitus or renal impairment (glomerular filtration rate less than 60 mL/min/1.73m²).
- Concomitant use with sacubitril/valsartan, or within 36 hours of switching to or from sacubitril/valsartan.
- Concomitant use with extracorporeal treatments that lead to blood contact with negatively charged surfaces (e.g., certain high-flux dialysis membranes), due to risk of anaphylactoid reactions.
Frequently Asked Questions about Indapamide + Perindopril Arginine
What is Indapamide + Perindopril Arginine used for?
Indapamide + Perindopril Arginine is used to treat high blood pressure (hypertension), particularly in patients whose blood pressure is not adequately controlled by either component alone, or as a convenient once-daily substitute for patients already stable on the two individual medicines.
Can I take Indapamide + Perindopril Arginine during pregnancy?
No. Indapamide + Perindopril Arginine is contraindicated in pregnancy because the ACE inhibitor component can cause serious harm or death to the developing fetus. If you become pregnant while taking Indapamide + Perindopril Arginine, contact your doctor immediately so treatment can be changed.
Why does Indapamide + Perindopril Arginine cause a dry cough?
A persistent dry cough is a well-known side effect of the ACE inhibitor (perindopril arginine) component of Indapamide + Perindopril Arginine, related to increased levels of bradykinin. If the cough is bothersome, discuss it with your physician rather than stopping the medicine on your own.
What should I do if my face, lips, or tongue swell while taking Indapamide + Perindopril Arginine?
This may be a sign of angioedema, a rare but potentially life-threatening reaction to the ACE inhibitor component of Indapamide + Perindopril Arginine. Stop the medicine and seek emergency medical attention immediately.
Can I take potassium supplements or salt substitutes with Indapamide + Perindopril Arginine?
Generally, no, unless specifically directed by your physician. Potassium supplements and potassium-containing salt substitutes can raise blood potassium to dangerous levels when combined with Indapamide + Perindopril Arginine, due to its ACE inhibitor component.
How should I take Indapamide + Perindopril Arginine?
Indapamide + Perindopril Arginine should be taken once daily by mouth, preferably in the morning before a meal, at the same time each day. Do not stop taking it suddenly without consulting your doctor, even if you feel well, since hypertension is usually a lifelong condition requiring ongoing treatment.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.