— тяжелая почечная недостаточность (клиренс креатинина менее 30 мл/мин);
— печеночная энцефалопатия;
— тяжелая печеночная недостаточность;
— гипокалиемия;
— одновременное применение с антиаритмическими препаратами с риском развития аритмии типа «пируэт»;
— период кормления грудью;
— препарат содержит лактозу. Периндоприл-Индапамид не следует принимать пациентам с недостаточностью лактазы, непереносимостью лактозы, галактоземией или синдромом глюкозо/галактозной мальабсорбции;
В виду недостаточности терапевтического опыта, препарат Периндоприл-Индапамид не следует назначать:
— пациентам, находящимся на диализе;
— пациентам с хронической сердечной недостаточностью IV функционального класса по классификации NYHA в стадии декомпенсации.
Способ применения и дозы
Внутрь, предпочтительно утром, натощак,по 1 таблетке препарата Периндоприл-Индапамид в соответствии с подобранной дозой 1 раз/сут.
Назначение комбинированного препарата в определенной дозе возможно после титрования дозы по отдельным компонентам препарата в монотерапии. При наличии терапевтического эффекта следует рассмотреть возможность сразу перейти с монотерапии на лечение препаратом Периндоприл-Индапамид.
Побочное действие
Побочные эффекты, перечисленные ниже, представлены по системно-органным классам в соответствии с классификацией MedDRA и со следующей частотой: частые (от ≥1/100 до <1/10); редкие (от ≥1/10000 до <1/1000); очень редкие (<1/10000)
Со стороны сердечнососудистой системы: редкие - чрезмерное снижение АД, ортостатическая гипотензия.
Со стороны нервной системы: редкие - парестезии, головная боль, слабость, головокружение, нарушения сна, лабильность настроения.
Со стороны дыхательной системы, органов грудной метки и средостения: частые - сухой упорный кашель, который исчезает при отмене ингибиторов АПФ.
Со стороны пищеварительной системы: частые - запор, сухость во рту, тошнота, боль в животе, анорексия, нарушение вкусовых ощущений; очень редкие - панкреатит. У пациентов с печеночной недостаточностью возможно развитие печеночной энцефалопатии.
Со стороны кожи и подкожной клетчатки: редкие - у пациентов, предрасположенных к аллергическим реакциям, возможно проявление повышенной чувствительности, главным образом в виде дерматологических реакций: кожная сыпь, макулопапулезные высыпания, пурпура, обострение течения системной красной волчанки; очень редкие -ангионевротический отек (отек Квинке).
Со стороны костно-мышечной системы и соединительной ткани: редкие - судороги.
Лабораторные показатели: в результате приема периндоприла в комбинации с индапамидом может развиться гипокалиемия (содержание калия в плазме крови менее 3.4 ммоль/л), особенно у пациентов с сахарным диабетом или почечной недостаточностью. Возможно снижение содержания натрия в плазме крови и гиповолемия вследствие обезвоживания и ортостатической гипотензии; повышение концентраций мочевой кислоты и глюкозы в крови; незначительное увеличение концентрации креатинина в моче и в плазме крови, обратимое после отмены препарата, наиболее вероятно при стенозе почечных артерий, лечении артериальной гипертензии диуретиками, почечной недостаточности; повышение содержания калия (обычно временное); редкие - повышенное содержание кальция в плазме крови; очень редкие - тромбоцитопения, лейкопения, агранулоцитоз, апластическая анемия, гемолитическая анемия, у некоторых пациентов (после трансплантации почки, у пациентов, находящихся на гемодиализе) на фоне приема ингибиторов АПФ может развиться анемия.
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