Compatibility «Indapamide+Ramipril» and «Perineva»
Between «Indapamide+Ramipril» and «Perineva» found 9 dangerous and 18 negative interactions, joint admission is not recommended without consulting a doctor.
Interaction tableCompare |
Perineva |
✘Indapamide+Ramipril [Indapamide and more 1Ramipril] Analogs | |
✘Perineva [Perindopril] Analogs |
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Interactions Indapamide+Ramipril with Perineva
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Dangerous interactions
Concomitant use with other ACE inhibitors increases the risk of developing renal insufficiency (in acute PM), hyperkalemia. The administration of ACE inhibitors to patients with hyponatremia (especially patients with renal artery stenosis) is accompanied by a risk of developing sudden arterial hypotension and/or acute renal failure. In chronic heart failure, treatment with ACE inhibitors should begin with the lowest doses, with a possible preliminary reduction in doses of diuretics. Patients taking diuretics, especially those who have recently started treatment, may sometimes experience an excessive decrease in blood pressure after starting therapy with perindopril erbumin. The use of a diuretic may further increase the risk of lithium toxicity. In the elderly, patients with insufficient BCC (in pm receiving diuretic therapy) or with impaired renal function, the combined use of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including perindopril, may lead to deterioration of renal function, including possible acute renal failure. In patients receiving diuretics, especially with excessive excretion of fluid and / or electrolytes, at the beginning of perindopril therapy, an excessive decrease in blood pressure may be observed, the risk of which can be reduced by discontinuing the diuretic, replenishing fluid loss (intravenous infusion of 0.9% sodium chloride solution), as well as using perindopril in lower doses. When using diuretics in the case of CHF, an ACE inhibitor should be prescribed at a low dose, possibly after reducing the dose of a potassium-sparing diuretic used simultaneously. Some drugs or drugs of other pharmacological classes may increase the risk of hyperkalemia: aliskiren and aliskiren‑containing drugs, potassium salts, potassium-sparing diuretics, ACE inhibitors, angiotensin II receptor antagonists (ARA II), heparin, immunosuppressants such as cyclosporine or tacrolimus, trimethoprim, drugs containing co-trimoxazole (trimethoprim + sulfamethoxazole). -
Negative interactions
When used concomitantly with other antihypertensive drugs, the antihypertensive effect of the indapamide + ramipril combination may be enhanced. If the patient needs these procedures, then other types of membranes should be used (in the case of plasmapheresis and hemofiltration) or the patient should be transferred to other groups of antihypertensive drugs. When used concomitantly with other antihypertensive agents, it is possible to enhance the antihypertensive effect of the drug CONCEALAR-D24. The use of indapamide can sum up or potentiate the effect of other antihypertensive drugs. In limited controlled studies comparing the effects of indapamide in combination with other antihypertensive drugs with the effects of other antihypertensive drugs used as monotherapy, there were no noticeable changes in the nature or frequency of adverse reactions associated with combination therapy. 3 days before the start of treatment with an ACE inhibitor, stop taking diuretics; in the future, if necessary, taking a non-potassium-sparing diuretic can be resumed;. if discontinuation of diuretics is not possible, then ACE inhibitor therapy should be started at low doses, followed by a gradual increase in the dose if necessary. In all cases, in the first week of taking ACE inhibitors in patients, it is necessary to monitor renal function (creatinine concentration in blood plasma). Blood pressure should be monitored and, if necessary, the doses of antihypertensive drugs should be adjusted. The possibility of hypotensive effects can be minimized by reducing the dose or canceling the diuretic, or increasing salt intake before starting treatment with perindopril. However, the bioavailability of perindoprilate was reduced by diuretics, which was associated with a decrease in ACE inhibition in plasma. In patients receiving diuretics that remove fluid and / or salts, at the beginning of Perindopril therapy, there may be a marked decrease in blood pressure, the risk of which can be reduced by discontinuing diuretics, replenishing the loss of fluid or salts before starting Perindopril therapy, as well as using Perindopril at a low dose with a further gradual increase. In hypertension in patients receiving diuretics, especially those that remove fluid and/or salts, diuretics should either be discontinued before the use of an ACE inhibitor (while a potassium-sparing diuretic may be prescribed again later), or an ACE inhibitor should be prescribed at a low dose with a further gradual increase. The additional use of thiazide diuretics against the background of the combined use of lithium preparations and ACE inhibitors increases the already existing risk of lithium intoxication. Antihypertensive and vasodilating agents. It enhances the antihypertensive effect of ACE inhibitors, blood pressure monitoring is required and, if necessary, dose adjustment of antihypertensive drugs. With antihypertensive drugs (for example, diuretics) and other drugs that reduce blood pressure (nitrates, tricyclic antidepressants, general and local anesthesia, baclofen, alfuzosin, doxazosin, prazosin, tamsulosin, terazosin). Ramipril and Perindopril belong to the same pharmaceutical group: ACE inhibitors. -
No interactions
Concomitant diuretics do not affect the rate and degree of absorption and excretion of perindopril. -
Positive interactions
With antihypertensive drugs (for example, diuretics) and other drugs that reduce blood pressure (nitrates, tricyclic antidepressants, general and local anesthesia, baclofen, alfuzosin, doxazosin, prazosin, tamsulosin, terazosin), there is a potentiation of the antihypertensive effect. The antihypertensive effect of perindopril may be enhanced when combined with other antihypertensive drugs, vasodilators, nitrates of short and prolonged action. -
Unclear interactions
Perindopril + Indapamide analgin and citramon are used together in 19 preparations. Diuretics. Potassium-containing diuretics (eplerenone, spironolactone). Potassium-sparing diuretics.
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Dangerous interactions
Decoding the colors of interactions and contraindications
Dangerous | — | a pronounced negative interaction or contraindication. |
Negative | — | negative interaction or side effect that may reduce effectiveness. |
Positive | — | the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication of the drug. |
No | — | the drugs do NOT interact, which is separately indicated in the instructions. |
Unclear | — | the system failed to pre-assess the danger. |
Video instruction
Additional information
- Kiberis checks interactions and evaluates drug compatibility online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
- Why do I need to
- Avoid dangerous prescriptions for your patients.
- Check the contraindications.
- Evaluate the safety of therapy in the treatment of children.
- See the compatibility of drugs with alcohol (enter it as a drug).
- Point the doctor to the found interaction - you may need to adjust the therapy.
- The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
- The article is written: artificial intelligence Kiberis
- Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
- Total analyzed: 169,972,605 possible combinations of drugs and their components were found 412,508 interacting combinations.
- Medicine section: Standard evidence-based medicine
- The date of the last update of the interaction database: 2024-04-11
Category - medicine