Compound
The drug Noliprel is offered in several different forms. All variations of the drug include perindopril and indapamide . Combined Noliprel contain 2 mg of perindopril and 0.625 mg of indapamide. The composition of Noliprel Forte includes 4 mg of perindopril and 1.25 mg of indapamide. Noliprel A contains 2.5 mg of perindopril and 0.625 mg of indapamide.
In this drug, perindopril is associated with the amino acid arginine, which has a beneficial effect on the condition of the cardiovascular system. Noliprel A Forte tablets contain 5 mg of perindopril and 1.25 mg of indapamide. Noliprel A Bi-forte contains 10 mg of perindopril and 2.5 mg of indapamide.
As additional substances in the composition of the drug Noliprel there is magnesium stearate, lactose monohydrate, colloidal hydrophobic silicon dioxide, microcrystalline cellulose.
Description of the original drug
Composition and release form
The drug Noliprel is produced in tablet form. Biconvex tablets of round shape and white color are packaged in individual blister cells. Each blister contains 14 tablets. Instructions for use are included. The price of Noliprel starts from 540 rubles.
The drug contains two main active ingredients: perindopril (2 mg), indapamide (625 mcg).
Other components of the drug for blood pressure:
- microcrystalline cellulose;
- lactose monohydrate;
- magnesium stearate;
- polysorb.
Pharmacological properties
The action of the blood pressure drug Noliprel is aimed at inhibiting the angiotensin-converting enzyme. The drug prevents angiotensin-1 from being converted into angiotensin-2, which is responsible for vasoconstriction. Under the influence of the tablets, the blood vessels dilate, excess water and sodium are removed from the body. ACEIs normalize the condition of patients with chronic heart failure.
The blood pressure medication is well absorbed after administration. The maximum content is reached 4 hours after administration. Metabolites of the drug are excreted through the kidneys within 24 hours.
Noliprel tablets
Reception scheme
The tablets are taken orally whole with a sufficient amount of water. The drug has a pronounced prolonged effect, so 1 tablet is prescribed per day. It is recommended to take the tablet in the morning before meals. In case of renal failure, no dosage adjustment is required.
Contraindications
Noliprel blood pressure tablets are contraindicated when:
- pregnancy;
- impairment of all kidney functions;
- increased susceptibility to ACE inhibitor components;
- individual intolerance to components;
- angioedema;
- hypokalemia;
- liver dysfunction;
- use of cardiac drugs.
It is necessary to take the blood pressure drug Noliprel with caution when:
- heart and vascular diseases;
- hypolactasia;
- renal failure;
- diabetes;
- connective tissue dysplasia;
- violation of metabolic processes;
- gout;
- dehydration due to diuretics.
To avoid unwanted effects from taking Noliprel, you should take the drug strictly as prescribed by your doctor.
Side effects
Taking the blood pressure drug Noliprel can cause adverse reactions in the body:
- indigestion;
- hepatitis;
- nervous system disorders;
- tinnitus;
- disorders of the heart and blood vessels;
- arrhythmia;
- respiratory disorders;
- urinary disturbance;
- itching;
- decreased blood counts.
Overdose
In case of an overdose, the patient experiences vomiting, seizures, and weakness. In case of overdose, it is necessary to rinse the stomach, give an adsorbent and call a doctor.
Drug interactions
Parallel use of other antihypertensive drugs increases the effectiveness of Noliprel tablets.
Nonsteroidal anti-inflammatory drugs reduce the hypotensive effect of Noliprel.
Potassium-containing drugs and diuretics can increase the level of potassium in the blood.
Tablets can be replaced with Bisoprolol.
pharmachologic effect
Noliprel is a combination drug that contains perindopril (an angiotensin-converting factor inhibitor) and indapamide (a diuretic that is part of the sulfonamide group).
The pharmacological effect of a drug is determined by a combination of some of the effects of these components. In this combination, both components mutually increase the effect. Noliprel is an antihypertensive drug that effectively lowers both diastolic and systolic blood pressure. The severity of the effect depends on the dose. After taking the drug, there is no rapid heartbeat. The clinical effect is observed 1 month after treatment was started. The antihypertensive effect lasts for one day. After therapy is suspended, the patient does not experience withdrawal symptoms. During treatment, the severity of left ventricular hypertrophy decreases, and the degree of total precardiac and postcardiac load decreases. Large vessels become more elastic, the walls of small vessels are restored. The medicine has no effect on the metabolic processes that occur in the body.
Perindopril reduces the level of aldosterone secretion, resulting in increased renin activity in the blood. Blood pressure decreases in people with different levels of renin . Under the influence of this component, blood vessels dilate.
When taking the drug, the likelihood of hypokalemia . The mechanism of action of indapamide is similar to thiazide diuretics: urination and excretion of sodium and chloride ions in the urine will increase.
Vascular hyperreactivity decreases under the influence of adrenaline. The amount of lipids in the blood does not change.
Substitutes for imported production
Perindopril
Composition and release form
The Polish analog for blood pressure is available in tablet form, which belongs to the group of ACE inhibitors and diuretics. The tablets contain:
- indapamide;
- perindopril;
- lactose;
- silica;
- magnesium stearate.
Packaging of the drug Perindopril
Pharmacological properties
The blood pressure medication increases renin activity. With prolonged use, total peripheral vascular resistance may decrease.
Perindopril restores myocardial function and reduces the load on the heart.
Other pharmacological properties of Perindopril:
- lowers pressure in the heart muscle;
- normalizes blood circulation;
- removes chlorine and sodium;
- lowers blood pressure levels.
The drug has a pronounced prolonged effect. One tablet lasts for 24 hours. Perindopril can be replaced by Noliprel for hypertension.
Reception scheme
The tablets are taken once a day in the morning.
Contraindications
Perindopril is contraindicated in:
- reporting;
- allergies;
- potassium deficiency;
- liver dysfunction;
- lactose intolerance.
Overdose
In case of an overdose, blood pressure drops sharply, nausea, seizures, and drowsiness appear.
If symptoms of overdose appear, it is necessary to correct hypovolemia.
Indapamide
The diuretic analogue is available in tablet form. It removes water and sodium from the body, normalizing blood pressure. When taking pills regularly, the blood vessels become more elastic and their resistance decreases.
Indapamide is a diuretic
Indapamide can be bought without a prescription. Pharmacies sell different versions of Indapamide tablets from different manufacturers. Only the attending physician can prescribe a drug to correct blood pressure.
Indapamide Teva
The drug is in the form of tablets made in Israel. Tablets are taken 1 time per day. The analogue contains indapamide and perindopril.
Other components:
- lactose;
- polyvinylpyrrolidone;
- bicarbonate of soda.
Perindid
An analogue made in India from . Main components: indapamide and perindopril. Excipients: titanium dioxide, talc, lactose.
Ko-Perineva
Tablets replacing Noliprel, made in Slovenia. Contains: calcium chloride, microcrystalline cellulose, silica.
Perindapam
Blood pressure tablets made in Slovenia. Cheap analogue of Noliprel. The cost starts from 130 rubles. Contains: indapamide, perindopril, microsilica, polyvinylpyrrolidone, hydroxypropyl betadex.
Pharmacokinetics and pharmacodynamics
The pharmacokinetics of perindopril and indapamide when used in combination is the same as when used separately. After oral administration, perindopril is rapidly absorbed. Bioavailability level - 65-70%. About 20% of total absorbed perindopril is later converted to perindoprilat (the active metabolite). The maximum concentration of perindoprilate in plasma is observed after 3-4 hours. Less than 30% binds to blood proteins, depending on the concentration in the blood plasma. The half-life is 25 hours. The substance penetrates the placental barrier. Perindoprilat is excreted from the body through the kidneys. Its half-life is 3-5 hours. There is a slower administration of perindoprilate in older people, as well as in patients with heart failure and renal failure.
Indapamide is completely and relatively quickly absorbed from the gastrointestinal tract. The maximum concentration of the substance in plasma is observed one hour after oral administration.
The substance binds to plasma proteins by 79%. Half-life is 19 hours. The substance is excreted in the form of inactive metabolites by the kidneys (approximately 70%) and intestines (approximately 22%). In people with renal failure, no changes in the pharmacokinetics of the substance are observed.
Domestic analogues
Ko Parnavel
An active analogue of the pharmaceutical drug Noliprel. The blood pressure medication is produced in the form of tablets. The medication has a pronounced diuretic and antihypertensive effect.
Packaging of the drug Co-Parnavel
Perindopril Plus Indapamide
Russian analogue of Noliprel for lowering blood pressure in the form of tablets. Tablets are prescribed instead of Noliprel for hypolactasia. Does not contain lactose.
Contraindications
Contraindications to the use of all types of the drug Noliprel are the following diseases and conditions:
- high sensitivity to the components of the drug or the presence of allergic reactions to its components;
- renal failure , in which creatinine clearance is less than 30 ml/min;
- liver failure , in which there is a tendency to encephalopathy ;
- combination with drugs that prolong the QT interval, as well as antiarrhythmic drugs;
- hypokalemia;
- renal artery stenosis;
- lactase deficiency, glucose-galactose malabsorption syndrome, galactosemia;
- history of angioedema;
- pregnancy , lactation ;
- age up to eighteen years.
Also, you should not take the drug at the same time as potassium supplements or potassium-sparing diuretics if the patient has hyperkalemia.
Due to the lack of sufficient information, it is not recommended to use the tablets for treatment in people who are on hemodialysis , as well as in patients with decompensated heart failure.
It is prescribed with caution to people with systemic connective tissue diseases, those taking antidepressants, and suppression of bone marrow hematopoiesis. angina pectoris are also treated with caution .
Side effects
- In the functions of the cardiovascular system : severe hypotension, orthostatic collapse, in rare cases: arrhythmia , stroke , myocardial infarction .
- In the functions of the genitourinary system : deterioration of kidney function, proteinuria in people with glomerular nephropathy, in rare cases - acute renal failure. There may be a decrease in potency.
- In the functions of the central and peripheral nervous system : severe fatigue, dizziness , headache , asthenia, unstable mood, impaired hearing, vision, decreased appetite, convulsions, and in some cases, stupor.
- In the functions of the respiratory system : cough, difficulty breathing, bronchospasm, nasal discharge.
- In the functions of the gastrointestinal tract : dyspepsia, abdominal pain, pancreatitis , cholestasis, increased transaminase activity, hyperbilirubinemia.
- In the functions of the blood system : against the background of hemodialysis or after a kidney transplant, patients may develop anemia, in rare cases - thrombocytopenia, pancytopenia, agranulocytosis, hemolytic anemia.
- Allergic manifestations : skin itching, rash, swelling, urticaria.
- Patients with liver failure may develop hepatic encephalopathy. People with impaired water-electrolyte balance may experience hyponatremia, hypovolemia, hypokalemia, and dehydration.
Instructions for use of Noliprel (Method and dosage)
It is advisable to take Noliprel tablets in the morning. The medicine is prescribed one tablet per day. The instructions for Noliprel Forte provide for a similar treatment regimen. Noliprel A and Noliprel A Bi Forte are prescribed to patients 1 tablet per day. If patients have creatinine clearance equal to or greater than 30 ml/min, then there is no need to reduce the dose. If clearance equals or exceeds 60 ml per day, then during treatment it is necessary to carefully monitor the level of potassium and creatinine in the blood.
If necessary, after several months of treatment, the doctor may increase the dose by prescribing Noliprel A Forte or another type of this drug instead of Noliprel.
Noliprel A Bi-forte is the main substitute for Noliprel
Composition and release form
The main analogue of the drug Noliprel is Noliprel A Bi-forte. These are tablets with similar pharmacological effects, but each tablet contains more active ingredients (10 mg of perindopril and 2.5 mg of indapamide).
Pharmacological properties
The analogue is prescribed for high blood pressure. It belongs to the angiotensin-predominant enzyme inhibitors with a pronounced diuretic effect. Contains indapamide and perindopril.
The complex effect has a pronounced hypotensive effect. The drug is prescribed for primary hypertension.
Noliprel A Bi-forte is an enhanced formula of the original drug
Reception scheme
The drug is taken twice a day, morning and evening, 1 tablet. For minor liver dysfunction, no dose adjustment is required.
The analogue is contraindicated in severe liver failure.
Contraindications
Blood pressure medication Noliprel A Bi-forte should not be taken if:
- individual intolerance to components;
- pregnancy;
- hemodialysis.
Side effects
When taking blood pressure tablets Noliprel A Bi-forte, undesirable reactions from the body may develop:
- tinnitus;
- anemia;
- a strong decrease in blood pressure;
- uncontrollable headache attacks;
- insomnia;
- allergic reactions;
- runny nose.
Overdose
If the prescribed dosage is exceeded, the patient may experience the following symptoms:
- gagging;
- drowsiness;
- decrease in pressure indicators to critical values;
- water-electrolyte imbalance.
In case of overdose, it is necessary to rinse the stomach, drink an adsorbent and consult a doctor.
Drug interactions
Blood pressure tablets Noliprel A Bi-forte should not be taken simultaneously with lithium-containing medications. This may lead to a risk of overdose and lithium poisoning. When combined with these drugs, it is necessary to monitor blood counts and lithium concentrations.
You cannot take Noliprel A Bi-forte tablets and the muscle relaxant Baclofen, as this will increase the hypotensive effect of Noliprel.
Noliprel A Bi-forte tablets are not prescribed simultaneously with tricyclics, as they enhance the pharmacological properties of Noliprel.
When taking corticosteroids, the antihypertensive effect of Noliprel A Bi-forte is reduced.
When taking the drug Noliprel A Bi-forte simultaneously with cytostatic agents or Allopurinol, the risk of a decrease in the level of leukocytes in the blood increases.
During the course of taking blood pressure pills, you should not drink alcohol.
Overdose
In case of an overdose of the drug, there is a severe decrease in blood pressure, nausea, vomiting, dizziness , mood instability, symptoms of renal failure, and electrolyte imbalance. In this case, you need to immediately bring the water-electrolyte balance back to normal, rinse the stomach, and take enterosorbents. Noliprel metabolites can be removed using dialysis. If necessary, intravenous saline is administered.
Interaction
Noliprel should not be taken at the same time as lithium medications. If it is impossible to discontinue one of the drugs, the lithium level in the blood should be closely monitored.
With simultaneous treatment with potassium-sparing diuretics or drugs with potassium, the concentration of potassium in the blood may increase. This combination is recommended only for hypokalemia.
When indapamide with vincamine, bepridil, sultopride, halofantrine, as well as with simultaneous intravenous administration of erythromycin , arrhythmia and bradycardia may occur.
Sometimes, with simultaneous treatment with Insulin and Noliprel, hypoglycemia may develop.
When taking non-steroidal anti-inflammatory drugs, the antihypertensive properties of Noliprel are inhibited. If you are dehydrated, this combination of medications can cause kidney problems or kidney failure.
When treated with Noliprel and antipsychotics or tricyclic antidepressants, orthostatic hypotension may develop.
Due to the retention of water and electrolytes in the body, with simultaneous treatment with Noliprel and mineralocorticoids, glucocorticosteroids, stimulant laxatives, tetracosactide, amphotericin B, the hypotensive effect is reduced and the likelihood of hypokalemia increases.
Due to the possibility of developing hypokalemia, the risk of toxic effects of cardiac glycosides increases.
When combined with Metformin, acidosis may develop .
Before using iodine-containing X-ray contrast agents with Noliprel, the body must be adequately hydrated.
The simultaneous use of calcium salts can provoke hypercalcemia.
Concomitant treatment with cyclosporine may increase blood creatinine levels.
What should you not combine ACE inhibitors with?
Angiotensin-converting enzyme inhibitors are not compatible with certain other drugs:
- lithium-containing drugs: increase the lithium content in the blood;
- muscle relaxant Baclofen: increases the hypotonic effect;
- non-steroidal anti-inflammatory drugs: reduce the effectiveness of ACE inhibitors.
Separately, doctors distinguish combinations of drugs:
- psychotropic and neuroleptic;
- corticosteroids and tetracosactides.
Taking these medications may cause the development of adverse reactions. If renal function is impaired, the drugs cannot be prescribed together. If signs of renal impairment appear during the course of treatment, it is necessary to discontinue therapy. During treatment, it is necessary to monitor the creatinine level in the blood.
special instructions
People who have been prescribed treatment with Noliprel need adequate dehydration of the body to prevent a sharp decrease in blood pressure.
People with heart failure may be treated with beta blockers at the same time.
When treated with Noliprel, a positive reaction is observed during a doping test.
In the first weeks of treatment, it is important to drive vehicles or operate precision machinery carefully when treating with Noliprel.
If during treatment there is a significant decrease in pressure, it may be necessary to administer 0.9% sodium chloride intravenously.
Treatment of patients with cerebral circulatory insufficiency or coronary heart disease should begin with small doses of Noliprel.
In people who have very high levels of uric acid in the blood, when treated with varieties of the drug Noliprel, the risk of developing gout .
Noliprel's analogs
Level 4 ATX code matches:
Akkuzid
Enap-N
Iruzid
Co-Diroton
Enalozide
Enap NL
Enapril-N
Capozide
Tritace Plus
Enzix
Liprazid
Co-Renitec
Hartil N
Hartil D
Ko-Perineva
Kaptopres
Analogs of Noliprel, as well as the drugs Noliprel A Bi Forte, Noliprel A Forte, are other drugs that are used to lower blood pressure and contain similar active ingredients, that is, perindopril and indapamide. Such drugs are Co-prenesa , Prestarium , etc. The price of analogues may be lower than the cost of Noliprel and its varieties.
Noliprel A forte is an identical drug
Composition and release form
The analogue is produced in tablet form with a thin film. The main active ingredients are indapamide and perindopril in double dosage - 1.25 mg and 5 mg, respectively. The tablets lower blood pressure and remove water from the body.
Noliprel A forte is a complete analogue of the original drug with prolonged action
Pharmacological properties
Noliprel A forte has a prolonged effect. To achieve a pharmacological effect, 1 tablet per day is sufficient. A pronounced hypotensive effect is achieved after a month of therapy.
Reception scheme
The tablets are taken before meals. 1 tablet per day is enough. The drug is taken as a single drug or in combination with other medications.
Contraindications
Noliprel A forte tablets should not be taken if:
- potassium deficiency;
- renal failure.
The drug is prescribed with caution for connective tissue diseases.
During pregnancy and lactation
For pregnant women and mothers while breastfeeding , the use of Noliprel is contraindicated. Systematic treatment with these drugs can lead to the development of abnormalities and diseases in the fetus, as well as lead to fetal death. If a woman finds out she is pregnant during treatment, there is no need to terminate the pregnancy, but the patient should be aware of the possible consequences. If blood pressure increases, other antihypertensive therapy is prescribed. If a woman took this drug in the second and third trimesters, an ultrasound of the fetus should be performed to evaluate the condition of its skull and kidney function.
Newborns whose mothers took the drug may suffer from manifestations of arterial hypotension, so they need to be constantly monitored by specialists.
When feeding with breast milk, the drug is contraindicated, so lactation should be stopped during therapy or another drug should be selected.
Combination drugs
Combination-type drugs are convenient to take for high blood pressure, since 2 tablets replace 1. Combined drugs are prescribed after examination and determination of the absence of contraindications. If taking a combination drug is not possible, a single drug is prescribed.
Original analogues include Prestarium A (perindopril) plus Arifon (indapamide).
Arifon can be replaced with Ravel and Indap. Arifon has a potent analogue, Arifon Retard, with a higher content of indapamide. Its analogues are Perineva and Parnavel.
Original drugs can be replaced with generic Noliprel (see above).
Reviews of Noliprel
Reviews on forums about Noliprel, as well as about the drugs Noliprel A, Noliprel A Forte, Noliprel A Bi Forte, indicate that this drug effectively lowers blood pressure. The medicine maintains normal blood pressure, reducing the likelihood of strokes and myocardial infarction.
Reviews of Noliprel Forte also often contain information that this medicine and its other varieties allow you to get a positive result in cases where other drugs are ineffective. Sometimes patients note the development of some side effects, in particular, dry cough, headache, but they are not very intense.
Doctors also note the positive effect of the drug, but they always note that the drug must be taken strictly according to the instructions and taking into account the recommendations of a specialist. In particular, the drug should be taken regularly, and not only during periods of intense surges in blood pressure.
Noliprel price, where to buy
The price of Noliprel is on average 500 rubles per pack of 30 pcs. The price in Moscow for Noliprel A is from 500 to 550 rubles. The price for Noliprel Forte is from 550 rubles per package. Noliprel A Forte 5 mg can be purchased at a price of 650 rubles. The cost of Noliprel A Bi Forte is from 700 rubles. per pack 30 pcs.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Noliprel A Bi-Forte tablets p.p.o.
10mg+2.5mg 30 pcs. Servier Rus LLC 788 rub. order - Noliprel A Forte tablets p.p.o. 5mg+1.25mg 30 pcs. Servier Rus LLC
RUR 738 order
- Noliprel A tablets p.p.o. 2.5 mg + 0.625 mg 30 pcs. Serdix LLC/SERVIER RUS LLC
RUR 642 order
Pharmacy Dialogue
- Noliprel A Bi-forte tablets 10mg+2.5mg No. 30Servier
RUB 807 order
- Noliprel A forte tablets po 5mg+1.25mg No. 30Servier
RUR 734 order
- Noliprel A tablets 2.5 mg + 0.625 mg No. 30Servier
RUR 746 order
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Pharmacy24
- Noliprel Bi Forte 10 mg No. 30 tablets Laboratories Serv'e Industry/Serve'e (Ireland) Industry Ltd., France/Ireland
207 UAH.order - Noliprel Arginine Forte 5 mg N30 tablets Lab.Serve Industries, France/Serve Industries Ltd., Ireland
176 UAH order
- Noliprel Arginine 2.5 mg No. 30 tablets Laboratories Serv'e Industry/Serve'e (Ireland) Industries Ltd., France/Ireland
141 UAH order
PaniPharmacy
- Noliprel arginine tablets Noliprel Arginine film-coated tablets 2.5 mg No. 30 France, Servier Industrie
164 UAH order
- Noliprel arginine tablets Noliprel Arginine tablets No. 30 France, Servier Industrie
155 UAH order
- Noliprel Arginine Forte tablets Noliprel Arginine Forte tablets No. 30 France, Servier Industrie
200 UAH order
- Noliprel bi-Forte tablets Noliprel BI-Forte tablets No. 30 France, Servier
229 UAH order
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