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Hospital Pharmacy Feb 2024
PubMed: 38223870
DOI: 10.1177/00185787231188919 -
American Journal of Cardiovascular... Oct 2015Perindopril, an ACE inhibitor, and amlodipine, a dihydropyridine calcium channel blocker, are established antihypertensive agents with complementary mechanisms of... (Review)
Review
Perindopril, an ACE inhibitor, and amlodipine, a dihydropyridine calcium channel blocker, are established antihypertensive agents with complementary mechanisms of action. Recently, a once-daily, orally-administered, fixed-dose combination (FDC) of perindopril arginine plus amlodipine besylate (Prestalia(®); hereafter referred to as perindopril/amlodipine FDC) was approved in the USA for the treatment of hypertension. This article reviews the efficacy and tolerability of perindopril/amlodipine FDC and briefly summarizes the agent's pharmacologic properties. As demonstrated in short-term randomized controlled trials, perindopril/amlodipine FDC was significantly more effective in reducing blood pressure (BP) than monotherapy with either of the component drugs, and it appeared to be more effective than an up-titration scheme using valsartan and valsartan/amlodipine. The FDC agent was generally well tolerated, with the most common adverse events (peripheral edema, cough, headache, and dizziness) being consistent with the well-defined tolerability profiles of the individual component drugs. Furthermore, perindopril/amlodipine FDC was associated with a numerically lower incidence of peripheral edema compared with amlodipine monotherapy. Thus, perindopril/amlodipine FDC represents a useful option for the treatment of hypertension, including as initial therapy for patients likely to require multiple drugs to achieve their BP targets.
Topics: Amlodipine; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Blood Pressure; Calcium Channel Blockers; Drug Combinations; Drug Interactions; Humans; Hypertension; Perindopril; Randomized Controlled Trials as Topic
PubMed: 26341621
DOI: 10.1007/s40256-015-0144-1 -
Expert Opinion on Drug Safety Feb 2018Controlling blood pressure is a global health priority; single-pill antihypertensive combinations may improve adherence, persistence, and outcomes. Areas covered: A... (Review)
Review
Controlling blood pressure is a global health priority; single-pill antihypertensive combinations may improve adherence, persistence, and outcomes. Areas covered: A novel combination of perindopril arginine and amlodipine besylate was recently approved. A systematic review of the literature revealed its most common adverse effects as: peripheral edema (depending on the dose of amlodipine, but attenuated by perindopril), cough, dizziness and hypotension. Dose-dependent hyperkalemia, impairment of renal function (especially in renovascular hypertension), angioedema, and teratogenicity were derived from experience with other ACE-inhibitors. Expert opinion: Substantial clinical trial experience with amlodipine or perindopril suggests that these two agents effectively lower blood pressure, and can reduce the risk of major adverse cardiovascular events, as in the Anglo-Scandinavian Cardiac Outcomes Trial. The incidence of adverse effects reported in clinical trials is lower than expected, likely due to exclusion of subjects previously exposed to its components; the nature of open-label, uncontrolled observational studies; and difficulty in recognizing and measuring cough and pedal edema. This new formulation of perindopril arginine protects its ethyl ester, without requiring physical separation from amlodipine in a single tablet, and is less hygroscopic than perindopril erbumine. These and other attributes may make this combination an attractive addition to the antihypertensive armamentarium.
Topics: Amlodipine; Antihypertensive Agents; Blood Pressure; Cough; Dose-Response Relationship, Drug; Drug Combinations; Edema; Humans; Hypertension; Perindopril
PubMed: 29065722
DOI: 10.1080/14740338.2018.1397129 -
Frontiers in Pharmacology 2023Uncontrolled blood pressure is a major risk factor for cardiovascular diseases. Fixed-dose combination (FDC) therapy offers a promising approach to addressing this... (Review)
Review
Uncontrolled blood pressure is a major risk factor for cardiovascular diseases. Fixed-dose combination (FDC) therapy offers a promising approach to addressing this challenge by providing a convenient single-tablet solution that enhances the effectiveness of blood pressure control. In our systematic review, we assess the effectiveness of perindopril/amlodipine FDC in managing blood pressure. We conducted a comprehensive search across four primary electronic databases, namely, PubMed, Virtual Health Library (VHL), Global Health Library (GHL), and Google Scholar, as of 8 February 2022. Additionally, we performed a manual search to find relevant articles. The quality of the selected articles was evaluated using the Study Quality Assessment Tools (SQAT) checklist from the National Institute of Health and the ROB2 tool from Cochrane. Our systematic review included 17 eligible articles. The findings show that the use of perindopril/amlodipine FDC significantly lowers blood pressure and enhances the quality of blood pressure control. Compared to the comparison group, the perindopril/amlodipine combination tablet resulted in a higher rate of blood pressure response and normalization. Importantly, perindopril/amlodipine FDC contributes to improved patient adherence with minimal side effects. However, studies conducted to date have not provided assessments of the cost-effectiveness of perindopril/amlodipine FDC. In summary, our analysis confirms the effectiveness of perindopril/amlodipine FDC in lowering blood pressure, with combination therapy outperforming monotherapy and placebo. Although mild adverse reactions were observed in a small subset of participants, cost-effectiveness assessments for this treatment remain lacking in the literature.
PubMed: 38410524
DOI: 10.3389/fphar.2023.1156655 -
American Journal of Cardiovascular... Mar 2022The single-pill combination (SPC) of perindopril (PER)/indapamide (IND)/amlodipine (AML) is a valuable and convenient treatment option for patients with hypertension... (Review)
Review
The single-pill combination (SPC) of perindopril (PER)/indapamide (IND)/amlodipine (AML) is a valuable and convenient treatment option for patients with hypertension controlled with two-drug SPC of PER/IND + AML given as two separate pills at the same dose level. PER [an angiotensin-converting enzyme (ACE) inhibitor], IND (a thiazide-like diuretic) and AML (a calcium channel blocker) are well established antihypertensive agents, which have been available for a long time as monotherapies and dual SPCs and have complementary mechanisms of action. Once-daily PER/IND/AML provided effective BP control, with good tolerability, in patients with uncontrolled hypertension in clinical trials and in large observational prospective studies. The efficacy and tolerability of PER/IND/AML was similar to that of PER/IND + AML in a randomized clinical trial. The therapeutic effect of PER/IND/AML was associated with improved health-related quality of life. Thus, switching from the two-pill PER/IND + AML regimen to single-pill PER/IND/AML reduces pill burden and simplifies drug administration, which may improve adherence to treatment, leading to better BP control and clinical outcomes.
Topics: Amlodipine; Antihypertensive Agents; Blood Pressure; Drug Combinations; Humans; Hypertension; Indapamide; Perindopril; Prospective Studies; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 35257306
DOI: 10.1007/s40256-022-00521-0 -
Kardiologiia Nov 2018In this article we deal with the problem of low adherence of patients with ischemic heart disease (IHD) to drug therapy congruent to current recommendations including...
In this article we deal with the problem of low adherence of patients with ischemic heart disease (IHD) to drug therapy congruent to current recommendations including patients who underwent invasive interventions aimed at myocardial revascularization. Based on analysis of literature, we undertake an attempt to answer the question: which of components of this therapy patients with IHD are the least likely to continue taking? We also discuss approaches to the search for optimal composition of a combination preparation with fixed doses of an adreno-blocker and angiotensin converting enzyme inhibitor. Based on analysis of literature we undertook an attempt to answer a question: which of components of this therapy patients with IHD are least likely to continue taking. We also included in this article discussion of approaches to the search of optimal composition of a combination preparation containing fixed doses of a в-adrenoblocker and angiotensin converting enzyme inhibitor, as well as data on the role in the treatment of patients with IHD of bisoprolol and perindopril. Fixed doses of these agents have been included into a novel combination preparation.
Topics: Angiotensin-Converting Enzyme Inhibitors; Bisoprolol; Drug Therapy, Combination; Humans; Hypertension; Myocardial Ischemia; Perindopril
PubMed: 30625074
DOI: 10.18087/cardio.2018.11.10194 -
The Medical Letter on Drugs and... Jun 2021
Review
Topics: Cardiovascular Agents; Chronic Disease; Heart Failure; Humans; Recovery of Function; Stroke Volume; Treatment Outcome; Ventricular Function, Left
PubMed: 34181628
DOI: No ID Found -
Supportive Care in Cancer : Official... Jul 2016Cancer cachexia is a complex and multifaceted disease state characterized by fatigue, weakness, and loss of skeletal muscle and adipose tissue. Recently, the profound... (Review)
Review
Cancer cachexia is a complex and multifaceted disease state characterized by fatigue, weakness, and loss of skeletal muscle and adipose tissue. Recently, the profound negative effects of cancer cachexia on cardiac tissue draw much attention, which is likely to contribute to mortality in tumor-bearing animals. The mechanism of cardiac remodeling is not so clear and involved with a series of molecular alterations. In cancer cachexia model, progressive loss of left ventricular mass and decrease in myocardial function is observed and cardiac autonomic functions are altered. Levels of several emerging cardiovascular neurohormones are found elevating in patients with cancer, but it is still controversial whether the changes could reflect the heart injury accurately. The remedy for cardiac remodeling has been explored. It is showed that exercise can modulate signaling pathways activated by wasting cytokines and impact on the resulting outcomes on heart adaptation. Some drugs, such as bisoprolol, spironolactone, perindopril, tandospirone, and simvastatin, can mitigate adverse effects of the tumor on the heart and prolong survival.
Topics: Animals; Cachexia; Heart; Humans; Neoplasms
PubMed: 27108265
DOI: 10.1007/s00520-016-3222-2 -
Photodermatology, Photoimmunology &... May 2020
Topics: Antihypertensive Agents; Humans; Lichenoid Eruptions; Male; Middle Aged; Perindopril; Photosensitivity Disorders
PubMed: 32003073
DOI: 10.1111/phpp.12534 -
The Medical Letter on Drugs and... Mar 2021
Review
Topics: Cardiovascular Agents; Drug Interactions; Heart Failure; Humans; Stroke Volume
PubMed: 33755656
DOI: No ID Found