PERINEVA or CO-PERINEVA: which is better and what is the difference (differences in composition, reviews from doctors)

Pharmacists offer many different drugs for high blood pressure: Perindopril, Perineva, Noliprel, Captopril and many others. One of the most popular is Perineva.

But the medicine you need is not always available at the pharmacy. In this case, substitutes are purchased.

What Perinev tablets are, analogues of the product and their price - the article will tell you about all this.

Compatibility of Perineva and alcohol

The drug is taken in the form of tablets, so there is a load on the body, starting with the gastrointestinal tract. Dyspeptic disorders occur and a person may vomit. The medicine is eliminated along with the digestive masses without causing an antihypertensive effect.

When the substance enters the blood, it spreads throughout the internal organs. There is a load on the heart and blood vessels. The latter expand excessively, the patient feels a loss of strength and loses consciousness. There is a risk of heart attack, stroke, which can lead to sudden death.

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pharmachologic effect

Co-Perineva blood pressure tablets are a combination drug that contains a combination of an ACE inhibitor - perindopril and a thiazide-like diuretic - indapamide. The drug has an antihypertensive effect without affecting metabolism and lipids. The result depends on the amount of medicine taken. Reducing the dose reduces the hypotensive effect regardless of the patient’s age and body position. The drug leads to the following effects on the human body:

1. dilates veins;
2. reduces the load on the heart muscle;
3. restores the elasticity of large arteries;
4. has a diuretic effect.

Brief characteristics of the drug

These are tablets based on perindopril erbumine. Penetrating into the body, it turns into an active metabolite. Blood pressure decreases. The vessels dilate, so blood flow normalizes. Clinical studies revealed a decrease in the incidence of heart attacks, strokes, and coronary heart disease.

Indications for use:

• arterial hypertension;
• chronic heart failure;
• prevention of repeated vascular damage after a heart attack, stroke, ischemia;
• chronic ischemic heart disease.

Side effects:

• decreased blood count, anemia, agranulocytosis;
• metabolic disorders, changes in the amount of microelements;
• numbness of the limbs, dizziness, headache, insomnia, fainting;
• decreased vision and hearing function;
• hypotension, vascular inflammation, increased heart rate, angina, heart attack, stroke;
• rhinitis, spasm of the bronchial tree, bronchitis, inflammation of the lower respiratory tract;
• dyspepsia, impaired stool formation, inflammation of the pancreas and liver;
• dermatitis, skin allergies;
• systemic allergic reactions;
• erectile disfunction;
• kidney inflammation;
• increased transaminases, jaundice.

Contraindications for use:

• history of systemic allergic reactions;
• pregnancy, lactation;
• minor age;
• hypersensitivity to the drug.

If the patient has an inflammatory pathology of the liver or kidneys, the drug is approved for use, but in a limited dosage.

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Contraindications

The medication is contraindicated in patients with at least one of the following symptoms:

• history of angioedema;
• hypokalemia;
• severe symptoms of acute renal failure;
• bilateral renal artery stenosis;
• high potassium concentration – hyperkalemia;
• lactose intolerance;
• acute heart failure;
• patients with diabetes;
• teenagers under 18 years of age;
• pregnancy and lactation;
• sensitivity to active substances;
• athletes – a false positive reaction may occur during doping control;
• undergoing dialysis.

Use of the drug for hangover

When a person has a hangover, ethanol is completely eliminated from the gastrointestinal tract. It is absorbed into the bloodstream, spreading throughout the tissues. The body becomes dehydrated and kidney function slows down. Therefore, any drug used is less excreted from the body during this period.

If you start treatment for a hangover, severe hypotension will occur, leading to a deterioration in health and fainting. There will be a risk of heart attack and stroke, especially in patients at risk.

Consequences of drinking alcohol

The antihypertensive drug should not be taken with ethanol.

The combined action causes the following consequences:

• nausea, vomiting, abdominal pain, flatulence, heartburn;
• convulsions, numbness of extremities, neurological disorders;
• lethargy, fatigue, depression, loss of consciousness;
• rupture of the walls of blood vessels, leading to stroke, heart attack;
• systemic allergic reactions that cause death without first aid (anaphylactic shock, Quincke's edema);
• hepatitis, fibrosis, cirrhosis of the liver;
• nephritis, nephrosis, renal failure;
• inflammation of the bronchial tree, nasal mucosa, and lung alveoli.

When combining substances there will be no minor consequences. Severe complications arise that aggravate a person’s well-being during the period of illness.

Side effects

What will happen if you independently, not according to the instructions for use, increase the dose of Perinev tablets recommended by the doctor? The composition of the drug is such that it rarely causes side effects, but they still happen. An overdose according to the instructions for use causes:

• a sharp decrease in pressure, up to collapse;
• development of renal failure;
• violation of pulmonary ventilation.

Both bradycardia and tachycardia are possible, cough, anxiety, and dizziness are not excluded.

If for some reason an overdose occurs, according to the instructions for use, the patient is placed with his legs elevated. Next, the volume of circulating blood (CBV) is replenished using solutions injected into a vein. Angiotensin II is also administered intravenously; if it is not available, catecholamines are administered.

If the patient takes these tablets, he should know what side effects the drug Perineva has:

• dry cough, shortness of breath;
• pain in the head, dizziness;
• noise in ears;
• asthenia;
• drop in blood pressure;
• dyspeptic disorders;
• skin rashes;
• convulsions.

How safe is the use of Perineva? Side effects occur infrequently and do not always require discontinuation of the drug. But if they occur, consultation with a specialist is necessary.

When to take the drug, after how long

To reduce blood pressure, wait until there is no ethanol in the body. It should not be in the bloodstream, gastrointestinal tract, liver, kidneys, or central nervous system. If a person has taken a single dose of alcohol, wait no more than 1 day from the end of the hangover.

If you drink alcohol frequently, it is recommended to wait at least 5-7 days for ethyl alcohol to be removed from the tissues. Alcoholism is a contraindication for taking the drug. A person must undergo addiction treatment before taking the drug.

When can you drink alcohol if you are taking or have taken the drug?

The possibility of drinking alcoholic beverages depends on the patient’s diagnosis. If therapy has completed, but he is at risk for internal hemorrhage in organs or hypertensive crisis, the doctor gives a complete ban on drinking drinks containing ethyl alcohol.

If there are no serious risks, you can drink small doses of alcohol after finishing taking the drug.

Wait 2-3 weeks. To obtain permission, contact your doctor. Only he decides how long after you can drink alcohol.

Organs affected by the toxin

The combined use of pharmacological agents and alcohol has a toxic effect on the internal organs and environments of the body. Alcohol, entering into a chemical reaction with a medicine, leads to poisoning, disrupts physiological processes, enhances or weakens the healing properties of drugs.

The liver suffers more than other organs. She gets hit twice. Many medications have a side effect - hepatotoxicity, destroy cells, and disrupt the physiology of the organ. In the liver, alcohol breaks down to ethanal, a substance 20-30 times more toxic than ethanol, which causes the death of hepatocytes.

Dangerous groups of drugs for the organ in combination with alcohol:

• anti-inflammatory;
• hormonal;
• antibacterial;
• antifungal;
• glucose control agents for diabetes mellitus;
• anti-tuberculosis;
• cytostatics (chemotherapy drugs);
• tranquilizers (anti-epileptic, psychotropic).

In second place among the internal organs exposed to the harmful effects of alcohol together with medications are the heart and vascular system. Strong drinks during drug therapy constrict blood vessels and increase blood pressure. The simultaneous intake of alcohol and chemical substances leads to failure of the myocardium and increases the risk of developing an attack of angina pectoris and a heart attack.

A mixture of ethanol and pharmaceuticals disrupts the quality of the blood and reduces clotting. This is dangerous due to internal bleeding and strokes.

Interaction

You should not combine Co-Perineva with ACE inhibitors and lithium preparations, as the level of lithium in the blood may increase. If co-administration is necessary, lithium levels should be monitored.

Use extreme caution when taking baclofen, which may increase the hypotensive effect. Blood pressure and kidney function should be monitored and the dose adjusted if necessary.

Neuroleptics and tricyclic antidepressants enhance the effect of hypotension and increase the likelihood of orthostatic hypotension.

Tetracosactitol and GCS help reduce the hypotensive effect.

When taken simultaneously with any other antihypertensive drugs, there is a possibility of a stronger manifestation of the hypotensive effect.

Perindopril

At the same time, it is not recommended to use it with potassium-sparing diuretics (Spironolactone, amiloride, eplerenone, triamterene) and potassium supplements. When used in parallel, the level of potassium in the blood may increase, which can lead to death. If joint therapy is necessary (for hypokalemia), it is necessary to monitor potassium levels and ECG parameters.

It is recommended to take Co-Perineva together with insulin and hypoglycemic agents with extreme caution. The risk of developing leukopenia increases when used with cytostatic immunosuppressants, allopurinol, corticosteroids and procainamide. When used with general anesthesia agents, their hypotensive effect may increase. When used in high doses, thiazide and loop diuretics can lead to hypovolemia.

Indapamide

Drugs that cause ari must be taken with caution, since there is a possibility of developing hypokalemia. It is recommended to take Indapamide with caution with medications such as antipsychotics (cyamemazine, trifluoperazine, chlopromazine, etc.), antiarrhythmic drugs (amiodarone, hydroquinidine, ibutilide, tosilade, etc.), benzamides (sultopride, tiapride, sulpiride, amisulpride), buterophenones (haloperidol , droperidol), other drugs (astemizole, mizolastine, sparfloxacin, methadone, bepridil, halofantrine, terfenadine, cisapride).

Medicines that can cause hypokalemia: tetracosactide, laxatives that stimulate intestinal motility, amphotericin B, glucocorticoids, mineralocorticoids, cardiac glycosides.

The risk of lactic acidosis increases when used with Metformin. Patients taking high-dose iodine contrast agents are at risk of kidney failure. Hypercalcemia can develop when taking medications containing calcium salts.

Rules for taking medications and alcohol

Drinking alcohol during treatment minimizes the clinical effect of therapy and creates a risk of developing complications of the disease.

If this cannot be avoided, follow the rules of behavior that will reduce the occurrence of negative consequences:

1. Do not drink strong drinks (vodka, cognac, whiskey), choose dry wine (100-150 ml), beer (no more than 300 ml). Don't drink alcohol on an empty stomach.
2. The interval between taking the medicine and alcohol should be at least 2 hours.
3. To reduce the toxic effect, take medications that protect the liver (hepatoprotectors), pancreas (pancreatin), and stomach (antacids ─ Rennie, Almagel).

If a person takes antiviral medications for colds, anti-inflammatory drugs, alcohol in moderation does not pose a threat to the body.

Alcoholic drinks during treatment are strictly contraindicated in cases of liver cirrhosis, severe infectious diseases, and during a course of chemotherapy.

Dosage

The course of treatment for arterial hypertension is prescribed by a doctor. According to the annotation, it is necessary to start taking the medication with a minimum content of perindopril and indapamide (2 mg and 0.625 mg). If blood pressure cannot be controlled within a month, the dose is adjusted. To obtain a strong hypotensive result, you can take the maximum daily dose of the drug (8 mg perindopril and 2.5 mg indapamide). For elderly patients, the initial dose of antihypertensive medication is 2 mg/0.625 mg.

Medicines, alcohol and chronic diseases

If a person has chronic diseases, simultaneous use of alcohol and medications is potentially dangerous for the functioning of vital organs. Since patients systematically take prescribed medications, the influence of alcohol can lead to negative consequences.

People with chronic heart disease (angina pectoris, heart defects) develop arrhythmias of varying severity. Heart attacks with severe pain syndrome develop, which is not relieved by Nitroglycerin, and the risk of developing myocardial infarction increases significantly.

In case of chronic liver diseases (viral hepatitis, hepatosis), alcohol during treatment can become a trigger in the development of cirrhosis and hepatocellular carcinoma (cancer).

Drinking alcohol during cirrhosis leads to the following consequences:

• bleeding into the abdominal cavity;
• liver decomposition, infection, peritonitis;
• hepatic coma;
• death.

If a person is on long-term treatment with sedatives, psychotropic drugs, tranquilizers, he is contraindicated in drinking alcohol. This leads to severe depression and the appearance of obsessive states (hallucinations, phobias). Suicidal feelings develop. Such a patient needs constant monitoring and assistance from a psychiatrist.

The most dangerous combinations and consequences

The combination of alcohol and chemical-based drugs can lead to serious disorders in the body, and in some cases to fatal consequences.

List of medications and their side effects in combination with alcohol:

Overdose

Symptoms of overdose: vomiting , nausea, muscle cramps, drowsiness , dizziness, confusion, decreased water and electrolyte balance, oliguria , significant decrease in blood pressure.

If the above symptoms appear, you should rinse your stomach, then take activated charcoal to restore the water and electrolyte balance. If the pressure decreases significantly, the patient should lie on his back and raise his legs, then inject a 0.9% sodium chloride solution.