TOP 12 analogues of the drug Prestarium: list of cheap substitutes

Prohibited during pregnancy

Prohibited during breastfeeding

Prohibited for children

Has restrictions for older people

Has limitations for liver problems

Has limitations for kidney problems

Prestarium is an antihypertensive drug containing the active substance perindopril. Belongs to the group of ACE inhibitors. Available in the form of tablets for oral administration with different concentrations of the active ingredient (2, 4 or 8 mg).

Prestarium is prescribed for arterial hypertension, heart failure, and also for prophylactic purposes: to prevent the development of strokes in patients with cerebrovascular pathologies and patients with confirmed coronary artery disease. Contraindications to prescribing the medication are:

• individual intolerance to the components of the drug;
• angioedema (also in history);
• renal failure;
• diabetes;
• pregnancy period or planning;
• lactation.

Composition of Prestarium

A type of medicine is Prestarium A, which is available in a dosage of 2.5; 5 and 10 mg. The difference lies in the dosage of the active substance and auxiliary components.

If necessary, your doctor can prescribe analogues of Prestarium. The substitute is selected individually, taking into account the diagnosis and severity of the current disease.

pharmachologic effect

Manufacturer: Les Laboratoires Servier (France)
Release form: tablets

Active ingredient: perindopril

Analogues: Perindopril, Prestance, Losartan

Prestarium, acting on one of the main enzymes of the blood pressure regulation system (ACE), helps to reduce it. Under the influence of the drug, partially impaired function of the cardiovascular system is restored. The number of heart contractions decreases, the elasticity of the vascular wall increases, and left ventricular hypertrophy decreases.

Inexpensive analogues

Those who do not have the opportunity to purchase Prestarium, of course, are looking for products that are similar in effect, but less expensive. The most famous analogues will be discussed below.

Perindopril-teva

This is a high-quality and, most importantly, inexpensive generic that can replace Prestarium in treatment. It comes in the form of tablets, which are in a convenient container. Perindopril contains tosylate. It is worth noting that the difference in composition does not at all affect the mechanism of action.

One of the similar drugs for the treatment

After transformation in the body, the drug has an effect on the cardiovascular system.

Interesting! Contraindications for use are exactly the same as for the original drug.

Perineva

This is the most popular European synonym that can relieve high blood pressure and cure heart failure. A stable effect can be achieved approximately a month after the start of treatment.

Elderly people tolerate the drug well, but excretion from the body occurs a little more slowly. Problems with rapid elimination may also occur if the patient suffers from renal and hepatic failure. Such factors affect the dosage, but are not a contraindication to use.

Ko-perineva

The only indication for taking the drug is primary or essential hypertension. For patients with kidney problems, the drug is rarely prescribed, but that’s all, because during the treatment the load on the organ will be increased several times.

Another drug substitute

Perindopril-Richter

Another similar drug, more affordable. The level of drug tolerance is quite good. People suffering from diabetes, as well as those taking antipyretics, are advised to monitor their glucose levels in the first month of treatment.

Perindopril North Star

The drug is a domestic substitute for Prestarium. The medication is prescribed exclusively in several cases: chronic heart failure, as well as arterial hypertension. It is not recommended to undergo a course of treatment in case of cerebrovascular accident, as well as in ischemic disease. This is explained by the fact that the pressure can drop significantly, which will worsen ischemia.

The range of inexpensive analogues of Prestarium is not large, but it is quite satisfactory and each patient will be able to choose for himself what suits his capabilities. Stopping antihypertensive therapy or changing it at will is unacceptable, even if the patient feels well. Otherwise, the treatment will not bring the desired result.

Indications for use of Prestarium

The medication is prescribed as a therapeutic and prophylactic agent for the following diseases:

• hypertonic disease;
• chronic cardiovascular failure;
• coronary heart disease in the form of a stable course;
• prevention after a stroke or transient vascular pathology.

The drug can be used for hypertension of any severity. While taking the medicine, a drop in blood pressure occurs in any body position (standing or lying down).

Reviews

Timofeeva Elena Andreevna City: Essentuki Heart failure, Berlipril

After 60 years, I began to experience shortness of breath, pain behind the sternum, and redness of the face. She underwent an examination, during which the disease was discovered. After starting medication therapy at the recommended dosage, I began to feel better on the third day.

Mironov Mikhail Anatolyevich City: Armavir Arterial hypertension, Ramazid

I felt constant headaches that increased during exercise. The cardiologist prescribed me to take the medicine in a small dose. Now the condition has improved.

Chernikova Maria Evgenievna City: Samara Coronary heart disease, Concor

Due to the disease, there was a high risk of heart attack or stroke within a year. To avoid this, the doctor prescribed antihypertensive medication. After a month of taking it, I took the tests again. The indicators have improved.

Analogues of Prestarium

The medical industry supplies the pharmaceutical market with a sufficient number of analogues and substitutes for the drug Prestarium. These medications provide an equivalent therapeutic effect in the treatment of vascular pathology and are sold in pharmacies in the form of:

• synonyms;
• generics;
• combination drugs.

If prescribed by a doctor, you can purchase analogues of Prestarium from Russian and foreign pharmaceutical companies.

Table of Prestarium analogues with price and country of origin.

The different prices for Prestarium analogues depend on the manufacturer and the amount of ingredients included in the medicine. The budget cost of Russian-made Prestarium analogues does not affect the properties of the drugs and does not reduce their effectiveness.

What else can replace Prestarium 5 mg, what drugs? You can supplement the list of analogues of Prestarium with the following medications:

• Ramipril;
• Edarby;
• Lerkamen 20;
• Enap;
• Cardosal;
• Dalneva;
• Bisoprolol;
• Egilok;
• Moxonidine;
• Renitek;
• Parnavel.

Only the doctor will decide which substitute for Prestarium in tablets is suitable for the patient.

Russian analogue drugs

Russian-made analogues of Prestarium are the following drugs: Perindopril, Parnavel, Arentopres and Perineva.

Perindopril

Oral tablets containing 4 mg perindopril erbumine. Has a pronounced hypotensive effect. Prescribed for hypertension, as well as for the prevention of heart disease.

Perindopril is contraindicated for use in:

• individual intolerance to its components;
• pregnancy and pregnancy;
• history of angioedema caused by taking drugs that inhibit the production of ACE.

The tablets are not prescribed to children under 18 years of age. Treatment begins with a dosage of 1-2 mg per day (at one time). If necessary, for the purpose of maintenance therapy, 2-4 mg/day is prescribed. For congestive heart failure, 4 mg is prescribed, less often - 8 mg/day.

Prestarium or Perindopril - which is better, what is the difference

Manufacturer: Minskintercaps (Belarus)
Release form: tablets

Active ingredient: perindopril erbumine

Both medications have the same active substances and an equivalent mechanism of action. Despite the similarity of the drugs, there are a number of differences between them. Prestarium will be a better remedy compared to Perindopril, since:

• the amount of active substance in tablets is higher;
• wider range of indications;
• the presence of a dispersible, that is, easily soluble in the oral cavity, form of the drug.

The presence of such advantages makes Prestarium a more effective remedy. According to doctors, the drug is well tolerated by patients and, with long-term use, stably maintains normal blood pressure, preventing its rise.

Other substitutes

If indicated, Prestarium can be replaced with other drugs from the category of ACE inhibitors - the most common drugs include:

• Berlipril;
• Captopril;
• Lisinopril;
• Normopres;
• Enalapril.

When replacing Prestarium with other drugs from this category, it is important to take into account that they have a similar mechanism of action on the body, but differ significantly in composition. Accordingly, the active ingredients may cause side effects and contraindications that are excluded when using perindopril.

The cost of drugs can also vary significantly depending on the manufacturer and the content of the active ingredient.

Prestarium or Prestance – which is better?

Manufacturer: Servier (France)
Release form: tablets

Active ingredient: perindopril, amlodipine

Prestarium and its analog have the equivalent active ingredient perindopril. But Prestance also contains amlodipine, which enhances the effect of the medication. It will be best for patients suffering from arterial hypertension complicated by coronary heart disease with stable angina.

According to reviews from patients taking Prestance, the medicine effectively lowers blood pressure, prevents angina attacks and significantly reduces the clinical manifestations of the disease.

Short description

Prestarium is an antihypertensive drug that dilates blood vessels. Refers to ACE inhibitors. The active substance is perindopril. Release form: light green tablets for oral administration. Concentration of active substance: 2 mg; 4 mg; 8 mg.

In addition to indications for arterial hypertension and heart failure, it is used for prophylactic purposes in patients with coronary artery disease and cerebrovascular pathologies to prevent the risk of stroke.

1. The drug is not prescribed:— In case of individual intolerance to its components;— In the presence of renal failure;— If there is angioedema;— Diabetes mellitus is diagnosed;— Women who are breastfeeding;
2. - During pregnancy, as well as at the time when it is planned.

• The drug prevents the occurrence of cognitive disorders, restores brain functions and maintains full thinking. When used regularly by patients who suffer from high blood pressure, the risk of developing: - stroke; - heart attack;
• - dementia, due to insufficient blood circulation to the brain.

If there are contraindications or individual intolerance to the main components, analogues are prescribed. Similar drugs also affect the circulatory system, like Prestarium, but the percentage of active substance in them is different, so the negative effect on the body will be reduced.

Russian analogues

1. Manufacturer: VEROPHARM JSC (Russia)
2. Release form: White tablets (2.4 mg)
3. Active ingredient: Perindopril
4. No current offers

Hypernik is a Russian-made drug that corrects blood pressure. It has a vascular tonic effect and has a beneficial effect on the smooth muscles of large arteries. The analogue is intended for patients with cardiac insufficiency and as a prevention of cerebrovascular accidents.

• Manufacturer: ATOLL LLC (Russia)
• Release form: Dark blue tablets (2, 4, 8 mg)
• Active ingredient: Perindopril

Best price: 221.00 rub. More details

Parnavel - the drug has proven effective against high blood pressure, with a very high rate of absorption, and therefore action, which indicates the possibility of use in emergency cases. When used regularly, this substitute maintains the patient’s working condition and prevents recurrent cardiovascular pathology.

1. Manufacturer: PRANAFARM LLC (Russia)
2. Release form: White tablets with a score (2, 4, 8 mg)
3. Active ingredient: Perindopril

Best price: 98.00 rub. More details

Perindopril is a cheaper analogue of Prestarium, used in the complex therapy of patients with heart failure and hypertension of various origins. The medicine has a positive effect on the quality of vascular elasticity. The effect of taking it appears quickly, but lasts a long time.

• Manufacturer: KRKA-RUS LLC (Russia)
• Release form: White tablets (4 mg)
• Active ingredient: Perindopril

Best price: 249.00 rub. More details

Perineva is a drug that affects a wide range of traditional problems of hypertensive patients, and as a result is a very popular domestic analogue of the original drug. Reduces blood pressure, relieves headaches, normalizes heart rhythm. Used to treat vein thrombosis. Used in stroke prevention therapy.

1. Manufacturer: TORRENT PHARMACEUTICALS Ltd. (India)
2. Release form: Tablets (2.4 mg)
3. Active ingredient: Perindopril
4. No current offers

Arentopres is the first of the foreign analogues presented on our list; the drug is used in long-term therapy for patients suffering from arterial hypertension. With regular use, you can reduce the risk of heart attack by 8%. It affects blood vessels, prevents thrombosis, reduces blood pressure, and eases the load on the heart muscle.

• Manufacturer: LUPIN Ltd. (India)
• Release form: White round tablets (4.8 mg)
• Active ingredient: perindopril erbumine 4 mg or 8 mg
• No current offers

Piristar is a drug to control blood pressure. Alleviates the symptoms of the disease, improves the patient’s quality of life. Regulates the load on the heart muscle, reduces pulse, and relieves headaches.

The product is indicated during physical activity. Able to regulate your emotional state helps you stay active during the day and fall asleep peacefully in the evening.

We invite you to familiarize yourself with a review of recipes for increasing potency - which ones should a man use?

It is not often prescribed as a replacement for Prestarium due to problems with availability in pharmacies.

1. Manufacturer: PFIZER MANUFACTURING DEUTSCHLAND GmbH (Germany)
2. Release form: Reddish tablets (5, 10, 20, 40 mg)
3. Active ingredient: Quinapril

Best price: 608.00 rub. More details

Accupro is a medicine that prevents blockage and spasm of blood vessels, expanding the lumen of blood vessels to the optimal possible extent. Regulates the activity of the heart muscle, relieves the phenomenon of strong heartbeat. The main indications for the use of this analogue are high blood pressure and heart failure, treatment of venous thrombosis.

Prestarium or Noliprel – which is better?

Manufacturer: Servier (France)
Release form: tablets

Active ingredient: indapamide, perindopril

Both medications have equivalent indications and the same active substances. But Noliprel contains one more component - indapamide, which has a diuretic effect. The combination of 2 active substances in Noliprel forte tablets enhances the hypotensive effect.

The drug will be best for patients suffering from hypertension and a tendency to edema, as well as shortness of breath during physical exertion.

Side effects

At the very beginning of treatment, there is a possibility that the pressure will decrease. In some cases, dosage adjustment may be required, and some patients even have to cancel further treatment altogether.

Below are the side effects that occur most often when taking the drug:

1. The appearance of cough, shortness of breath and bronchial spasm. Side effects are directly related to how the drug works.
2. The muscular and central nervous system can react negatively. A headache, dizziness appears, the limb becomes numb and numb.
3. From the digestive tract, there is a urge to vomit, taste disturbances, and nausea.

Many patients are bothered by vomiting

It is extremely rare to experience tinnitus, skin rashes, itching, or visual disturbances. If you experience such side effects, you should stop taking the drug and seek help from your doctor.

Prestarium or Perineva – which is better?

Manufacturer: KRKA-RUS (Russia)
Release form: tablets

Active ingredient: perindopril

Perineva and Prestarium have the same active substance and mechanism of action. The difference between medications lies in the dosage of the drugs and the additional ingredients included in their composition.

According to patient reviews, Perineva is in high demand, since the medication is well tolerated, convenient to take, and you can also buy this Prestarium substitute cheaper.

Prestarium A

Active substance:

Perindopril*

Pharmgroup:

ACE inhibitors

Average price in pharmacies

Prestarium or Losartan – which is better?

Manufacturer: OZONE (Russia)
Release form: tablets

Active ingredient: losartan

Losartan and Prestarium have the same treatment effect, but different active substances and mechanism of action.

Prestarium will be the best for the treatment of hypertension and chronic heart failure. It has wider indications, fewer contraindications and side effects. Patients report good results from its use.

The Russian analogue of Prestarium Losartan is more often prescribed as part of complex therapy and has the advantage of low cost.

Review of the cheapest generics

Analogues that cost less than Prestarium are Prenesa, Bi-Prestarium, Accupro, Captopril.

Prenesa

Prenesa is a tablet preparation based on perindopril tert-butylamine. One tablet may contain 2; 4 or 8 mg of active ingredient. The drug belongs to the group of monocomponent ACE inhibitors. The medicine is prescribed for:

• hypertension;
• stable angina;
• cerebrovascular pathologies (for the purpose of preventing stroke);
• confirmed ischemic heart disease (for the prevention of myocardial infarction).

Angina pectoris

The drug is contraindicated in patients with hypersensitivity to any of its components and a history of angioedema caused by taking ACE. Prenesa is not used during pregnancy and lactation.

Tablets are taken 1 pc. in the morning before meals. Frequency of administration – 1 time/day. The duration of treatment is determined individually.

Bi-Prestarium

This is a combination drug containing several components:

• perindopril;
• amlodipine.

Perindopril is an ACE inhibitor, while amlodipine is a slow calcium channel inhibitor. This medication is used to treat hypertension and ischemia. Reception limited:

• persons with hypersensitivity to perindopril, amlodipine or auxiliary components of the tablets;
• patients with angioedema or a predisposition to it;
• hypotensive patients with severe arterial hypotension;

  
  Application and side effects

• patients in a state of shock (hemorrhagic, cardiogenic, etc.);
• patients with left ventricular outflow obstruction;
• persons with heart failure (in particular, after myocardial infarction);
• women during breastfeeding and pregnancy;
• diabetics with any type of diabetes.

Kidney failure is also included in the list of contraindications for taking Bi-Prestarium. Tablets are taken once a day, regardless of the dosage, since the specific type of drug is selected individually. It is recommended to take the medicine in the morning, on an empty stomach. The tablet should be swallowed whole with a sufficient amount of liquid.

Accupro

Accupro is an American analogue of Prestarium, classified as an ACE inhibitor. It has a hypotensive effect, while simultaneously reducing the process of platelet adhesion. Thus, the drug is partly an anticoagulant agent. The drug Accupro contains the active component in the form of quinapril hydrochloride - 10, 20 or 40 mg/tablet.

Important! The medication is not recommended to be combined with potassium-sparing diuretics and potassium supplements, since such a combination increases the risk of developing hyperkalemia.

Accupro is recommended for:

• arterial hypertension (can be used as an independent remedy, but it is recommended to combine the drug with thiazide diuretics and beta blockers);
• various forms of hypertension;
• acute or chronic heart failure (in combination with diuretic drugs or cardiac glycosides).

Pharmacological action of Accupro

The drug is contraindicated in persons with intolerance to any components of the tablets, a history of angioedema or a predisposition to it, diabetes mellitus, lactase deficiency or lactose intolerance, as well as HGM syndrome. Accupro is not prescribed during pregnancy and breastfeeding, as well as for children under 18 years of age.

At the beginning of therapy, 1 tablet of Accupro 10 mg is prescribed twice a day. If there is no effect, the dosage is increased to 20 mg. If this approach does not help eliminate the signs of the disease, the daily dose is increased to 40 mg.

Captopril

A product based on the active substance of the same name. Contains 25 mg of active ingredient in 1 tablet.

Captopril is prescribed for hypertension and heart failure (as part of complex therapy). Contraindicated for:

• Quincke's edema;
• impaired renal function;
• azothermia;
• hyperkalemia;
• liver dysfunction;
• hypersensitivity of the body to captopril or other components.

Effects of Captopril

The dosage regimen starts with 25 mg twice daily. If necessary, the dosage is increased until a therapeutic response from the therapy is achieved.

Prestarium or Lisinopril - which is better?

Manufacturer: VERTEX (Russia)
Release form: tablets

Active ingredient: lisinopril

Prestarium and its Russian analogue Lisinopril have the same indications and are used to treat hypertension.

In the presence of diabetes mellitus and diabetic nephropathy in patients with hypertension, Lisinopril will be the best. It protects the kidneys from further development of pathology.

Similar drugs by mechanism of action

Generics of Prestarium, which have a different composition but have the same effect, are the drugs Vitopril, Berlipril, Polapril and Diroton.

Vitopril

Vitopril is a tableted antihypertensive medicine containing lisinopril dihydrate. Under its influence, blood pressure decreases and the intensity of renal blood flow increases.

Vitopril is recommended to be taken for:

• hypertension;
• symptomatic heart failure;
• the need for short-term complex treatment of acute myocardial infarction;
• initial nephropathy in patients with type 2 diabetes mellitus accompanied by hypertension.

Symptoms of HF

The following medications should not be prescribed:

• persons with primary hyperaldosteronism;
• patients who have undergone a kidney transplant;
• for any type of shock;
• people with hypovolemia;
• patients with myocardial infarction accompanied by unstable hemodynamics;
• in acute renal failure accompanied by high blood pressure;
• patients with severe (malignant) arterial or renovascular hypertension;
• persons with aortic or mitral stenosis;
• during pregnancy and lactation;
• children under 18 years of age.

The medication is taken once a day. Preference should be given to taking the tablet in the morning, and only before meals.

If there is a need to increase the dosage of a drug, this decision should be made only by the attending physician.

Berlipril

Berlipril is a German generic of Prestarium. This is one of the cheapest analogues of this drug. The tablets contain the active substance enalapril in a dose of 5 mg.

Berlipril is prescribed to patients with:

• different types of hypertension;
• CHF;
• asymptomatic course of left ventricular dysfunction (in order to prevent the development of a clinically pronounced form of the pathological process).

Note. Contraindications and restrictions for taking this drug are completely identical to those that apply to Prestarium and its other analogues.

The tablets can be taken regardless of food. The dosage of the drug is selected taking into account the diagnosis and severity of the pathology. Initially, the doctor may prescribe Berlipril in an amount of 5 mg/day, but over time it is increased to achieve the maximum therapeutic response from the patient’s body.

Polapril

Polapril is a generic version of the drug Prestarium produced in Poland. The tableted medication contains ramipril in a dose of 2.5; 5 or 10 mg. The medicine is intended for the treatment of hypertension. It is also used for preventive purposes to reduce the risk of developing CVD and prevent death in patients:

• with severe CVD developing against the background of thrombosis;
• suffering from diabetes mellitus and at risk of developing cardiovascular complications.

Positive features of ramipril

The drug is prescribed for the initial stage of heart and kidney failure. The drug is contraindicated in hypotensive patients or patients with hemodynamically unstable conditions. It is not prescribed to patients with a history of ANO caused by taking angiotensin-converting enzyme inhibitors, pregnant patients, or children.

Polapril is recommended to be taken daily, preferably at the same time. The starting dose for patients taking diuretics is 1.25 mg of the drug. For hypertensive patients who do not receive diuretics, the medicine is prescribed in a dosage of 2.5 mg with a gradual increase. The frequency of administration is once a day.

Diroton

Diroton is a Hungarian antihypertensive drug containing lisinopril as the main component. It has a pronounced hypotensive and vasodilating effect. The medicine begins to act an hour after administration.

Diroton is indicated for the treatment of:

• essential and renovascular hypertension;
• CHF (as one of the elements of complex therapy);
• myocardial infarction;
• nephropathy of diabetic origin.

Advantages of Diroton

The medicine is contraindicated during pregnancy, lactation, and intolerance to its components. It is also not prescribed to children, patients with a history of ANO, persons with hyperkalemia, malignant hypertension and severe impairment of renal or hepatic function.

The drug is taken once a day, in the morning and only on an empty stomach, with plenty of liquid. Therapy is usually started at 10 mg/day, but it can be increased to the maximum allowable amount of 40 mg/day.

Prestarium or Lorista – which is better?

Manufacturer: KRKA (Slovenia)
Release form: tablets

Active ingredient: losartan

Lorista and Prestarium are prescribed for the treatment of arterial hypertension and chronic heart failure, but have different mechanisms of action due to different active substances.

For patients suffering from diabetes mellitus with the presence of protein in the urine, Lorista will be the best. This analogue, in addition to lowering blood pressure, slows down the progression of chronic renal failure.

Prestarium drug overdose, symptoms and treatment

Symptoms of an overdose of any ACE inhibitors are severe hypotension, circulatory shock, tachycardia, bradycardia, electrolyte imbalance, renal failure, hyperventilation, dizziness, anxiety. In case of overdose, the patient should be hospitalized and under the supervision of a physician. The level of electrolytes and creatinine in the blood plasma should be monitored. Treatment depends on the nature and severity of symptoms. It is necessary to reduce the absorption of the ACE inhibitor by gastric lavage and the administration of enterosorbents. In case of severe arterial hypotension, the patient must be placed in a horizontal position with the head down and the blood volume must be restored by infusion of isotonic sodium chloride solution. If necessary, angiotensin II and/or catecholamines are administered intravenously. In severe cases, temporary implantation of a cardiac pacemaker is indicated. It is necessary to monitor and correct the vital functions of the body. Perindopril can be removed from the body using hemodialysis. The use of high-flow membranes is not recommended.

Enalapril

Manufacturer: OZON LLC (Russia)
Release form: tablets

Active ingredient: enalapril

Enalapril therapy for a long time has a beneficial effect on patients with chronic heart failure, reducing its severity.

This analogue of Prestarium 5 mg increases cardiac output and resistance to physical stress, slows the progression of a serious complication - dilation (expansion) of the left ventricle.

Cheap analogues and substitutes for the drug Prestarium: list with prices

The medicine is used to successfully protect the body from the effects of angiotensin converting enzyme (ACE). Angiotensin II constricts blood vessels, causes a rise in blood pressure, and increases the likelihood of heart attacks, strokes, and ischemia.

The drug is recommended for heart failure, arterial hypertension, coronary artery disease, for the prevention of myocardial infarction, strokes, and the establishment of normal heart function.

Contraindications:

• Allergy to ACE inhibitors.
• Periods of pregnancy and breastfeeding.
• Diabetes.
• Renal artery stenosis, absence of one kidney.

The main active ingredient of the drug is perindopril arginine or tert-butylamine salt. When perindopril enters the body, it is converted into an active metabolite and prevents the active harmful effects of ACE.

Prestarium and Prestarium A are produced in French and Russian medical laboratories in the form of tablets of 5, 10 mg:

• The cost of a package consisting of 30 pieces of 5 milligram tablets in Moscow or St. Petersburg ranges from 350 to 500 rubles.
• The price of 30 pieces of 10 milligram tablets ranges from 550 to 625 rubles.

Prestarium analogues

Due to the presence of the main active ingredient, its effective analogues are cheaper drugs that can be bought in Russia, Ukraine, and the Republic of Belarus. A list of the main inexpensive analogues that can be used to replace the prestarium is given in the table.

Important! Methods of use, dosages, and the optimal choice of medication should be discussed with the doctor who constantly monitors and treats the patient!

Important! Replacing a cardiological drug with a cheaper one is effective after mandatory consultation and prescription by the attending physician!

Effective and inexpensive analogues and substitutes for Prestarium

We suggest you read how long does it take for Microlax to work in adults?

The original drug from the French company Servier, Prestarium, can significantly alleviate the patient’s burden caused by high blood pressure and heart failure. The cardiac drug belongs to the group of antihypertensive medications that are a priority in the fight against these diseases.

The active component Perindopril belongs to the group of angiotensin-converting enzyme inhibitors (hereinafter referred to as ACE inhibitors). The drug is characterized by the property of expanding the vascular lumen and, as a consequence of the first, producing a hypotensive effect.

The ultimate goal of Perindopril is to reduce the amount of the vasoconstrictor hormone angiotensin II in the blood, an increased amount of which causes high blood pressure on the vessels. This is facilitated by slowing or inhibiting the release of the AP enzyme, which further inhibits the process of converting the hormone angiotensin I into angiotensin II.

The improvement of heart function occurs due to the uniform distribution of the load on the muscle. Additionally, a positive effect of Perindopril on the elasticity of the vascular wall of large and small arteries is noted.

Areas of application of the cardiac drug:

• Hypertension of any complexity;
• Chronic heart failure;
• Prevention of cardiovascular complications in the treatment of coronary artery disease;
• In order to help avoid a secondary episode of stroke in those who have had a stroke or have suffered other disorders of cerebral blood flow.

Medical sources note that the benefit of the drug for cerebrovascular disorders gives the expected positive effect only in combination with the diuretic Indapamide.

Prestarium is a priority line of therapy in patients with unhealthy high blood pressure and concomitant diabetic nephropathy, as well as in acute myocardial infarction.

• The body's immunity to Perindopril is expressed by too low blood pressure or a dry, unproductive cough.
• A hyperallergic reaction to any other name of a number of ACE inhibitors in the form of Quincke's edema.
• Angioedema of unknown or hereditary origin.
• Lactase deficiency, lactose intolerance, glucose-galactose malabsorption syndrome.
• Age up to 18 years.

Perindopril is strictly prohibited during pregnancy. The consequences of failure to comply with this point lead to kidney problems and improper fusion of the skull bones.

Taking Prestarium should be stopped without delay and alternative antihypertensive drugs that are safer for the child and mother should be used if pregnancy is just being planned or immediately when it becomes known that it has occurred.

The lack of information about the biological property of the Perindopril molecule to pass through breast milk limits its use to those in the lactation stage. Women requiring ACE inhibitors are advised to stop breastfeeding.

Side effect

At the beginning of treatment, the possibility of low blood pressure cannot be ruled out. In some cases, this may serve as a basis for dosage adjustment, or less often for complete withdrawal.

- From the respiratory system: cough, shortness of breath, bronchial spasm. The side effect of cough is directly related to the mechanism of action of Perindopril, which destroys a protein substance - bradykinin, which exhibits vasodilatory activity. Its inactivation leads to bronchospasm.

• — The central nervous system and the muscular system may react negatively: an asthenic state, muscle spasms, headaches, episodic or systemic dizziness, a feeling of numbness or tingling in the extremities.
• — Digestive tract: dyspepsia, nausea, vomiting, impaired taste.
• - From the senses: tinnitus, visual disturbances, skin rash, itching.

Eating slows down the metabolic distribution of Perindopril, so the tablets are taken only in the morning on an empty stomach. The hypotensive effect is prolonged throughout the day, so it is indicated for use only once a day. The dosage regimen and its further adjustment are controlled by a cardiologist, taking into account the individual characteristics of the patient.

Hard-coated tablets are taken with water. In a dispersible format, it is enough to place the tablet on the tongue and swallow it with saliva as soon as it melts and disintegrates.

Metabolites of Prestarium are excreted primarily by the renal system. Therefore, the selection of the dose in elderly patients depends on creatinine clearance. In case of functional failures of the liver, the treatment regimen is prescribed in the general manner.

Lozap

Manufacturer: ZENTIVA (Slovakia)
Release form: tablets

Active ingredient: losartan

Lozap is used to treat hypertension. Under the influence of this analogue of Prestarium, a decrease in pressure in the pulmonary circulation occurs with the subsequent development of a diuretic effect. The medication reduces afterload and prevents myocardial hypertrophy.

The therapeutic effect of systematic use of the drug occurs after 3–6 weeks.

Risks and Precautions

It is important to remember the risk of developing severe arterial hypotension, especially if the water-salt balance in the body is disturbed. During the treatment period, you need to undergo regular tests in order to notice and prevent sodium loss in time.

You cannot combine Prestarium and Perindopril with a diuretic. For the period of treatment, the latter are canceled at least 3 days before the start of the course of treatment. Patients at risk with severe systemic diseases undergo therapy under the supervision of medical personnel.

Due to the risk of dizziness and hypotension, driving and engaging in activities requiring increased attention are limited for the entire treatment period. The drugs may affect concentration and motor activity.

Both drugs cope with their task and are widely used to treat arterial hypertension. If one medicine is poorly tolerated by the patient, the doctor may prescribe another. The means have more in common than differences. If you follow your doctor's instructions, each medication is well tolerated with minimal chance of adverse reactions. Be aware of the risks of self-medication and always tell your doctor about unusual symptoms that occur during treatment.

Concor

Manufacturer: Merck (Germany)
Release form: tablets

Active ingredient: bisoprolol

Concor is a selective beta-blocker with hypotensive and antiarrhythmic effects. A special feature of the drug is its ability to quickly eliminate arrhythmia, which is stopped within 30–40 minutes from the moment of taking the Prestarium substitute.

Dosage and method of administration

As a result of food intake, the metabolic distribution of the main substance slows down, which is why it is recommended to take tablets in the morning and on an empty stomach. The hypotensive effect is prolonged and lasts for 24 hours, which is why there is no need to take more than one tablet. Dosage adjustments can only be made by a cardiologist.

If your condition worsens, you should visit a doctor as soon as possible

The tablets are hard-coated and should be taken with water. Metabolites of the drug are excreted by the kidneys. It is important to select the dosage for older people based on their creatinine clearance.

Cost of the drug

Among all antihypertensive drugs, Prestarium is considered the most popular, which is why you can purchase it at any pharmacy chain, after presenting a doctor's prescription. If we take into account online pharmacies, the average cost of a medicine is 600 rubles.

Important! The cost may vary up or down depending on the region of residence.

Amlodipine

Manufacturer: OZON LLC (Russia)
Release form: tablets

Active ingredient: amlodipine

Amlodipine belongs to the group of calcium channel blockers. The Prestarium analogue has the ability to lower blood pressure by relaxing the smooth muscles of the vascular wall.

Therapy with the drug leads to expansion of the capillary network of the myocardium during ischemia, increases the supply of oxygen to the heart muscle and prevents the development of coronary vascular spasm.

Prestarium - features

The drug Prestarium is an antihypertensive drug. The main active ingredient is perindopril. This substance has a vasodilating effect, acting as a catalyst for a number of chemical processes in the body.

The product is available in tablet form. You can get it with a doctor's prescription. It has strict indications and contraindications, which excludes self-medication. Before prescribing the medicine, the doctor prescribes a series of diagnostic procedures that allow you to determine the most optimal treatment tactics.

Reference!

There is also a drug Bi-Prestarium, which already contains 2 components - perindopril and amlodipine.

Indapamide

Manufacturer: Teva (Israel)
Release form: tablets

Active ingredient: indapamide

Indapamide is an antihypertensive drug similar to thiazide diuretics. This analogue of Prestarium has a moderate diuretic effect and lowers blood pressure by reducing the tone of vascular smooth muscles.

The drug reduces left ventricular hypertrophy and is effective in the treatment of edema syndrome in chronic heart failure.

Contraindications and adverse reactions

The risk of side effects from Prestarium and Perindopril increases if the instructions for use are not followed. It is important to strictly follow the course of treatment and dosage prescribed by your doctor.

Valsacor

Manufacturer: KRKA (Slovenia)
Release form: tablets

Active ingredient: valsartan

This analogue of Prestarium tablets is used in therapeutic practice as a means of lowering blood pressure. Valsacor reduces peripheral vascular resistance, improves cardiac blood output, but does not affect heart rate. Drug therapy reduces shortness of breath and swelling in patients with chronic heart failure.

Taking Prestarium substitutes, recommended by a doctor, will improve heart function, lower blood pressure and avoid serious vascular complications.

Instructions:

Clinical and pharmacological group

01.024 (ACE inhibitor)

Release form, composition and packaging

The tablets are round, biconvex, white.

Excipients: microcrystalline cellulose, lactose monohydrate, colloidal hydrophobic silicon dioxide, magnesium stearate.

14 pcs. - blisters (1) - cardboard packs. 30 pcs. - blisters (1) - cardboard packs.

The tablets are rod-shaped, rounded at both ends, light green in color, scored on both sides and engraved with the company logo on one side. Slight heterogeneity of coloring and the presence of minor inclusions are allowed.

Excipients: microcrystalline cellulose, lactose monohydrate, colloidal hydrophobic silicon dioxide, magnesium stearate.

14 pcs. - blisters (1) - cardboard packs. 30 pcs. - blisters (1) - cardboard packs.

The tablets are round, biconvex, green, with a “heart” engraving on one side and the company logo on the other. Slight heterogeneity of coloring and the presence of minor inclusions are allowed.

Excipients: microcrystalline cellulose, lactose monohydrate, colloidal hydrophobic silicon dioxide, magnesium stearate.

30 pcs. - blisters (1) - cardboard packs.

pharmachologic effect

ACE inhibitor. Reduces blood pressure, which is mainly due to the disruption of the formation of angiotensin II and the elimination of its constricting effect primarily on arterial vessels, as well as the stimulating effect of angiotensin II on the secretion of aldosterone. With long-term use, Prestarium helps restore the elasticity of large arterial vessels and reduces left ventricular hypertrophy.

In patients with chronic heart failure, Prestarium reduces myocardial hypertrophy, reduces the excess amount of subendocardial collagen, normalizes the isoenzymatic profile of myosin, and reduces the frequency of reperfusion arrhythmias. Prestarium normalizes heart function, reducing preload and afterload. When using the drug, a decrease in the filling pressure of the left and right ventricles, a decrease in peripheral vascular resistance, and a moderate decrease in heart rate were noted. During treatment, there is a significant improvement in the clinical signs of heart failure and an increase in exercise tolerance (according to the bicycle ergometer test).

When Prestarium is used for the treatment of heart failure in recommended doses, no significant changes in blood pressure are observed after the first dose and after long-term use. Long-term treatment with Prestarium does not lead to renal dysfunction and does not affect the level of potassium in the blood. After oral administration of an average single dose, the maximum hypotensive effect is achieved after 46 hours and persists for 24 hours. Stabilization of blood pressure occurs after 1 month of therapy and persists for a long time. Discontinuation of treatment is not accompanied by the development of withdrawal syndrome. An international, multicenter, double-blind, randomized, placebo-controlled study (PROGRESS) was conducted to evaluate the effect of active therapy (perindopril as monotherapy or in combination with the diuretic indapamide) for 4 years on the risk of recurrent stroke in patients with a history of cerebrovascular disease. .

After a run-in period of perindopril 2 mg once daily for 2 weeks and then 4 mg once daily for the next 2 weeks, 6105 patients were randomized to placebo (n=3054) or perindopril 4 mg. as monotherapy or in combination with indapamide (n=3051). Indapamide was additionally prescribed to patients who did not have direct indications or contraindications for the use of diuretics. This therapy was prescribed in addition to the usual treatment of stroke and/or arterial hypertension or other pathological conditions. All randomized patients had a history of cerebrovascular disease (stroke or transient ischemic attack) within the past 5 years. Blood pressure was not an inclusion criterion: 2916 patients had hypertension and 3189 had normal blood pressure. After 3.9 years of therapy, blood pressure (systolic/diastolic) decreased by an average of 9.0/4.0 mm Hg, and a significant reduction in the risk of recurrent stroke (both ischemic and hemorrhagic in nature) of about 28% (95% CI / 17;38/ p<0.0001) compared with the placebo group (10.1%vs13.8%). Additionally, an overall reduction in the risk of fatal or disabling stroke was shown (4.0%vs5.9%, respectively, up to a 33% risk reduction); major cardiovascular events, including death, nonfatal myocardial infarction and nonfatal stroke (15.0%vs19.8%, respectively, up to a 26% risk reduction), development of stroke-related dementia (1.4%vs2.1%, respectively, up to a 34% risk reduction ) and the development of severe cognitive decline (1.6%vs2.8%, respectively, up to a 45% risk reduction). These therapeutic benefits were observed in both hypertensive and normotensive patients, regardless of age, gender, presence or absence of diabetes, and type of stroke. Results from the PROGRESS study demonstrate that active therapy over 5 years avoids one stroke in 23 patients and one major cardiovascular event in 18 patients. The 4-year, international, multicenter, randomized, double-blind, placebo-controlled EUROPA study examined the effect of perindopril in patients with stable coronary heart disease (CHD). The clinical trial involved 12,218 patients over 18 years of age: 6,110 patients received perindopril 8 mg and 6,108 patients received placebo. The main outcome measures were cardiovascular mortality, non-fatal myocardial infarction and/or cardiac arrest followed by successful resuscitation. The trial included patients with CAD who had known myocardial infarction at least 3 months before screening, had undergone coronary revascularization at least 6 months before screening, had angiographically detected stenosis (at least 70% narrowing of one or more major coronary arteries), or positive stress test if there is a history of chest pain. The drug was prescribed in addition to standard therapy used for hyperlipidemia, hypertension and diabetes mellitus. Most patients took antiplatelet agents, lipid-lowering drugs and beta-blockers. At the end of the study, the ratio of the number of patients taking these groups of drugs was 91%, 69% and 63%, respectively. After 4.2 years, the result of therapy with perindopril at a dose of 8 mg 1 time / day was a significant reduction (by 20%; 95% CI) in the relative risk of developing pre-specified complications: in 488 (8%) patients in the perindopril group, in 603 (9.9 %) in patients from the placebo group (p=0.0003). The result did not depend on gender, age, blood pressure, or a history of myocardial infarction.

Pharmacokinetics

Suction

After oral administration, perindopril is rapidly absorbed from the gastrointestinal tract. Cmax is reached after 1 hour. The bioavailability of the drug is 65-70%.

Distribution and metabolism

During metabolism, perindopril is biotransformed to form an active metabolite - perindoprilate (about 20%) and 5 inactive compounds. Cmax of perindoprilate in plasma is achieved between 3 and 5 hours after taking Prestarium. The binding of perindoprilate to plasma proteins is insignificant (less than 30%), depending on the concentration of the drug. Vd of free perindoprilate is close to 0.2 l/kg.

The drug does not accumulate in the body. Repeated administration does not lead to accumulation, and T1/2 corresponds to the period of its activity.

When taking the drug with food, the metabolism of perindopril slows down.

Removal

T1/2 of perindopril is 1 hour.

Perindoprilat is excreted from the body through the kidneys; T1/2 of its free fraction is 3-5 hours.

Pharmacokinetics in special clinical situations

In elderly patients, as well as in patients with renal and heart failure, the elimination of perindoprilate slows down.

Dosage

In the treatment of essential arterial hypertension, the initial dose is 4 mg 1 time / day in the morning. If therapy is ineffective within a month, the dose can be increased to 8 mg 1 time / day.

When prescribing ACE inhibitors to patients receiving diuretic therapy, a sharp drop in blood pressure may be observed, to prevent which it is recommended to stop taking diuretics 2-3 days before the intended start of Prestarium therapy or prescribe the drug in lower doses - 2 mg 1 time / day.

In patients with renovascular arterial hypertension, the recommended initial dose is 2 mg 1 time / day. If necessary, the dose may be increased in the future.

In elderly patients, treatment should begin with a dose of 2 mg/day and then, if necessary, gradually increase it up to a maximum dose of 8 mg/day.

Treatment of patients with chronic heart failure with Prestarium in combination with a non-potassium-sparing diuretic and/or digoxin is recommended to begin under close medical supervision, prescribing the drug at an initial dose of 2 mg 1 time / day in the morning. Subsequently, after 12 weeks of treatment, the dose can be increased to 4 mg 1 time / day.

To prevent recurrent stroke in patients with a history of cerebrovascular disease, Prestarium therapy should be started with 2 mg during the first 2 weeks before indapamide administration. Therapy should be started at any time (from 2 weeks to several years) after a stroke.

In patients with stable coronary artery disease, therapy with Prestarium should begin with a dose of 4 mg 1 time / day for 2 weeks. Then the daily dose should be increased to 8 mg 1 time / day (depending on renal function). Elderly patients should begin therapy with a dose of 2 mg 1 time/day for one week, then 4 mg 1 time/day for the next week before increasing the dose to 8 mg 1 time/day (depending on renal function).

For patients with renal failure, the dose of Prestarium is set individually, depending on the level of potassium in the plasma and the values ​​of creatinine clearance. With CC 30-60 ml/min, the drug is prescribed at a dose of 2 mg/day; with CC 15-30 ml/min – 2 mg every other day; for patients on hemodialysis (with CC less than 15 ml/min) – 2 mg per day of hemodialysis. When CC is more than 60 ml/min or in patients with liver failure, no dosage adjustment is required.

The drug should be taken before meals. If you miss one or more doses, take 1 tablet. before your next meal.

Overdose

To date, no cases of overdose have been described.

Possible symptoms: marked decrease in blood pressure, shock, stupor, bradycardia, electrolyte imbalance, renal failure.

Treatment of possible overdose: gastric lavage, and then intravenous infusion of saline solution. Perindopril is dialyzed (70 ml/min).

Drug interactions

The hypotensive effect of Prestarium is enhanced by the simultaneous administration of saluretics. With the simultaneous administration of Prestarium and potassium-sparing diuretics or potassium supplements, the risk of hyperkalemia increases.

The combined use of lithium preparations and Prestarium can lead to a decrease in the excretion of lithium from the body (monitoring the concentration of lithium in plasma is necessary).

With the simultaneous use of Prestarium and hypoglycemic drugs - sulfonylurea derivatives or insulin, the effectiveness of antidiabetic drugs increases (by increasing glucose tolerance).

When Prestarium is used together with muscle relaxants or agents used for anesthesia, the hypotensive effect may be enhanced.

When imipramine antidepressants or antipsychotics are used simultaneously with Prestarium, the risk of developing postural hypotension increases. When Prestarium is used together with other antihypertensive drugs, their effect is mutually enhanced.

When used simultaneously with NSAIDs, the antihypertensive effect of Prestarium is reduced. ACE inhibitors and NSAIDs have been shown to have an additive effect on increasing plasma potassium levels, with a possible decrease in renal function. These effects are reversible and are usually observed in patients with impaired renal function.

When used together with sympathomimetics, the hypotensive effect of Prestarium may be reduced.

Use during pregnancy and lactation

The drug is contraindicated for use during pregnancy.

If it is necessary to prescribe the drug during lactation, the issue of stopping breastfeeding should be decided.

Side effects

Frequent side effects – <10% and >1%; rare – <1% and >0.1%; very rare – <0.1% and >0.01%; extremely rare – <0.01%.

From the cardiovascular system: often - excessive decrease in blood pressure and associated symptoms; extremely rarely - arrhythmia, angina pectoris, myocardial infarction, stroke.

From the urinary system: rarely - decreased renal function; extremely rarely - acute renal failure.

From the respiratory system: often – dry cough, difficulty breathing; rarely – bronchospasm; extremely rarely - rhinorrhea.

From the digestive system: often - nausea, vomiting, abdominal pain, diarrhea, constipation, taste disturbance; rarely – dry mouth; extremely rarely – cholestatic jaundice, pancreatitis.

From the central nervous system and peripheral nervous system: often - headache, asthenia, dizziness, ringing in the ears, blurred vision, muscle cramps, paresthesia, taste disturbance; rarely – decreased mood, sleep disturbance; extremely rarely - confusion.

Allergic reactions: often – skin rash, itching; rarely – urticaria, angioedema; extremely rarely - erythema multiforme.

Other: rarely - increased sweating, impaired sexual function.

From laboratory parameters: a slight increase in the concentration of creatinine in urine and blood plasma (reversible after discontinuation of the drug - most likely with renal artery stenosis, treatment of arterial hypertension with diuretics, the presence of renal failure), temporary hyperkalemia, proteinuria (in patients with glomerular nephropathy) . Some patients (after kidney transplantation, hemodialysis) may develop anemia while taking ACE inhibitors. Rarely – thrombocytopenia, decreased hemoglobin, hematocrit; extremely rarely - agranulocytosis, pancytopenia, increased activity of liver transaminases, hyperbilirubinemia. It is possible to develop hemolytic anemia due to deficiency of glucose-6-phosphate dehydrogenase.

Storage conditions and periods

List B. The drug should be stored out of the reach of children at a temperature not exceeding 30°C. Shelf life: 2 years. Do not use after the expiration date indicated on the package.

Indications

- arterial hypertension;

— chronic heart failure;

— prevention of recurrent stroke in patients with a history of cerebrovascular diseases (as part of complex therapy with indapamide);

— reducing the risk of cardiovascular complications in patients with stable coronary artery disease.

Contraindications

- history of angioedema;

- pregnancy;

- breast-feeding;

- hypersensitivity to the drug and to other ACE inhibitors.

special instructions

The drug should be prescribed with caution when there is a decrease in blood volume (taking diuretics, a salt-free diet, vomiting, diarrhea, hemodialysis), hyponatremia, cerebrovascular diseases, angina pectoris - the risk of a sharp decrease in blood pressure; with renovascular hypertension, bilateral renal artery stenosis or stenosis of the artery of the only functioning kidney - the risk of developing severe arterial hypotension and renal failure; in case of chronic renal and heart failure - the risk of hypokalemia; with systemic connective tissue diseases (SLE, scleroderma) and therapy with immunosuppressants (including after kidney transplantation) - the risk of developing neutropenia, agranulocytosis; with hyperkalemia; with aortic valve stenosis, hypertrophic obstructive cardiomyopathy; when treated with hypoglycemic drugs in patients with diabetes mellitus, there is a risk of developing hypoglycemia; when carrying out hemodialysis using high-flow polyacrylonitrile membranes, carrying out desensitizing therapy - the risk of developing allergic reactions; during surgery/general anesthesia – the possibility of developing arterial hypotension; in the presence of lactase deficiency, galactosemia or glucose/galactose malabsorption syndrome; elderly patients (treatment should begin with low doses); children and adolescents under 18 years of age (efficacy and safety of use have not been established).

The use of the drug Prestarium can cause a sharp decrease in blood pressure. Symptomatic arterial hypotension rarely develops in patients without concomitant diseases. The risk of an excessive decrease in blood pressure is increased in patients with reduced blood volume (which can be observed during diuretic therapy, following a strict salt-free diet, hemodialysis, as well as vomiting and diarrhea), in patients with severe heart failure (both in the presence of concomitant renal failure and and in its absence). This side effect is most often observed in patients receiving loop diuretics in high doses, as well as against the background of hyponatremia or impaired renal function. In these cases, treatment should begin under close medical supervision, preferably in a hospital setting. In this case, the drug is prescribed in small doses, followed by careful titration of the dose. A similar approach is also used in patients with angina or cerebrovascular disease, in whom severe hypotension can lead to myocardial infarction or cerebrovascular complications. Before prescribing Prestarium and during its use, blood pressure levels, kidney function indicators and the concentration of potassium ions in the blood serum should be carefully monitored. In order to reduce the likelihood of developing symptomatic arterial hypotension during concomitant therapy with diuretics in high doses, their dose should be reduced several days before starting Prestarium use. If arterial hypotension develops, the patient should be transferred to the supine position. If necessary, the blood volume should be replenished (iv administration of isotonic sodium chloride solution). A pronounced decrease in blood pressure when taking the drug for the first time is not an obstacle to its further use. After restoration of blood volume and blood pressure, treatment can be continued after careful selection of the dose of the drug.

The use of Prestarium in patients with renovascular arterial hypertension, as well as with bilateral renal artery stenosis or arterial stenosis of one functioning kidney is accompanied by an increased risk of developing severe arterial hypotension and renal failure. With concomitant use of diuretics, the risk of these complications increases. Impaired renal function may be manifested by only minor changes in serum creatinine. The use of Prestarium in such patients begins in a hospital setting under close medical supervision with the prescription of small doses of the drug and further careful selection of the dose. During the first few weeks of therapy, it is necessary to temporarily stop taking diuretics and monitor renal function.

Because the drug inhibits the activity of the renin-angiotensin-aldosterone system, renal function may be impaired in susceptible patients. As a result, the drug should be prescribed with caution to patients with renal failure (it is necessary to reduce the dose or frequency of taking the drug). Careful monitoring of renal function during treatment should be carried out in the same way as in patients with renal failure. There are reports of the development of renal failure during the use of ACE inhibitors, but in most cases this is typical for patients with severe heart failure or kidney disease, including renal artery stenosis.

With concomitant administration of diuretics, it is possible to increase the concentration of urea and creatinine in the blood serum. In these cases, it may be necessary to reduce the dose of Prestarium and/or stop taking the diuretic. During the first few weeks of Prestarium therapy, dynamic monitoring of renal function is recommended.

The risk of developing neutropenia while taking Prestarium is dose-dependent and depends on the presence of concomitant diseases. This reaction is extremely rare in patients without concomitant diseases; the risk increases with impaired renal function, especially against the background of systemic connective tissue diseases (SLE, scleroderma) and treatment with immunosuppressants. Neutropenia is reversible and disappears after discontinuation of Prestarium.

During treatment with Prestarium, especially in the presence of renal and/or heart failure, hyperkalemia may develop. It is not recommended to prescribe potassium supplements or potassium-sparing diuretics during Prestarium therapy due to the possibility of severe hyperkalemia. If taking the above drugs is necessary, they should be prescribed against the background of regular monitoring of potassium levels in the blood serum.

When treating heart failure, before prescribing Prestarium and during its use, blood pressure, renal function indicators and serum potassium levels should be carefully monitored.

In patients undergoing hemodialysis using high-flux membranes or receiving LDL apheresis using dextran sulfate absorption, several cases of persistent, life-threatening anaphylactic reactions have been observed when ACE inhibitors are prescribed. Prescribing ACE inhibitors to such patients should be avoided. The development of anaphylactic reactions can be prevented by temporarily discontinuing the ACE inhibitor at least 24 hours before the procedure.

There are isolated reports of the development of life-threatening anaphylactic reactions in patients receiving ACE inhibitors during desensitizing therapy with bee venom. ACE inhibitors should be used with caution in patients prone to allergic reactions undergoing desensitization procedures. Prestarium should be avoided in patients receiving immunotherapy with bee venom. However, the development of anaphylactic reactions can be avoided by temporarily discontinuing Prestarium at least 24 hours before the start of the procedure.

Angioedema of the face, extremities, lips, mucous membranes, tongue, glottis and/or larynx may develop during the use of Prestarium, especially during the first few weeks of therapy. In rare cases, severe angioedema may occur during prolonged use of the drug. In such cases, Prestarium should be immediately discontinued and an antihypertensive drug of a different pharmacological class should be prescribed.

Angioedema of the tongue, glottis, or larynx can be fatal. If it develops, emergency therapy includes immediate subcutaneous injection of 0.3-0.5 ml of a 0.1% solution of epinephrine (adrenaline) or slow intravenous administration under ECG and blood pressure monitoring. The patient should be hospitalized for treatment and observation for at least 24 hours until the symptoms of this reaction completely disappear.

The antihypertensive effect of Prestarium can sharply increase during general anesthesia during surgery. If Prestarium cannot be discontinued, blood pressure should be maintained by gradually replenishing blood volume.

Anemia while taking Prestarium can develop in patients after kidney transplantation or on hemodialysis. In this case, the decrease in hemoglobin is greater, the higher its initial value. A slight decrease in hemoglobin occurs during the first 6 months, then the hemoglobin level remains stable and is completely restored after discontinuation of the drug. If anemia develops, treatment with Prestarium can be continued, but hematological tests should be carried out regularly.

The development of proteinuria while taking Prestarium is most typical for patients who already have impaired renal function, as well as when ACE inhibitors are prescribed in high doses.

During therapy with Prestarium, a dry, non-productive cough may occur, which stops after discontinuation of the drug.

The use of Prestarium in elderly patients should be started with low doses and renal function should be regularly monitored during the initial period of therapy.

Caution should be exercised in combination therapy with Prestarium with lithium drugs, hypoglycemic agents, anesthetics, opioid analgesics, antipsychotics, antihypertensive drugs, allopurinol, cytostatics, immunosuppressants, corticosteroids for systemic use, procainamide.

It is not recommended to administer potassium salts and potassium-sparing diuretics, such as spironolactone, triamterene and amiloride, together with Prestarium.

It should be borne in mind that the excipients of the drug include lactose monohydrate, therefore Prestarium is not recommended for use by persons with lactase deficiency, galactosemia or glucose/galactose malabsorption syndrome. Prestarium tablets of 2 mg, 4 mg, 8 mg contain 31.39 mg, 62 mg and 124 mg of lactose monohydrate, respectively.

Use in pediatrics

The effectiveness and safety of Prestarium in children and adolescents under 18 years of age have not been established.

Impact on the ability to drive vehicles and operate machinery

Due to the risk of developing arterial hypotension and dizziness, Prestarium should be prescribed with caution to persons driving vehicles and engaged in activities that require increased concentration and speed of psychomotor reactions.

Use for renal impairment

For patients with renal failure, the dose of Prestarium is set individually, depending on the level of potassium in the plasma and the values ​​of creatinine clearance. When CC is 30-60 ml/min, the drug is prescribed at a dose of 2 mg/day; with CC 15-30 ml/min – 2 mg every other day; for patients on hemodialysis (with CC less than 15 ml/min) – 2 mg per day of hemodialysis. When CC is more than 60 ml/min, no adjustment of the dosage regimen is required.

Use for liver dysfunction

In patients with liver failure, no dosage adjustment is required.

Conditions for dispensing from pharmacies

The drug is available with a doctor's prescription.

Price and analogues

You can buy the drug Prestarium at a price of 370 rubles, Perindopril - from 90 rubles, the average cost from different manufacturers is about 250 rubles.

When choosing analogues, a doctor may consider the following options:

1. Prilamide;
2. Bi-Prestarium;
3. Prestarium-Combi;
4. Promepril;
5. Triplix;
6. Triveram.

The drugs Prestarium and Perindopril are analogues. The choice of medication depends on the underlying disease and associated disorders.