To stabilize blood pressure (BP), various groups of drugs are used, including those that have a vasodilating (vasodilating) effect. These include Noliprel A, which contains an angiotensin-converting enzyme (ACE) inhibitor.

Noliprel A is considered effective in the correction of arterial hypertension (AH). Taking the medicine should begin only with the appointment of the attending physician on the basis of the examination.

Tablets Noliprel A is a drug combination drug based on two active ingredients - perindopril arginine and indapamide. Both substances are antihypertensive, i.e., those that are designed to reduce blood pressure to a physiological norm.

In the amount of 2.5 mg or 2 mg in one tablet, Noliprel arginine is, and its main pharmacological action is to suppress the formation of an enzyme that promotes the conversion of the hormone angiotensin I to angiotensin II. The second, in turn, tends to cause narrowing of the lumen of the blood vessels, causing an increase in blood pressure.

Perindopril reduces the concentration of angiotensin-converting enzyme, thereby stabilizing the condition of the arteries and veins. Also, perindopril helps to reduce the production of aldosterone, a mineralocorticosteroid hormone of the adrenal glands, which also has a hypertensive effect. Due to the simultaneous decrease in the concentration of angiotensin II and aldosterone in the blood, perindopril has an effective hypotensive effect.

Indapamide in the amount of 625 mcg per tablet is a thiazide diuretic, that is, a substance that increases diuresis - the process of removing water, sodium and calcium from the body. Diuresis helps to reduce the load on the cardiovascular system and also leads to the stabilization of blood pressure.

The combined effect of Noliprel A is to enhance and supplement the therapeutic properties of an ACE inhibitor and a diuretic, which effectively stabilizes blood pressure in patients with hypertension.

How is it different from Noliprel?

There is almost identical in action and composition, which is also an antihypertensive drug. It contains another type of perindopril salt - erbumine, as well as the diuretic indapamide.

It should be understood that the choice of the dosage of the active substance, as its increase / decrease, is the task solely of the attending physician. It is strictly forbidden for patients to change the dosage on their own, even following the instructions for use of Noliprel arginine for the treatment of hypertension.

You can not prescribe Noliprel to yourself with a larger or smaller dosage of medicinal substances without consulting your doctor.

What are these pills for?

In the instructions for use and description of the drug, the manufacturer clearly indicated what Noliprel A tablets are from. Nosological classification refers Noliprel A to drugs intended for the treatment of arterial hypertension. An antihypertensive drug should be used only in diagnosed hypertension, when blood pressure tends to overcome the mark of 140/90 mm Hg. Art.

The diuretic effect of Noliprel also gives reason to prescribe it for non-insulin-dependent diabetes mellitus, however, the treatment of hypertension is a priority in the use of Noliprel.

Instructions for use

As with other drugs that affect the functioning of the heart, taking Noliprel A should be strictly within the allowable dose prescribed by the doctor. The specialist can adjust the dosage of Noliprel A, reducing or increasing it, depending on the general health of the person.

With special care, doctors prescribe drugs containing diuretics to patients suffering from kidney disease - narrowing of the arteries, kidney failure.

For other groups of patients, the instructions for the use of Noliprel A are as follows:

• you need to take one tablet of Noliprel A per day;
• reception time - any, preferably in the morning;
• reception does not depend on food, but it is better to drink it before or during a meal;
• The tablet is not chewed, but taken whole with a liquid.

And for Noliprel A, and for other drugs based on ACE inhibitors and diuretics, there are a number of serious restrictions on admission. So, Noliprel A is contraindicated in the following conditions:

• if there is a predisposition to angioedema (if there was even one case in history);
• severe form of renal failure (creatinine clearance more than 30 ml / min);
• increased levels of potassium in the blood;
• narrowing of the lumen of the arteries in one or both kidneys;
• taking anti-arrhythmia drugs or drugs that increase the QT interval;
• individual sensitivity to the basic and auxiliary substances in the composition of Noliprel A.

Pregnancy and lactation, as well as the age of up to 18 years, is an important contraindication for taking Noliprel A.

Dosage

In the absence of special indications, the drug Noliprel A, the composition of which includes perindopril 2.5 mg and indapamide 0.635 mg, should be used in accordance with the dosage indicated by the doctor. That is, to correct hypertension, it is enough to take 1 tablet of the drug per day, and a stable effect of taking it will come a month after the start of therapy.

In cases where it is necessary to increase the dosage (for example, in the absence of the desired effect from taking Noliprel A in severe hypertension), the doctor may prescribe drugs such as:

• (5 mg);
• Noliprel A Bi-forte (10 mg).

These are stronger antihypertensive drugs with an increased dose of antihypertensive components - an ACE inhibitor and a diuretic. It is important to remember that it is necessary to increase the dose of Noliprel with extreme caution for the elderly, as well as those suffering from kidney pathologies.

Complications of arterial hypertension

Features of use

Noliprel and Noliprel A, as well as other combined antihypertensive drugs containing a diuretic and an ACE inhibitor, at the very beginning of administration can give an excessive hypotensive effect, i.e. reduce pressure below the physiological norm. Therefore, it is desirable to start taking the minimum dose of the drug and then increase it, observing the patient's condition.

As a rule, with a significant decrease in blood pressure, Noliprel is not required to be abandoned, since most often this condition is corrected (for example, by changing the position of the body or using saline).

Side effects

Like other substances, the side effects of Noliprel A are a list of negative and non-specific reactions of the patient's body to the drug:

• dry mouth, thirst, lack of appetite;
• dyspeptic symptoms (pain in the epigastrium, nausea, heartburn);
• dry cough;
• allergic reactions;
• sleep disturbances, mood swings;
• headaches, fainting, muscle spasms;
• anemic conditions.

The above, which occurs at the beginning of taking the drug, is also included in the list of side effects.

For close substitutes for Russian-made drugs, the composition is similar to the original.

Name	Price in rubles	About the drug
Co-Parnavel	from 13-350	Inexpensive and effective product. The Ozone company is engaged in the production of medicines. The tablets are white and do not have a shell. Pharmaceutical agent treats arterial hypertension. It is recommended to consult a doctor during pregnancy
Ko-Perineva	from 300-1000	Inexpensive and effective product. The composition of the active substance is calcium chloride hexahydrate, but there is no lactose. The cost of the product is determined by the amount of dosage, as well as the availability of tablets in one package. Modern medicines are designed to treat arterial hypertension
Perindopril PLUS Indapamide	from 245-530	Inexpensive and effective product. This medicine is sold cheaper, it is made in a similar way. Now there is something to replace Noliprel. The shell is yellow with a slightly pink tinge. The tablets are round in shape, they are biconvex. The composition of the drug is the same as that of the domestic manufacturer, only there is no lactose

1. Liprazide

   The drug is used to treat arterial hypertension, which has several degrees of severity. Sometimes the drug is used in mono - and combination therapy.

2. Tritace- the drug is sold at a price of 82.88 to 331.30 UAH. The application is aimed at eliminating arterial hypertension in order to reduce blood pressure.

   Treat congestive heart failure, diabetic glomerular disease, or primary nephropathy. After taking the medication, the risk of myocardial infarction and stroke is reduced.

3. Enap- the cheapest medicine from 15.40 to 359.95 UAH. The medicine is good to treat arterial hypertension.

   Doctors advise preparations of Ukrainian production. They treat severe heart failure.

• 4 mg ACE inhibitor.
• 1.25 mg diuretic.

• Lactose.
• Corn starch.
• Povidone.

• Magnesium stearate.
• Macrogol, talc.

The cost of original drugs is much higher than that of analogues..

With this opportunity, other pharmaceutical companies can develop similar products.

Analogues characteristic of Noliprel are cheaper, while they have the same effect. The composition of Noliprel includes perindopril and indapamide, so the drug is prescribed for arterial hypertension.

The mechanism of action of the original drug is aimed at preventing the formation of angiotensin 2. The vessels expand, sodium and water retention decreases. Therefore, during the treatment of Noliprel, the pressure decreases. With the help of ARF inhibitors, the condition of patients suffering from CHF improves.

Before replacing Noliprel, it is recommended to consult with a therapist. Indapamide is often prescribed - a diuretic sulfonamide that effectively removes excess water and sodium from the body. Against the background of such an impact, the volume of blood in the channel decreases, and the pressure drops. If you constantly drink Indapamide, then the elasticity of the CS will improve, their resistance on the periphery will decrease. At the same time, ventricular hypertrophy regresses.

Any substitute for Noliprel is completely absorbed in the digestive tract. The original medical product is converted into perindoprilat. It takes 4 hours for maximum concentration. The original drug and its analogues are excreted from the body within 25 hours. The kidneys are involved in this process.

The hypotensive effect is throughout the day, which will allow you to drink Noliprel analogues 1 time per day. Doctors distinguish the following contraindications for taking the original and its generics:

• intolerable active substances;
• angioedema;
• potassium deficiency;
• severe liver damage;
• taking heart medications.

Conditions in which therapy with Noliprel and its analogues is carried out under the supervision of the attending physician:

• diseases of the cardiovascular system;
• lactose intolerance;
• kidney disease;
• diabetes;
• systemic pathologies of connective tissue;
• metabolic disorder contributing to the development of gout;
• fluid loss due to diuretic treatment.

Treatment with Noliprel and its generics provokes the following negative effects:

• various digestive problems;
• rarely develops hepatitis;
• disorders of the nervous system, the appearance of tinnitus;
• problems in the work of the heart and cardiovascular system, including rhythm disturbance;
• breathing problems;
• violation of urination;
• the appearance of skin itching;
• decrease in the level of basic blood parameters.

With an overdose of analogues of Noliprel A, the pressure drops below the minimum value. This condition is accompanied by various clinics, including nausea and vomiting. Seizures may occur. Additionally, the composition of blood electrolytes changes. The effectiveness of treatment is directly affected by the complex intake of other medicines. If you drink an antihypertensive agent, then the effect of Noliprel and its analogues will increase. NSAIDs prevent pressure drop. If you drink potassium medicines and diuretics, hyperkalemia will occur.

Analogues of Noliprel include drugs of various forms, including Noliprel A Bi-forte. The above means differ among themselves in the dosage of active substances. The drug refers to a combination of ACE inhibitors, perindopril, indapamide. The mechanism of its action is associated with the properties of active substances and their complex effect. Noliprel A Bi-forte is prescribed for essential hypertension.

It is taken orally twice a day. If the patient has a severely impaired liver function, the drug is contraindicated. If the patient has a moderate dysfunction of the organ, then the dosage is not adjusted.

Taking the drug in a large dosage can provoke a water and electrolyte disturbance. Additionally, vomiting, nausea, drowsiness and hypertension may occur. During therapy with Noliprel A Bi-forte, the following adverse reactions may occur:

• ringing in the ears;
• anemia;
• migraine;
• bad sleep;
• allergy;
• rhinitis.

Noliprel A Bi-forte is contraindicated if the patient's body is hypersensitive to the drug or ACE inhibitors. Not prescribed for patients on hemodialysis and pregnant women. Noliprel A Bi-forte should not be taken with lithium medicines. Otherwise, toxicity will increase. If this combination of drugs is prescribed, constant monitoring of the concentration of lithium in the blood is indicated. Against the background of treatment with Baclofen, the effect of Noliprel A Bi-forte is enhanced. A similar effect occurs with the complex administration of the agent in question with a tricyclic antidepressant.

Against the background of taking corticosteroids, the hypotensive effect of Noliprel A Bi-forte decreases. The drug is not prescribed for diabetics, as the hypoglycemic effect may increase. Cytostatics and allopurinol in combination with Noliprel A Bi-forte increase the likelihood of leukopenia. Do not drink alcohol during treatment with Noliprel A Bi-forte.

The drug is available in the form of coated tablets. The composition of the drug includes indapamide and perindopril arginine. Noliprel A forte is a combined antihypertensive agent, the pharmacological effect of which is justified by a combination of the properties of each component.

With the help of Noliprel A forte, there is a pronounced effect on different levels of pressure. The drug affects the body throughout the day. The therapeutic effect is observed after a month. After discontinuation of its administration, there is no withdrawal syndrome. With the help of Noliprel A forte, the symptoms of LV hypertrophy are reduced.

The drug is not prescribed if the patient has hypokalemia, severe PN. Drink carefully with scleroderma. The drug is drunk before meals. If necessary, Noliprel A forte is included in combination therapy immediately after monotherapy. Noliprel A forte has analogues of imported and domestic production. In each generic, except for the preparations of the company "Teva", there is an erbumine salt of perindopril.

Perindopril is a Polish-made drug, which includes an ACE inhibitor, a diuretic and indapamide. Excipients include lactose, silicon dioxide and magnesium stearate. Perindopril is the main component of the drug, which is an enzyme inhibitor and reduces the secretion of aldosterone. Against its background, the activity of renin in the blood increases, and with prolonged use of the drug, OPSS decreases.

With the help of Perindopril, the work of the myocardium is normalized, pre- and afterload are reduced. If you study the hemodynamic parameters, then during therapy, the drug can:

• reduce pressure in the ventricles of the heart;
• increase cardiac output.

The second component of the drug is indapamide. It increases the excretion of chloride and sodium ions by the kidneys. This lowers blood pressure. This effect persists throughout the day.

Against the background of taking the drug, OPSS decreases.

Perindopril is not prescribed in the following cases:

• swelling and allergies;
• hypokalemia;
• liver problems;
• lactose deficiency.

The drug is prescribed for internal use 1 time per day. Against the background of an overdose, there is a pronounced decrease in blood pressure, which is combined with drowsiness, convulsions, and vomiting. To eliminate the symptoms of overdose, hypovolemia is corrected.

With the complex intake of lithium and ACE inhibitors, the concentration of this substance in the blood increases. Additional intake of diuretics contributes to the subsequent increase in its level. In a separate group, medicines are allocated that are taken only under the supervision of physicians:

• Baclofen - enhances the antihypertensive effect. Against the background of such treatment, control of blood pressure and kidney function is indicated. If necessary, the doctor adjusts the dosage of the antihypertensive drug;
• NSAIDs - interferes with the effects of the first remedy.

If you drink ACE inhibitors and NSAIDs at the same time, you can increase the risk of deterioration in kidney function. Particular attention is paid to the following combinations of medicines:

• antidepressants + antipsychotics;
• corticosteroids + tetracosactides.

The considered substitute for Noliprel causes adverse reactions if the patient has hypokalemia. But at the first stage of treatment, 2 antihypertensive drugs are prescribed, which were not previously prescribed. By carefully monitoring the patient, the risk of idiosyncrasy can be minimized. To do this, doctors use various instrumental and laboratory methods of examination.

Patients with poor kidney function, the drug is not prescribed. Patients with hypertension without prior impairment of renal function may experience laboratory signs of renal failure during treatment. In this case, the treatment is stopped. In the future, the resumption of combination therapy is allowed. In this case, the drug is prescribed in a small dosage. The patient is prescribed one or more drugs. In parallel, doctors control the level of creatinine.

Another imported analogue of Noliprel is Indapamide from the Israeli manufacturer Teva. The dosage of the drug is close to the original remedy. It contains indapamide and perindopril tosylate. From the additional components, lactose, povidone and sodium bicarbonate are isolated. Tablets are sold in a plastic container.

Co-Parnavel is considered an effective domestic analogue. It is produced by the pharmaceutical company Ozon. The tablets do not have a shell, but they have diuretic and inhibitory properties.

The Slovenian drug Ko-Perinev differs in its composition from analogues. It contains calcium chloride hexahydrate. MCC and silicon dioxide are isolated from the remaining effective components. During storage requires compliance with the temperature regime. Treatment is carried out with minimal doses.

A Slovenian pharmacological company produces an analogue of Noliprel, the drug Perindapam. From the additional components of the drug, MK and povidone are isolated. Additionally, the drug contains the substance hydroxypropyl betadex.

Perindid is an Indian drug manufactured by Edge Pharma. The tablets are available in orange and red colors. Their excipients include titanium dioxide, talc and lactose.

The Swiss company Sandoz produces an analogue of Perindopril in blisters. The composition of the drug is similar to other cheap analogues.

Effective domestic analogues include the drug Perindopril Plus Indapamide. It does not contain lactose, therefore it is prescribed to patients for whom it is contraindicated. It is preliminary recommended to examine the blood of patients.

Such medications are convenient to use, since 2 tablets replace 1. At the same time, the effectiveness of therapy does not decrease. If taking a two-component drug is not possible, monopreparations are prescribed. The original perindopril is Prestarium A, and the original indapamide is Arifon. The production of such funds is carried out by the company "Servier".

The drug Prestarium A consists of indapamide. If necessary, it is replaced with a drug in the form of a slow release. Arifon retard has cheaper analogues - Perineva, Parnavel. You can drink generics that do not have a brand name. But such perindopril is taken after consulting a doctor.

Of the effective analogues of Arifon, Ravel and Indap are distinguished. In the pharmacy you can buy Indapamide, which is produced by various pharmaceutical manufacturers. The name of the drug corresponds to the active ingredient. Given the variety of medical means, the patient can undergo effective therapy. The selection of a treatment regimen should be carried out by a doctor, taking into account the clinical picture. Before treatment, the patient must be examined by several specialists.

Noliprel A is the original drug. Produced in France by the pharmaceutical company Servier, which has been on the market for over 60 years. The drug is a combination of an angiotensin-converting enzyme inhibitor (perindopril) and a diuretic (indapamide). The main indication for the appointment is arterial hypertension. A special group of patients are people suffering from carbohydrate metabolism disorders (diabetes mellitus). By prescribing a medicine in such a situation, it is possible to reduce the risk of vascular complications.

Initially, original drugs have a high cost, which is associated with the need to develop a new drug, conduct numerous studies, and use high-quality raw materials. As soon as such an opportunity arises, other pharmaceutical companies begin to produce cheap analogues. This makes treatment more accessible. But before starting treatment, you need to consult a doctor. You should carefully study the original instructions for the drug.

The mechanism of action of the original and generics is practically the same. The ACE inhibitor prevents the formation of angiotensin II. Vasodilatation occurs, less sodium and water are retained. As a result, the pressure drops. ACE inhibitors improve the condition of patients with signs of chronic heart failure. The class effect is nephroprotection.

Indapamide belongs to the sulfonamide group of diuretics. The main effects are associated with the removal of excess sodium and water from the body. A decrease in the volume of blood circulating in the vascular bed leads to a drop in pressure. With regular use of the drug, the elasticity of the vessels improves and their total peripheral resistance decreases. There is a regression of left ventricular hypertrophy. The absence of a pronounced effect on metabolic processes, a slight effect on the exchange of potassium and magnesium allows us to recommend this remedy to most patients.

Both components are quickly and almost completely absorbed in the digestive tract. Perindopril is a prodrug and part of it, undergoing some transformations in the liver, turns into a more active substance - perindoprilat. Peak plasma concentrations are reached in about 3-4 hours. The half-life of this ACE inhibitor is on average 25 hours. In the process of excretion of the drug, mainly the kidneys are involved.

To achieve the maximum content of indapamide in the blood plasma, it takes about an hour from the moment the drug enters the bloodstream. The elimination half-life varies from 14 to 24 hours. Excretion of the drug is also carried out mainly by the kidneys. Only a small part of the metabolites leaves the body bypassing the intestines.

An ACE inhibitor and a diuretic mutually enhance the hypotensive effect, which persists throughout the day. This allows you to take the medicine once a day. It is advisable to do this in the morning on an empty stomach, although food intake does not play a big role.

Among the contraindications are the following conditions:

• intolerance to the active substances and other components that make up the tablet;
• decrease in the level of potassium below the permissible limit;
• Quincke's edema in history;
• critical narrowing of the artery of the only functionally active kidney;
• severe liver damage with the development of insufficiency of this organ, especially with the development of hepatic encephalopathy;
• changes in kidney function when creatinine clearance is less than 30 ml / min;
• the use of drugs that affect the conduction system of the heart, provoking rhythm disturbances;
• pregnancy and breastfeeding period.

When prescribing the drug, the doctor must take into account other conditions in which treatment is possible, but under special control:

1. Lactose intolerance.
2. Cardiovascular pathology: instability of blood pressure, severe aortic valve stenosis, cardiomyopathy (hypertrophic variant), coronary heart disease (angina pectoris), late stage of chronic heart failure, cerebral ischemia of any etiology.
3. Pathology of the kidneys, leading to the development of symptomatic hypertension. Condition after kidney transplantation, as well as hemodialysis using certain high-flow membranes.
4. Violation of the hematopoietic function of the bone marrow, including against the background of immunosuppressive therapy.
5. Endocrine pathology (diabetes mellitus).
6. Systemic connective tissue diseases (scleroderma, systemic lupus erythematosus).
7. Metabolic disorders leading to the development of gout, the formation of urate stones. When prescribing treatment, it is also necessary to take into account a condition such as hyperuricemia, when the level of uric acid in the blood is higher than normal, even if there are no symptoms of gout.
8. Fluid loss associated with the use of diuretic therapy, diarrhea or vomiting. The cause of dehydration can also be hemodialysis and the complete refusal to use salt.
9. A special period is the preparation for low-density lipoprotein apheresis, when specific desensitization is used.
10. The age of patients is up to 18 years.

Against the background of taking Noliprel, negative effects can also be observed:

• From the digestive system: abdominal pain, dyspepsia, nausea, vomiting, stool disorders, dry mouth, taste perversion. Rarely, hepatitis, jaundice of the skin and mucous membranes, hepatic encephalopathy in patients with liver pathology, and angioedema of the intestine are detected.
• From the senses and nervous system: visual disturbances, tinnitus; often headache and dizziness; sensory disturbances (paresthesias) are possible. Patients may suffer from insomnia, changes in the emotional background. A violation of consciousness is not excluded, fainting is possible.
• From the side of the heart and blood vessels: a drop in pressure below normal, rhythm disturbances, attacks of retrosternal pain (angina), and even myocardial infarction.
• On the part of the respiratory system: attacks of dry cough or coughing, bronchospasm, manifested by shortness of breath; eosinophilic pneumonia, rhinitis.
• On the part of the urinary organs: a rare complication is impaired renal function (renal failure), sexual dysfunction in men is possible.
• On the part of the skin: there may be complaints about the occurrence of itching, various rashes up to severe skin lesions, hemorrhages under the skin and mucous membranes. A dangerous complication of therapy is Quincke's edema. Sometimes there is an increased susceptibility to ultraviolet light (photosensitivity).
• On the part of the hematopoietic organs: a decrease in the level of platelets in the blood below the norm, the total number of leukocytes, as well as individual fractions of white blood cells: neutrophils, agranulocytes. Anemia may develop.
• On the part of laboratory indicators: an increase above the norm in the content of potassium in the blood, creatinine, uric acid, glucose, calcium. The concentration of potassium, sodium may fall. Sometimes an increase in liver transaminases (ALAT, AST) is detected. With the help of an ECG, it is possible to identify a prolonged QT interval. Less commonly, metabolic alkalosis develops due to loss of chlorine.
• Adverse reactions also include: muscle spasm, severe sweating, asthenia.

In case of an overdose, first of all, the pressure drops below critical values, which may be accompanied by the appearance of dizziness, nausea, vomiting, as well as loss of consciousness. Convulsions, violation of urine discharge are possible. Changes in the electrolyte composition of the blood are detected.

The effectiveness of therapy can be significantly affected by the simultaneous use of other medications. So, all drugs belonging to the group of antihypertensives enhance the effect of Noliprel. And the usual painkillers from the NSAID group do not allow active substances to fully reduce pressure. Other medicines increase the chance of unwanted reactions. For example, potassium supplements and potassium-retaining diuretics contribute to the development of hyperkalemia. And there are many such interactions. More information about them can be found in the official instructions, which is attached to the drug Noliprel.

The medicine is produced only in tablet form. Each tablet has a white film coat. The shape is oblong, there are risks on both sides. The composition of Noliprel contains perindopril arginine - 2.5 mg, as well as indapamide - 0.625 mg. Auxiliary components are: silicon dioxide, lactose, magnesium stearate, sodium carboxymethyl starch, maltodextrin. The shell contains macrogol, magnesium stearate, glycerol, titanium dioxide.

Packaging is carried out in plastic bottles, equipped with a lid-dispenser. There is a cork in which a gel is placed that absorbs moisture. The bottle can contain 14 or 30 tablets. Available in packs containing 90 tablets.

Noliprel is dispensed by prescription. Shelf life is 3 years without special storage requirements. The price of one package, designed for a month of treatment, is approximately 550 rubles.

There are 2 more forms of medicine: Noliprel A forte and Noliprel A Bi-Forte. These drugs differ only in the dosage of the active ingredients. In the first case, the doses of perindopril and indapamide are 5 and 1.25 mg, respectively, and for Noliprel Bi-Forte, 10 and 2.5 mg. The price of the forte form reaches 700, and the Bi-Forte - up to 800 rubles per month of treatment.

To date, Noliprel has several analogues of domestic and imported production. But in all generics, except for Teva's drug, the erbumine salt of perindopril is used.

Produced in Poland by the pharmaceutical company Gideon Richter. The combination may contain 4 mg of an ACE inhibitor and 1.25 mg of a diuretic, or 2 mg of perindopril and 0.625 of indapamide. Excipients are: MCC (microcrystalline cellulose), lactose, magnesium stearate and silicon dioxide.

Tablets are placed in a blister pack. The blister contains 10 pieces. One package contains 3 blisters. The shelf life is 2 years. It is necessary to store the medicine at a temperature not exceeding 30 ° C. It is difficult to track information on the price, since not all pharmacies have it in stock.

Teva is an Israeli company. The composition is somewhat different from both the original and other generics, but the dosages are closer to the original medicine. It contains perindopril tosylate 2.5 mg and indapamide 0.625 mg. There is a larger dosage - 5 / 1.25 mg. Tablets have a shell. Additional components are: lactose, povidone, corn starch, magnesium stearate and sodium bicarbonate. The composition of the shell is represented by substances such as macrogol, polyvinyl alcohol, talc and titanium dioxide.

Tablets are placed in a plastic container of 30 pieces. The shelf life is 2 years. The medicine is stored at temperatures up to 25 ° C. Not the most common pharmacy drug, so it is difficult to determine the cost of therapy.

This combined product is produced on the territory of the Russian Federation by the Ozone company. Tablets are white. They can be divided, as there is a risk. The shell is missing. The ratio of diuretic and ACE inhibitor can be 1.25/4 mg and 0.625/2. Auxiliary substances are used as in the Israeli counterpart, only there is no sodium bicarbonate and MCC is added.

Tablets are placed in blisters of 10, 20 or 30 pieces. Plastic jars are also produced, in which 10, 20, 30, 40, 50 and even 100 pieces are placed. There is practically no medicine in pharmacies. Shelf life is 3 years provided that the storage temperature does not exceed 25 °C.

The manufacturer is the pharmaceutical company Krka, Slovenia. Although production is currently carried out in Russia. Dosages 3 depending on the ratio of active substances: 0.625/2; 1.25/4 and 2.5/8 mg. White tablets have a biconvex shape, there is a risk.

The composition is somewhat different from analogues. Here calcium chloride hexahydrate is added. lactose is present. The remaining components are repeated: crospovidone, sodium bicarbonate, MCC, silicon dioxide, magnesium stearate. Packaging is carried out in 10 pieces in blisters. There are 3, 6 or 9 such packages in a carton box. During storage, the temperature regime should also be observed. Stored for three years.

The price depends on the dosage and the number of tablets in the package. A monthly course of treatment with minimal doses will cost 300-500 rubles. A package containing 90 tablets costs about 1000 rubles. You can buy the largest dosage for a month of treatment for 480-560 rubles. The cost of a package for 3 months of therapy is about 1200 rubles.

Produced in Slovenia by LEK. Dosages are standard: 0.625 + 2 mg and 1.25 + 4 mg. Additional components in the bulk are repeated: lactose, silicon dioxide, magnesium stearate, povidone, MCC (prosolv). But here a new substance appears - hydroxypropyl betadex. The tablets themselves are biconvex, elongated. There are risks. Placed in blisters of 7 or 10 pieces. One pack can contain 28, 30, 50, 90 pieces. The shelf life is limited to two years, the requirements for temperature conditions during storage are standard. Almost never found in pharmacies.

The medicine is produced in India by the pharmaceutical company Edge Pharma Private Limited. The ratio of active ingredients can be 1.25/4 and 0.625/2. Tablets are distinguished by the color of the film shell, which can be red or orange. Excipients are standard: MCC, magnesium stearate, hypromellose, macrogol, talc, silicon dioxide, lactose, titanium dioxide. The dye used in the casing is iron oxide red.

Packing blister on 14 and 10 pieces. The pack contains 1, 2 or 3 blisters. Expiration date and storage temperature as in other generics. The price of the smallest dosage ranges from 270-340 rubles, and a larger dose - from 400 to 515 rubles.

Sandoz was founded in Switzerland, but has offices in many countries. The most common producer is Slovenia. Dosages are standard: 0.625/2 and 1.25/4 mg. The blisters may contain 7 or 10 tablets. There are packages of 14, 30, 50, 90 tablets. The composition practically does not differ from other cheap analogues. It's hard to find in pharmacies.

This is another domestic analogue of Noliprel. Produced by Izvarino Pharma LLC. All 3 dosages are available: 0.625/2; 1.25/4 and 2.5/8 mg. The shell of the tablets is yellow in color with a characteristic pinkish tint. The shape is round, biconvex. Additional components are standard, but there is no lactose in the composition. This allows you to prescribe this remedy to people who are lactose intolerant. Iron oxide yellow and red are used as dyes for the shell.

Packings contour cell on 10 pieces. There are 1, 3, 6 or 9 such packages in a pack. Expiration date and storage conditions as in other generics. The price varies from 245 to 530 rubles.

Combination preparations were created for ease of use. Instead of two tablets, you can take just one and get effective treatment. If for some reason it is impossible to take a two-component agent, for example, a high price, it is difficult to find the right dosage, etc., then you can take monopreparations. The original perindopril is Prestarium A, the original indapamide is Arifon. These funds are also produced by Servier.

Prestarium A has dosages of 2.5; 5 and 10 mg. Depending on the dose, the price of a package ranges from 400–600 rubles. Arifon contains 2.5 mg of indapamide. A month of treatment can cost about 350-400 rubles. A slow release form is also available - Arifon retard 1.5 mg. The average price for 30 tablets is 350 rubles.

These drugs also have cheap counterparts. Prestarium substitutes - Parnavel, Perineva. Generics are also available that do not have a brand name. This is perindopril, produced by domestic and foreign manufacturers. The price is from 160 rubles and above.

Analogues of Arifon are: Indap, Ravel SR, Acripamide. Pharmacies sell indapamide, produced by various pharmaceutical companies. The name corresponds to the active substance. The cheapest drugs can cost about 20 rubles.

Given all the variety of medicines, each person can receive effective treatment. But only a doctor should be engaged in the selection of therapy. You can't experiment with your health on your own.

In the pharmacy kiosk you can buy an inexpensive medicine - Noliprel Forte. Cheap analogues of the drug are purchased due to existing contraindications to the product, or because of the high price.

Thanks to a special table, you can choose the best substitutes for Noliprel Forte:

Among inexpensive medical products like Noripel Forte, close drug substitutes stand out, which are included in the group of antihypertensive drugs.

The list contains synonyms, they are not considered exact analogues. For such products, indications for use are the same as for the original drug:

1. Liprazide- the cost of a medical ingredient in pharmacy kiosks is UAH 22.30-112.50.

As a replacement for the cheap drug Noliprel Forte, you can use imported drugs from the list below.

The drug has a minimum cost of 237-364 rubles. The Polish company Gedeon Richter is engaged in the production of similar medicines Noliprel forte.

There are 4 elements in the combination:

• 4 mg ACE inhibitor.
• 1.25 mg diuretic.
• 2 mg peridondopril together with 0.625 indapamide.

Among the additional components, there are three elements:

• microcrystalline cellulose.
• Magnesium stearate along with silicon dioxide.

The drug Indapamide / Perindopril-Teva is purchased at a cost of 240-342 rubles. The medical product is manufactured by Teva.

According to the set of ingredients, the product is not similar to the original, it also differs from the jereneks.

Medical products are sold in the shell. Several effective elements stand out from the additional components:

• Lactose.
• Corn starch.
• Povidone.
• There is also the presence of sodium bicarbonate along with magnesium stearate.

The shell consists of macrogol, talc, as well as polyvinyl alcohol and titanium dioxide.

For the sale of the drug, a plastic container is provided, in the amount of 30 pieces. The medical product is valid for 2 years, storage temperature should not exceed 25°C.

Average prices are set for the drug: 319-1034 rubles. The Slovenian company LEK is engaged in the production of a similar drug Noliprel Forte.

Among the additional ingredients, you can consider the same as the rest of the analogues. The only difference is the presence of a substance - hydroxypropyl betadex.

The tablets have an elongated shape, biconvex, with a risk. The medicine is sold in blisters, the amount is 7-10 pieces, use the medicine for up to 2 years.

The product is sold at a price of 400-515 rubles. The product is produced by an Indian pharmaceutical company called Edge Pharma Private Limited.

From the additional components, the elements are distinguished:

• Magnesium stearate.
• Macrogol, talc.
• As well as silicon dioxide along with lactose and titanium dioxide.

The package consists of 10-14 tablets. In one pack there are up to 3 blisters.

The price of the medicine: 98-350 rubles. The medical product is released in Slovenia. Blisters consist of 7-10 tablets.

The components are the same components as in cheap counterparts. After the action of the drug, the veins expand.

The tablets have vasodilating properties, and after application, the restoration of the elasticity of large arteries begins.

Before starting treatment, you should visit a specialist, as well as read the original instructions.

© 2018 Women's magazine | Womans7 Copying site materials without permission is prohibited

High blood pressure is not just a problem for the elderly. Such a diagnosis can be made to the patient at a young age. The disappointing statistics of cardiovascular diseases has many reasons, the main ones are non-compliance with a healthy lifestyle, constant stressful situations, a busy life schedule, malnutrition and, of course, heredity.

It is very difficult to deal with hypertensive surges; simplified antihypertensive drugs do not help many people to normalize blood pressure; for them, combined strong drugs are used in therapy. The medicine "Noliprel9raquo;" also belongs to their group. In this article we will consider its main properties.

Since many are interested in a cheap analogue of Noliprel9raquo;, we will select several replacements for this drug according to its main characteristics. And also consider several analogues thereof.

This is a combined remedy that includes the active substance perindopril, erbumine salt and the diuretic indapamide. This combination of substances allows you to expand the arteries, increase the minute volume of blood, and thereby normalize blood pressure and heart function.

In other words, the components contained in the composition effectively affect the vessels, restoring their elasticity property.

Strengthened therapy with this drug is prescribed only when weaker ACE inhibitors do not affect the body properly.

A package of tablets of this medicine costs 350 rubles. Knowing the price of the drug "Noliprel9raquo;, it is easy to find analogues cheaper. But first you need to deal with the provisions that are contained in the instructions attached to the medicine.

Attached to the drug "Noliprel9raquo; instructions for use analogue does not define. It only indicates the properties of the drug.

This remedy is prescribed for essential hypertension, if necessary, to minimize the risk of complications such as myocardial infarction and stroke.

Often, the drug is prescribed to people with diseases of the kidneys, heart, with high blood pressure, diabetes mellitus (type 2).

The medicine is taken once a day (one tablet). It is advisable to do this in the morning. During therapy with this medicine, blood levels of creatinine and potassium should be carefully monitored.

In order to prevent cases of overdose with this drug, only a competent doctor should prescribe it.

A fairly strong medication in relation to the normalization of blood pressure has an impressive list of side effects on the body of sick people, the main ones are:

• arrhythmia;
• decrease in potency;
• impaired renal function;
• bronchospasm, cough, runny nose;
• skin itching.

The advantages of this remedy include rapid action and the possibility of prescribing medication for patients with diabetes mellitus. Cheap analogue of Noliprel9raquo; should also have similar properties, but it is not always possible to find an exact copy of the drug in terms of composition and action.

You can not take the drug "Noliprel9raquo; with kidney diseases, since it contains a diuretic, in the presence of allergic reactions to the components contained in the medication, during pregnancy and lactation, with liver diseases, pathologies associated with the body not absorbing glucose. You can not combine this medicine with antidepressants.

Very often, people suffering from high blood pressure wonder what is better - the medicine "Noliprel9raquo; or Noliprel A. These drugs are interchangeable. The only difference between them is that the drug "Noliprel9raquo; contains erbumine salt in the composition, and "Noliprel A" - arginine salt. Arginine is identical to erbumine, only it prolongs the shelf life of the medicines it contains. Its presence is indicated by the letter A.

The cost of packing Noliprel A tablets is 550 rubles. Search among drugs identical both in composition and in terms of effects on the body of drugs for a cheap analogue of Noliprel9raquo; meaningless. Their cost is on a par with the original combined remedy and higher.

These also include the drug "Noliprel A Forte", it costs 670 rubles, the tablets "Noliprel A B Forte", their price is 680 rubles per pack, the pills "Ko-Pyreneva9raquo;, they can be bought for 650 rubles, the drug" Prestarium Arginin Combi”, its price is 600 rubles. Cheaper medicines are Co-Prenessa9raquo; tablets, they cost 400 rubles, and Prlamid9raquo;, its price is 300 rubles.

It is necessary to select cheaper analogues from a number of combined ACE inhibitors for identical drugs Noliprel9raquo;, Noliprel A, Noliprel A Forte. They should have the same effect on the patient's body as a combination of the components contained in them.

It should be understood that analogues of Noliprel Forte, for example, or an identical drug under a different name, instead of perindopril and indapamide, may include other components.

At present, similarities in the effect on the patient's body of such active elements as perindopril, quinapril, ramipril, elanopril, lisinopril, captopril have been revealed. Therefore, from the group of combined ACE inhibitors, it is possible to take Noliprel9raquo; pick up cheap analogues that include these substances in their composition. They are listed below.

So, a cheap analogue of Noliprel9raquo; from this group - the medicine "Quinard N", it costs 200 rubles. Produced in tablet form. Contains quinapril and diuretic hydrochlorothiazide. It is prescribed for arterial hypertension. It is taken once a day (one tablet). May cause insomnia, anemia, headaches, intestinal upset, cough, runny nose, skin rashes and itching.

Even for the drug "Noliprel" a cheap analogue from this group of combined ACE inhibitors - tablets "Quinapril Sandoz Comp", they cost 250 rubles. Their composition and effect on the stabilization of blood pressure is identical to the drug "Quinard N".

From this group of complex drugs, attributed to cheap analogues of the drug "Noliprel9raquo; the following tablets are available: "Ramag N", they cost 250 rubles, and "Rami Sandoz Compositum", their price is 300 rubles.

Let us dwell, for example, on the medicine "Ramag N". Its composition includes ramipril and the diuretic hydrochlorothiazide. It is prescribed for arterial hypertension. The medicine is taken once (one tablet) in the morning. It can cause severe persistent cough, anemia, skin rashes and itching, nausea, intestinal disorders and inflammation of the gastrointestinal tract. It is not prescribed for diseases of the kidneys and liver.

Tablets "Berlipril Plus" and "Elanozid9raquo; - the drug "Noliprel9raquo; analogues, reviews of which are mostly positive. In their composition, they contain elanopril and the diuretic hydrochlorothiazide.

They are prescribed for chronic heart failure and arterial hypertension. Taken once a day (one tablet). May cause side effects such as arrhythmia, thirst, nervous tension, insomnia, tinnitus, blurred vision, urticaria, eczema, pruritus.

Tablets "Berlipril Plus" cost 250 rubles, "Elanozid9raquo; half the price - 100 rubles.

From this group of drugs to cheap analogues of the drug "Noliprel9raquo; can be attributed tablets "Liprazid9raquo;, the cost of which is 210 rubles, and" Lopril Bosnalek N ", you can buy them for 240 rubles.

For example, the drug "Liprazid9raquo; in their composition contain lisinopril and diuretic hydrochlorothiazide. It is prescribed for arterial hypertension. It is taken once a day (one tablet). May cause side effects such as vomiting, abdominal pain, weakness, irritability, loss of appetite, pancreatitis, chest pain, confusion, bronchospasm.

From this group of drugs to cheap analogues of the drug "Noliprel9raquo; can be attributed tablets "Capotiazid9raquo;, their price is 150 rubles, and" Normopress9raquo;, which can be bought for 200 rubles.

So, for example, the drug "Normopress9raquo; includes captopril and diuretic hydrochlorothiazide. It is prescribed for arterial hypertension. It is taken once a day (half a tablet). May cause hypoglycemia, blurred vision, rhinitis, dry cough, pruritus, impotence, weakness, intestinal irritation, palpitations.

Choosing the medicine "Noliprel9raquo; analogues are cheaper (Russia), you can focus on such domestic combined drugs as Dalneva9raquo tablets; (perindopril + diuretic amlodipine), they cost 500 rubles, pills "Egipres9raquo; (ramipril + diuretic amlodipine) - 200 rubles, the medicine "Ekvator9raquo; (lisinopril + diuretic amlodipine) - 250 rubles, the drug "Iruzid9raquo; (lisinopril + diuretic hydrochlorothiazide) - 300 rubles.

The drug "Noliprel9raquo; they are also replaced by such domestic non-combined strong drugs as Captopril AKOS and Enalapril AKOS, they cost 200 rubles.

As you can see, the list of similar drugs that affect the normalization of high blood pressure is very large. This can only be explained by the fact that a certain type of medicine is suitable for each person.

It is possible to choose a remedy for individual treatment of blood pressure only by trial and under the strict supervision of the attending doctor. After all, each combined ACE inhibitor can cause serious side effects that are life-threatening.

Also, the independent use of such drugs can be the cause of an overdose, in which low blood pressure is observed, which is also not normal.

Have you had any side effects with this medicine? Mechanism of actionNoliprel® A Bi-forte The combination of perindopril and indapamide enhances the antihypertensive effect of each of them. Perindopril Perindopril is an inhibitor of the enzyme that converts angiotensin I to angiotensin II (ACE inhibitor). ACE, or kininase II, is an exopeptidase that both converts angiotensin I to the vasoconstrictor angiotensin II and breaks down the vasodilator bradykinin to an inactive heptapeptide. As a result, perindopril reduces the secretion of aldosterone; by the principle of negative feedback increases the activity of renin in the blood plasma; with prolonged use, it reduces OPSS, which is mainly due to the effect on the vessels in the muscles and kidneys. These effects are not accompanied by sodium and fluid retention or the development of reflex tachycardia. Perindopril normalizes myocardial function, reducing preload and afterload. When studying hemodynamic parameters in patients with chronic heart failure (CHF), a decrease in filling pressure in the left and right ventricles of the heart, a decrease in peripheral vascular resistance, an increase in cardiac output, and an increase in peripheral muscle blood flow were revealed. Indapamide Indapamide belongs to the group of sulfonamides, in terms of pharmacological properties it is close to thiazide diuretics. Indapamide inhibits the reabsorption of sodium ions in the cortical segment of the loop of Henle, which leads to an increase in the excretion of sodium ions, chloride ions and, to a lesser extent, potassium and magnesium ions, thereby increasing diuresis and reducing blood pressure. Antihypertensive actionNoliprel® A Bi-forte Noliprel® A Bi-forte has a dose-dependent antihypertensive effect on both diastolic and systolic blood pressure, both in the standing and lying position. The antihypertensive effect persists for 24 hours. A stable therapeutic effect develops in less than 1 month from the start of therapy and is not accompanied by tachyphylaxis. Termination of treatment does not cause a withdrawal syndrome. Noliprel® A Bi-forte reduces the degree of left ventricular hypertrophy (GTLZh), improves arterial elasticity, reduces peripheral vascular resistance, does not affect lipid metabolism (total cholesterol, HDL and LDL cholesterol, triglycerides). The effect of the use of a combination of perindopril and indapamide on GTLH in comparison with enalapril has been proven. In patients with arterial hypertension and LVOT treated with perindopril erbumine 2 mg (equivalent to 2.5 mg perindopril arginine) / indapamide 0.625 mg or enalapril at a dose of 10 mg 1 time / day, and when the dose of perindopril erbumine is increased to 8 mg (equivalent to 10 mg perindopril arginine) and indapamide up to 2.5 mg, or enalapril up to 40 mg 1 time / day, there was a more significant decrease in the left ventricular mass index (LVMI) in the perindopril / indapamide group compared to the enalapril group. At the same time, the most significant effect on LVMI is noted with the use of perindopril erbumine 8 mg / indapamide 2.5 mg. A more pronounced antihypertensive effect was also noted in combination therapy with perindopril and indapamide compared with enalapril. Perindopril Perindopril is effective in the treatment of arterial hypertension of any severity. The antihypertensive effect of the drug reaches a maximum after 4-6 hours after a single oral administration and lasts for 24 hours. 24 hours after taking the drug, a pronounced (about 80%) residual ACE inhibition is observed. Perindopril has an antihypertensive effect in patients with both low and normal plasma renin activity. The simultaneous appointment of thiazide diuretics enhances the severity of the antihypertensive effect. In addition, the combination of an ACE inhibitor and a thiazide diuretic also reduces the risk of hypokalemia while taking diuretics. Double blockade of the RAAS There are data from clinical studies of combination therapy with an ACE inhibitor with ARA II (angiotensin II receptor antagonist). Clinical studies have been conducted in patients with a history of cardiovascular or cerebrovascular disease, or type 2 diabetes mellitus with confirmed target organ damage, as well as studies in patients with type 2 diabetes mellitus and diabetic nephropathy. These studies did not reveal a significant positive effect on the occurrence of renal and / or cardiovascular events and on mortality rates in patients receiving combination therapy, while the risk of developing hyperkalemia, acute renal failure and / or arterial hypotension increased compared with patients who received monotherapy. Taking into account the similar intragroup pharmacodynamic properties of ACE inhibitors and ARA II, these results can be expected for the interaction of any other drugs, representatives of the classes of ACE inhibitors and ARA II. Therefore, ACE inhibitors and ARA II should not be used simultaneously in patients with diabetic nephropathy. There is evidence from a clinical trial investigating the beneficial effects of adding aliskiren to standard therapy with an ACE inhibitor or ARA II in patients with type 2 diabetes mellitus and chronic kidney disease or cardiovascular disease, or a combination of these diseases. The study was terminated early due to an increased risk of adverse outcomes. Cardiovascular death and stroke occurred more frequently in the aliskiren group than in the placebo group. Also, adverse events and serious adverse events of special interest (hyperkalemia, arterial hypotension and impaired renal function) were recorded more often in the aliskiren group than in the placebo group. Indapamide The antihypertensive effect is manifested when the drug is used in doses that have a minimal diuretic effect. The antihypertensive effect of indapamide is associated with an improvement in the elastic properties of large arteries, a decrease in peripheral vascular resistance. Indapamide reduces GTLZh, does not affect the concentration of lipids in the blood plasma: triglycerides, total cholesterol, LDL, HDL; carbohydrate metabolism (including in patients with concomitant diabetes mellitus). Note! The list contains synonyms for Noliprel forte, which have a similar composition, so you can choose a replacement yourself, taking into account the form and dose of the medicine prescribed by the doctor. Give preference to manufacturers from the USA, Japan, Western Europe, as well as well-known companies from Eastern Europe: Krka, Gedeon Richter, Actavis, Egis, Lek, Geksal, Teva, Zentiva. Most of the respondents most often take this drug once a day. The report shows how often the other participants in the survey take this drug. 1 per day 12 75.0% 3 times a day 2 12.5% 2 times a day 1 6.2% 4 times a day 1 6.2% In most cases, survey participants felt an improvement in their condition after 5 days. But this may not correspond to the period after which you will improve. Talk to your doctor about how long you need to take this medicine. The table below shows the results of the survey on the beginning of an effective action. Users of the site most often report taking this medication after meals. However, your doctor may recommend a different time for you. The report shows when the rest of the interviewed patients take their medicine.

Registration number: LCP-004327/10-170510

Trade name of the drug: Ko-Perineva®

International nonproprietary name (INN): indapamide + perindopril

Dosage form: tablets

Compound:

Description:

Tablets 0.625 mg + 2 mg: round, biconvex tablets, white or off-white, beveled, short line engraved on one side.
Tablets 1.25 mg + 4 mg: round, biconvex tablets of white or almost white color with a risk on one side and with a chamfer.
Tablets 2.5 mg + 8 mg: round, biconvex tablets of white or almost white color with a risk on one side.

Pharmacotherapeutic group: combined antihypertensive agent (diuretic + angiotensin-converting enzyme inhibitor)

ATX code C09BA04

Pharmacokinetics

The combined use of perindopril and indapamide does not change their pharmacokinetic parameters compared with the separate administration of these drugs. Perindopril after oral administration is rapidly absorbed from the gastrointestinal tract (GIT). Bioavailability is 65-70%. Eating reduces the conversion of perindopril to perindoprilat. The half-life (T½) of perindopril from blood plasma is 1 hour.
The maximum plasma concentration is reached 3-4 hours after ingestion. Since taking with food reduces the conversion of perindopril to perindoprilat and the bioavailability of the drug, perindopril should be taken once a day in the morning, before breakfast. Taking perindopril 1 time per day, the equilibrium concentration is reached within 4 days.
In the liver, it is metabolized to form the active metabolite of perindoprilat. In addition to the active metabolite of perindoprilat, perindopril forms 5 more inactive metabolites. Communication with plasma proteins of perindoprilat is dose-dependent and amounts to 20%. Perindoprilat easily passes through the blood-tissue barriers, excluding the blood-brain barrier, a small amount crosses the placenta and into breast milk. Excreted by the kidneys, T½ of perindoprilat is about 17 hours. Does not accumulate.
In elderly patients, in patients with renal and heart failure, the excretion of perindoprilat is slowed down.
In renal failure, it is recommended to reduce the dose of perindopril depending on the severity of renal failure (creatinine clearance (CC)).
The dialysis clearance of perindoprilat is 70 ml/min.
The kinetics of perindopril is changed in patients with cirrhosis of the liver: hepatic clearance is reduced by half. However, the amount of perindoprilat formed does not decrease, which does not require dose adjustment.
Indapamide
Quickly and almost completely absorbed in the gastrointestinal tract. Eating somewhat slows down absorption, but does not significantly affect the amount of absorbed indapamide. Peak plasma concentrations are reached 1 hour after a single oral dose. It binds to plasma proteins by 79%. T½ is from 14 to 24 hours (on average, 18 hours). Does not accumulate.
Metabolized in the liver. It is excreted by the kidneys (70%) mainly in the form of metabolites (the fraction of unchanged drug is about 5%) and by the intestine with bile in the form of inactive metabolites (22%). In patients with renal insufficiency, the pharmacokinetic parameters of indapamide do not change significantly.

Use during pregnancy and lactation

Reception of the drug Ko-Perineva® is contraindicated during pregnancy. The use of the drug can cause fetoplacental ischemia with the risk of slowing down the development of the fetus.
It is not recommended to use the drug during breastfeeding (indapamide passes into breast milk). If necessary, the use of the drug Ko-Perineva® breastfeeding should be discontinued.

Doses are given for the indapamide/perindopril ratio.

The initial dose is 1 tablet of Ko-Perinev® (0.625 mg / 2 mg) 1 time per day.
If after 1 month of taking the drug it is not possible to achieve adequate control of blood pressure, the dose of the drug should be increased to 1 tablet of the drug Ko-Perinev® (1.25 mg / 4 mg) 1 time per day.
Elderly patients
The initial dose is 1 tablet of 0.625 mg / 2 mg of Ko-Perinev® once a day.
Patients with impaired renal function
Patients with renal insufficiency (CC 60 ml / min or more) dose adjustment is not required.
For patients with CC 30-60 ml / min, the maximum dose of Ko-Perinev® is 0.625 mg / 2 mg 1 time per day.
In case of severe impairment of kidney function (CC less than 30 ml / min), therapy with Ko-Perinev® is contraindicated (see section "Contraindications").
Patients with impaired liver function
In patients with moderate hepatic impairment, dose adjustment is not required.
Children and teenagers
The drug Ko-Perineva® should not be used in children and adolescents under 18 years of age, since efficacy and safety have not been established.

Interaction with other drugs Ko-Perinev®

Simultaneous use is not recommended:
Lithium preparations:
with the simultaneous use of lithium preparations and ACE inhibitors, cases of a reversible increase in the concentration of lithium in the blood serum have been reported.
Simultaneous administration of thiazide diuretics may increase the concentration of lithium and the risk of its toxic effect while taking an ACE inhibitor.
Concomitant use of potassium-sparing diuretics (such as spironolactone, eplerenone, triamterene, amiloride), potassium preparations or potassium-containing table salt substitutes, as well as the use of other drugs that increase the content of potassium in the blood plasma (for example, heparin).
Concomitant use of drugs requiring special care:
Baclofen: potentiation of the hypotensive effect. It is necessary to control blood pressure, kidney function and, if necessary, adjust the dose of antihypertensive drugs.
non-steroidal anti-inflammatory drugs (NSAIDs):
The combination of ACE inhibitors with NSAIDs (non-selective COX inhibitors from the NSAID group, for example, acetylsalicylic acid in doses that have an anti-inflammatory effect; cyclooxygenase-2 (COX-2) inhibitors).

In the pharmacy kiosk you can buy an inexpensive medicine - Noliprel Forte. Cheap analogues of the drug are purchased due to existing contraindications to the product, or because of the high price.

For close substitutes for Russian-made drugs, the composition is similar to the original.

Analogues of Russian production

Thanks to a special table, you can choose the best substitutes for Noliprel Forte:

Name	Price in rubles	About the drug
Co-Parnavel	from 13-350	Inexpensive and effective product. The Ozone company is engaged in the production of medicines. The tablets are white and do not have a shell. Pharmaceutical agent treats arterial hypertension. It is recommended to consult a doctor during pregnancy
Ko-Perineva	from 300-1000	Inexpensive and effective product. The composition of the active substance is calcium chloride hexahydrate, but there is no lactose. The cost of the product is determined by the amount of dosage, as well as the availability of tablets in one package. Modern medicines are designed to treat arterial hypertension
Perindopril PLUS Indapamide	from 245-530	Inexpensive and effective product. This medicine is sold cheaper, it is made in a similar way. Now there is something to replace Noliprel. The shell is yellow with a slightly pink tinge. The tablets are round in shape, they are biconvex. The composition of the drug is the same as that of the domestic manufacturer, only there is no lactose

Ukrainian substitutes

Among inexpensive medical products like Noripel Forte, close drug substitutes stand out, which are included in the group of antihypertensive drugs.

The list contains synonyms, they are not considered exact analogues. For such products, indications for use are the same as for the original drug:

1. Liprazide- the cost of a medical ingredient in pharmacy kiosks is UAH 22.30-112.50.

   The drug is used to treat arterial hypertension, which has several degrees of severity. Sometimes the drug is used in mono - and combination therapy.

2. Tritace- the drug is sold at a price of 82.88 to 331.30 UAH. The application is aimed at eliminating arterial hypertension in order to reduce blood pressure.

   Treat congestive heart failure, diabetic glomerular disease, or primary nephropathy. After taking the medication, the risk of myocardial infarction and stroke is reduced.

3. Enap- the cheapest medicine from 15.40 to 359.95 UAH. The medicine is good to treat arterial hypertension.

   Doctors advise preparations of Ukrainian production. They treat severe heart failure.

Other foreign analogues

As a replacement for the cheap drug Noliprel Forte, you can use imported drugs from the list below.

Peridonpril-Indapamide Richter

The drug has a minimum cost of 237-364 rubles. The Polish company Gedeon Richter is engaged in the production of similar medicines Noliprel forte.

There are 4 elements in the combination:

• 4 mg ACE inhibitor.
• 1.25 mg diuretic.
• 2 mg peridondopril together with 0.625 indapamide.

Among the additional components, there are three elements:

• microcrystalline cellulose.
• Magnesium stearate along with silicon dioxide.

Indapamide / Perindopril-Teva

The drug Indapamide / Perindopril-Teva is purchased at a cost of 240-342 rubles. The medical product is manufactured by Teva.

According to the set of ingredients, the product is not similar to the original, it also differs from the jereneks.

Medical products are sold in the shell. Several effective elements stand out from the additional components:

• Lactose.
• Corn starch.
• Povidone.
• There is also the presence of sodium bicarbonate along with magnesium stearate.

The shell consists of macrogol, talc, as well as polyvinyl alcohol and titanium dioxide.

For the sale of the drug, a plastic container is provided, in the amount of 30 pieces. The medical product is valid for 2 years, storage temperature should not exceed 25°C.

Perindapam

Average prices are set for the drug: 319-1034 rubles. The Slovenian company LEK is engaged in the production of a similar drug Noliprel Forte.

Among the additional ingredients, you can consider the same as the rest of the analogues. The only difference is the presence of a substance - hydroxypropyl betadex.

The tablets have an elongated shape, biconvex, with a risk. The medicine is sold in blisters, the amount is 7-10 pieces, use the medicine for up to 2 years.

Perindid

The product is sold at a price of 400-515 rubles. The product is produced by an Indian pharmaceutical company called Edge Pharma Private Limited.

From the additional components, the elements are distinguished:

• Magnesium stearate.
• Macrogol, talc.
• As well as silicon dioxide along with lactose and titanium dioxide.

The package consists of 10-14 tablets. In one pack there are up to 3 blisters.

Perindopril + Indapamide Sandoz

The price of the medicine: 98-350 rubles. The medical product is released in Slovenia. Blisters consist of 7-10 tablets.

The components are the same components as in cheap counterparts. After the action of the drug, the veins expand.

The tablets have vasodilating properties, and after application, the restoration of the elasticity of large arteries begins.

The cost of original drugs is much higher than that of analogues..

With this opportunity, other pharmaceutical companies can develop similar products.

Before starting treatment, you should visit a specialist, as well as read the original instructions.

Similar posts

Noliprel is a combination of perindopril (an ACE inhibitor) and (a diuretic from sulfonamide derivatives). This interaction is quite effective in the fight against high blood pressure, so Noliprel has a lot of analogues and substitutions.

It is a French drug that is produced in France at the Servier Industry Laboratories. The presented pharmacological company has its representative office in Russia, where it also manufactures this product.

Noliprel. Composition and form of release

The main components of Noliprel are and indapamide. It is sold in pharmacies in five formats: Noliprel has the lowest dosage of active substances, containing 2 mg of perindopril and 0.625 indapamide. Noliprel forte contains exactly twice as much of each of the components.

Noliprel A is also produced, with a content of 2.5 mg of the first component and 0.625 of the second. The next format - Noliprel A Forte, includes a double portion of the previous dosage. Noliprel A Bi-Forte comes in the largest consistency, collecting 10 mg of the first ingredient and 2.5 mg of the second.

The existing letter "A" in some interpretations indicates that in this preparation perindopril is supplemented with the amino acid arginine. Which, in turn, improves the condition of the heart and blood vessels.

Properties

It owes its characteristics to the main ingredients - perindopril and indapamide. The first of the list is known for fast absorption. Once in the body, it helps to lower blood pressure, reducing the load on the heart.

One fifth of the total volume ingested into the body is transformed into the active metabolite perindoprilat. The half-life is on average four hours.

This process can be somewhat delayed with existing renal and heart failure.

Indapamide is also rapidly absorbed from the gastrointestinal tract. Two-thirds of the entire portion comes out with urine, a quarter - with feces. Stimulates the excretion of sodium salts through the urinary system, which results in a decrease in blood pressure.

Purpose

Essential hypertension is the main reason for taking Noliprel.

It is also actively used in patients suffering from high blood pressure, but at the same time having type 2 diabetes mellitus. It is needed to reduce the risk of kidney microvascular complications and likely macrovascular complications in terms of cardiovascular disease.

Noliprel - instructions for use

You need to take it in the morning, on an empty stomach, before breakfast, one tablet once a day. Depending on the age and condition of the patient, the dosage is selected. If after thirty days the expected result has not been achieved, a single dose should be increased.

In elderly patients, before treatment, it is imperative to analyze the content of potassium in the body and perform a complete diagnosis of kidney function in order to avoid possible problems in the work of this organ in the future.

The initial dosage should be selected taking into account the work of the kidneys.

With a clearance of 30-60 ml / min. adjustments are not required. With readings of 60 and above, correction is also not required. At lower readings, an individual approach is required.

Overdose

The most common symptom is low blood pressure. In private situations, vomiting, nausea, convulsions may occur. In some cases, drowsiness, confusion were noted.

Gastric lavage is the first action to be taken in case of an overdose. To do this, you need to drink as much warm water as possible and press on the root of the tongue, thereby causing vomiting. After the procedure, you can take activated charcoal.

If there is too much pressure jump down, you should immediately put the patient down, slightly raising his legs, if necessary, you can enter drugs that raise blood pressure.

Side effects

In terms of the gastrointestinal tract, digestive disorders are often noted, accompanied by diarrhea, vomiting, and constipation. There may be disturbances in the perception of tastes, a feeling of thirst in the mouth, and often there is no appetite. Extremely rare, but still likely swelling of the intestine, pancreatitis. Possible manifestation of hepatic encephalopathy.

It is extremely rare, but still there is a decrease in the level of platelets, leukocytes, aplastic anemia, increased destruction of red blood cells. In the case of a kidney transplant, Noliprel can cause anemia.

Quite often there is a headache, dizziness, increased fatigue, mood swings, poor sleep, confusion.

Visual disturbances may occur, tinnitus is noted.

Too much pressure drop, with a sharp rise, dizziness and even fainting are observed, tachycardia, bradycardia, and arrhythmia are extremely rarely noted. Against the background of low blood pressure in patients at high risk, myocardial infarction may occur.

Prolonged dry cough, shortness of breath, bronchospasm, runny nose, eosinophilic pneumonia - all these side effects disappear immediately after discontinuation of this medication.

It is not excluded the likelihood of a rash on the skin, itching. Occasionally, swelling of the face or its individual parts, limbs of the body, mucous membranes of the mouth is noted. All these symptoms are noted in people with asthma or predisposed to allergic reactions. Erythema multiforme, Lyell's syndrome, a form of toxic epidermal necrolysis, and photosensitivity are extremely rare.

Quite often there are spasms in the muscles, less often, but kidney failure is also likely, its acute form of manifestation occurs extremely rarely.

Infrequently, but there are also cases of impotence, excessive sweating, chronic fatigue syndrome is often noted.

During the course of Noliprel, a decrease in the concentration of sodium and potassium ions in the blood is noted, at the same time, an increase in uric acid and glucose, creatinine may occur. All these indicators are aligned immediately after the end of the drug.

Contraindications

Do not prescribe Noliprel in the treatment of potassium-sparing diuretics, as well as with an increase in the blood of this microelement. It is also impossible to conduct a parallel course of treatment with antiarrhythmic drugs.

Pregnancy in any trimester, breastfeeding, and age under 18 are strong contraindications.

With the existing increased susceptibility to the ingredients of Noliprel, it is not worth prescribing it. If Quincke's edema occurs, it should also be excluded from therapy. Renal failure will also be a reason for refusal, especially in situations where the clearance is below 30 ml / min. Encephalopathy is also a good reason to choose a more suitable analogue that does not put such a burden on the liver.

In the presence of chronic heart failure at the time of instability, you should also not take Noliprel. Rheumatic diseases, including diffuse diseases of the connective tissue, for example, Sjögren's disease, dermatomyositis.

Treatment with immunosuppressants in parallel with Noliprel can lead to the appearance of agranulocytosis.

The state of depressed bone marrow hematopoiesis is also an undesirable syndrome for this drug. Treatment with diuretics, a salt-free diet, instability of glucose levels, high levels of uric acid in the blood, unstable blood pressure, arterial valve stenosis, as well as a condition after a kidney transplant - all these conditions are a good reason to choose a drug that is more suitable for indications among analogues.

Interaction

Noliprel has a "complex" character, so not every drug is in good contact with it. So, in combination with lithium, it is able to create its increased presence in the blood, as a result - toxic effects.

Concurrent therapy with thiazide diuretics leads to the same result. If there is a need to prescribe lithium preparations, constant monitoring of its level is required. Without special need, it is better not to prescribe such combinations.

In conjunction with NSAIDs, including Acetylsalicylic acid, there is a risk of a decrease in the diuretic result, and, as a result, a decrease in the effect of treatment. But, at the same time, with a strong loss of fluid, acute renal failure is possible.

Accompanied by the treatment of diuretics in high dosages, it can provoke a significant decrease in the body-centered cubic system and a strong decrease in blood pressure.

Baclofen can enhance the effect of Nolipril treatment, so with this tandem, you need to more carefully monitor the level of pressure, not forgetting to monitor kidney function. If necessary, immediately reduce the dosage.

In combination with tricyclic antidepressants, there is also the possibility of too much reduction in blood pressure, the possibility of dizziness when standing up and even the development of fainting is high.

In the treatment of glucocorticosteroids and tetracosactides, the removal of excess fluid from the body worsens, so the effectiveness of the antihypertensive drug may decline sharply.

ACE inhibitors delay the release of potassium through the kidneys. As a result, death may occur. To prevent such a result, it is necessary to check the content of potassium salts in the blood, it will not be superfluous to regularly conduct an ECG.

To prevent potassium levels from falling below the permissible level, antiarrhythmic drugs should be chosen with utmost care. Separate antipsychotics can also lead to a similar deviation. In such a tandem, constant monitoring of potassium levels is needed.

Laxatives can also lead to hypokalemia, in this case, monitoring of the level of potassium is also required, and if necessary, its correction. If there is a need to take laxatives, one should choose those that do not stimulate the bowels.

Metformin and indapamide in the complex can lead to kidney failure due to the diuretic effect of the second. There is also the possibility of accumulation of lactic acid in the blood.

Analogues

Co-Perineva, Perindide, Perindopril-Indapamide Richter. All of them are complete analogues of Noliprel, having the same ingredients. Therefore, in their characteristics, for the most part, they coincide with it. Available in various dosages, which allows you to more accurately adjust the course of treatment.

Despite the fact that all analogues have the same composition as Noliprel, the cost is different for everyone. On average, it starts from 250 and for some drugs reaches 1200 rubles per pack.

special instructions

If a person has never received treatment with perindopril and indapamide before, then at first, a comprehensive monitoring of his condition should be carried out, first of all, to exclude the appearance of hypokalemia. Also, the risk of idiosyncrasy cannot be ruled out. To minimize the likelihood of these side effects, monitoring is essential.

It must be taken into account that with severe swelling of the larynx, breathing difficulties are likely and even death is possible. With such an outcome, immediate adrenaline therapy is required. Extremely rare, but intestinal edema is also likely.

While taking Noliprel, there is a high probability of anaphylactic shock from a bee or wasp sting. For the same reasons, a parallel course of ACE inhibitors and immunotherapy based on bee venom should not be carried out.

In order to avoid trouble, taking poisonous drugs should be stopped at least a day before treatment.

Neutropenia may occur from Noliprel, the risk of this disease is higher in patients with kidney disorders. Depends solely on the size of a single serving. After the end of the course of treatment, all the symptoms of neutropenia disappear by themselves, without treatment. To reduce the risk of this deviation, you need to carefully monitor the dosage and compare all the pros and cons before treatment.

Often during therapy, a dry cough appears. As soon as the treatment ends, it goes away on its own. Whether or not to continue treatment against the background of such a deviation is decided by the doctor.

With renal insufficiency, CC below 30 ml / min Nolipril is undesirable, for treatment it is better to choose analogues containing one of its main components. If, during the course of treatment, tests revealed renal failure, it also makes sense to switch to an analogue with one of the leading components.

After a while, you can take Noliprel again, but at a lower dosage. At the same time, constant monitoring of the level of potassium and creatinine is necessary. As a rule, such monitoring is carried out for the first time two weeks after the start of administration, in the future, such an analysis should be done at least once every two months.

In patients suffering from stenosis of the arteries of the kidneys, the likelihood of hypotension is high. To avoid such an outcome, special attention should be paid to the water content in the body, especially after diarrhea or vomiting. Constant monitoring of electrolytes in the blood in this case is required.

If, however, there was too much decrease in blood pressure, you can enter intravenously 0.9% sodium chloride. A temporary too strong decrease in blood pressure is not a reason to cancel Noliprel. It is possible to switch to a lower dosage or use analogues containing one of the active components.

We must not forget that in addition to the main ingredients in Noliprel there are additional substances, one of which is lactose monohydrate. Therefore, people suffering from intolerance to this component or lactase deficiency should also choose one of the analogues.

In order to avoid anemia in people who have undergone a kidney transplant, monitoring the level of iron in the blood is required. The trend is that the higher its initial indicator, the higher the likelihood that it could fall below the maximum allowable level.

Such a reaction of the body does not depend on the dosage, therefore, in the first six months of the course, careful monitoring is needed, after which the situation stabilizes by itself. After discontinuation of the drug, the hemoglobin level is completely restored.

To avoid the development of hypotension and renal failure, especially in elderly patients and with pre-existing kidney disease, treatment should be started with a small dose, gradually increasing it until the desired result is achieved.

In addition to hypotension, it can also develop. Such a risk exists with bilateral renal stenosis, so it makes sense to start treatment with a low dosage, gradually bringing it up to the desired one, while not forgetting to control the level of potassium in the blood. After discontinuation of the drug, all symptoms disappear.

In the case of severe heart failure, therapy should also be started with minimal portions and at the same time constantly monitor the patient's condition. These recommendations also apply to insulin-dependent patients.

If, in addition to hypertension, the patient also has heart failure, in no case should beta-blockers be withdrawn from the course. They must be taken in combination with ACE inhibitors.

When conducting general anesthesia in those taking Noliprel, a too large jump in blood pressure down is likely, especially if the drug used for anesthesia also has a hypotensive property. Therefore, at least a day before taking the ACE inhibitor should be stopped. The anesthesiologist should also be informed about the use of these drugs.

With obstruction of the outflow tract of the left ventricle, therapy should be carried out with extreme caution.

Cholestatic jaundice as a fact may occur during treatment in patients with liver failure. If the processes are fast, liver necrosis may occur. In extreme cases, death is likely. The reasons for the appearance of such a deviation are unclear, therefore, at the first signs of jaundice or malfunctions in the liver, you should stop taking the drug and consult a doctor.

Hyponatremia is another diagnosis that can develop as a result of taking drugs that have a diuretic effect. The difficulty may also lie in the fact that at the beginning of treatment, symptoms may not appear, but occur after some time, so monitoring this indicator is required especially carefully.

If there are liver diseases, for example, cirrhosis, or the elderly, heart failure, then the likelihood of hyponatremia increases several times.

Against such a background, the chance of arrhythmias, including arrhythmias of the "pirouette" type, increases, as a result, in exceptional cases, a fatal outcome is likely.

Often occurring hypokalemia requires immediate treatment, which can be reduced to taking thiazide diuretics, which reduce the amount of excreted potassium from the body. As a result, the situation is stabilizing.

In this case, it is important to ensure that hypercalcemia does not occur, which can also occur against the background of such treatment. This deviation can also occur if a person had hyperparathyroidism, which was not detected in a timely manner.

With existing diabetes, constant monitoring of the patient's blood sugar is required.

The risk of gout occurs when too high levels of uric acid are present in the blood.

If the patient has malfunctions of the kidneys, when hyponatremia and hypovolemia appear during the procedures, there is a chance of a decrease in the glomerular filtration rate, against which a surge in the content of urea and creatinine in the body occurs.

When taken rarely, but photosensitivity situations still occur. With such a deviation, the reception should be stopped, if necessary, later you can start treatment again, but carefully hiding from direct sunlight.

Indapamide present in Noliprel is able to show a positive reaction to the presence of doping in the body, for these reasons it is not recommended for athletes to take it.

Noliprel can be taken by patients driving a car, but in some situations, if a person has special reactions to pressure reduction: dizziness and other disturbances in psychomotor function, driving should be abandoned.

Noliprel and alcohol, like most of these drugs, are not compatible. Moreover, such a combination can lead to a lot of complications, including death. Given the toxicity of alcoholic beverages, the load on the liver increases, contributing to its destruction.

The metabolism of Noliprel also takes place in the liver, as a result, too much responsibility falls on this organ, which can cause serious changes and cell death, as a result - alcoholic hepatitis or cirrhosis.

In addition to the negative impact on the liver, there is an increased load on the central nervous system. The ethanol contained in alcohol can increase the side effects of Noliprel on this side of the body.

The absorption of ACE inhibitors is also reduced due to alcohol intake, which contributes to a decrease in the therapeutic effect. After that, you will have to start the whole course again. In contrast, ethanol can also increase the effectiveness of the drug, which can lead to too much vasodilation and a significant decrease in blood pressure.

During pregnancy, the drug is contraindicated, so when planning one, you should immediately stop taking it and choose another one that is more suitable in this position. Not refusing to take Noliprel can cause fetal malformations and lead to abnormal development, for example, oligohydramnios, especially in the second and third trimesters. The drug can cause complications in newborn babies. A pregnant woman may develop hypovolemia.

Information that perindopril passes into breast milk is considered unreliable, but indapamide has such an ability. As a result, the baby is likely to increase sensitivity to sulfonamide derivatives, and there is also a possibility of nuclear jaundice, and the manifestation of hypokalemia is not excluded.

4.6

9 reviews

Sort

by date

I started taking it after belrepril, as it was called. Year was a terrible cough dry. Then like a verse. The pressure of the 6670 kept fine but there was another problem. Every six months there were attacks of gout. Sometimes more often. Went to rheumatologists. We watched and ordered tests, they say it looks like gout, but the fingers are normal. Uric acid 5 times... I started taking it after belrepril, as it was called. Year was a terrible cough dry. Then like a verse. The pressure of the 6670 kept fine but there was another problem. Every six months there were attacks of gout. Sometimes more often. Went to rheumatologists. We watched and ordered tests, they say it looks like gout, but the fingers are normal. Uric acid is 5 times higher than allowed. After 4 years of admission, he stopped holding pressure. I read on the Internet that diuretics cause gout in many hypertensive patients, or rather increase the level of uric acid. Basically, I'm my own doctor. I went to another specialist, described the situation, he agreed with me and prescribed a new drug. Now I drink exforge. 4 years. The dose probably needs to be increased a little, but it's just much better for me. There have been no more attacks of gout since. Cough too. Noliprel was not evaluated, since any drug affects different people differently and the side effects are also different.

It holds pressure well, but a terrible cough appeared, until I realized that I managed to drink a course of antibiotics on Nolipril, but nothing helped, I stopped taking it and gradually from 4 days the cough began to pass, and for now I remove the pressure with capoten

You can drink noliprel at night during the day, my blood pressure is normal as it rises in the evening and no pills help, I tried noliprel bi10 / 2.5 helped

I have been taking Noliprel Arginine for 10 years, there are no obvious side effects. I haven't measured my blood pressure every day for several years, so it happens from time to time. This drug suits me in combination with bisoprolol-ratiopharm in a low dosage

great drug! I have been taking it for 7 years, it reduces blood pressure, there is no headache, but there is a cough in the morning .... and a little expensive

I have been taking Noliprel for two months and have been suffering from a dry, throat-tearing cough for a month. They drove me to an x-ray, to a pulmonologist ... until they figured out that the reason was in this drug. It doesn't suit everyone. For me, it significantly undermined the quality of life.

I have been taking it for almost 2 years, it is an excellent medicine, only the price is high. In Makhachkala, 5 mg cost from 650 to 850 rubles.

Since January 2015, I have been taking Noliprel in combination with Lozap and Amlodipine. The pressure was very high, now it has dropped. Lozap, indapamide and amlodpine were taken before, there was no such effect. But I was just tormented by a dry cough, which bothers me less often during the day and especially often at night, starting from the moment when I just lie down ... Since January 2015, I have been taking Noliprel in combination with Lozap and Amlodipine. The pressure was very high, now it has dropped. Lozap, indapamide and amlodpine were taken before, there was no such effect. But I was simply tormented by a dry cough, which bothers me less often during the day and especially often at night, starting from the moment when I just go to bed. I even feel embarrassed in front of my neighbors, because I cough all the time. It is a pity, apparently, I will have to replace Noliprel with something else.

Noliprel helps me a lot. It has literally saved me for the past three years. I am hypertensive and fight high blood pressure only with Noliprel. Although it is expensive, but with such an effect that Noliprel gives, no money is a pity. Now I live calmly and feel fine. Of course, one day... Noliprel helps me a lot. It has literally saved me for the past three years. I am hypertensive and fight high blood pressure only with Noliprel. Although it is expensive, but with such an effect that Noliprel gives, no money is a pity. Now I live calmly and feel fine. Of course, once, apparently I bought either a fake, I have no more options, but it didn’t help at all. I drank the whole pack and not a single day was normal. After that, I bought it again and everything is fine. So, most likely Noliprel is faked and you need to be careful.