Престанс

Престанс – the drug of a combination of an amlodipin and perindopril which is applied to treatment of primary and secondary hypertensia, stenocardia, chronic coronary heart disease. Престанс treats APF inhibitors in combinations and to blockers of calcium channels in combinations.

Pharmacological action of Prestans

Престанс consists of two active operating components of various direction – anti-anginal and anti-hypertensive. Action of each component and drug in general is treated apart.

Perindopril in Prestans inhibits a kininaza of II – enzyme which turns angiotensin I into vasoconstrictive angiotensin II and vasodilating bradikinin destroys to inactive heptapeptide.

Inactivating bradykinin, APF increases activity not only circulating, but also fabric kinin-kallikrein system, along with activation of system of prostaglandins.

Therapeutic action of a perindopril is caused by APF inhibition an active metabolite perindoprilaty. Престанс use for treatment of any degree of complexity of arterial hypertension. Its use promotes decrease in diastolic and systolic arterial pressure, both in a prone position, and in a standing position. Reducing OPSS, perindoprit improves a peripheral blood stream, the ABP reduces, without influencing ChSS. Increasing a renal blood stream, drug does not change at the same time a glomerular filtration rate.

Perindopril in Prestans expands vessels, recovers elasticity of large arteries and structure of vascular walls of small arteries, reduces a hypertrophy of a left ventricle.

After one-time reception the maximum anti-hypertensive action is reached in 4-6 hours and 24 hours proceed. Very quickly reducing the ABP, drug with rather high performance continues to work also 24 hours later after reception.

Less than in a month from the beginning of reception of Prestans the therapeutic effect occurs. Drug does not cause dependence, phase-out is not followed by a withdrawal.

Decline in mortality as a result of diseases of cardiovascular system and essential reduction of frequency of development of complications at reception of a perindopril is confirmed.

Amlodipin in Prestans blocks slow calcium channels of groups of derivatives of dihydropyridine. At the level of dihydropyridinic receptors interferes with receipt of calcium ions to smooth muscle cells of vessels and a myocardium. The anti-hypertensive action of an amlodipin prolonged and dozozavisimy. Weakening unstriated muscles of vessels, promotes expansion:

• The main coronary arteries and arterioles (including and in the zones of a myocardium affected with ischemia);
• Peripheral arterioles.

Influence of an amlodipin in Prestans on atrioventricular and sinus nodes is poorly expressed, delay of AV-conductivity is insignificant. Decrease in aggregation of thrombocytes promotes increase in a glomerular filtration rate, accelerates removal of sodium and a diuresis. As a result of the prolonged effect of the ABP decreases smoothly, reflex stimulation of a sympathetic nervous system is minimum. At AG extent of hypertrophic change of a myocardium of a left ventricle significantly decreases.

At stenocardia the single daily dose of an amlodipin in Prestans allows to increase the general time of exercise stresses, to detain time of approach of attacks of stenocardia, having reduced their frequency therefore to reduce a dose of the consumed nitroglycerine.

At arterial hypertension the single daily dose of drug will provide considerable decrease in the ABP for 24 hours in a standing position and lying, not causing acute hypotension because of the slow beginning of action.

Lack of negative influence on the level of lipids in a blood plasma and a metabolism is proved that allows to appoint drug to patients in case of bronchial asthma, a diabetes mellitus and gout.

Престанс – the combination perindoprit also an amlodipin, promotes decrease:

• Frequencies of attacks of stenocardia;
• Risk of development of a heart attack;
• Cardiovascular mortality.

Form of release of Prestans

Престанс tablets of white color, biconvex, on one party an engraving – a logo of the producer, on another – a quantitative ratio of maintenance of a perindoprila/amlodipin. The form of tablets depends on this ratio:

• Oblong – 5/5;
• Square – 5/10;
• Triangular – 10/5;
• Round – 10/10.

Excipients: microcrystallic cellulose, monohydrate of lactose, magnesium stearate, silicon dioxide colloid anhydrous.

Tablets of Prestans are packed up in polypropylene bottles with the doser on 30 pieces, a bottle in a cardboard pack with control of the first opening.

Analogs of Prestans

Analog of Prestans on the active operating component – Dalnev's tablets.

Analogs of Prestans on the mechanism of influence of one pharmacological subgroup – Triapin, the Equator, Koripren, Ekvakard, Enanorm.

Indications to use of Prestans

According to the instruction, Prestans appoint the patient:

• Arterial hypertension;
• Coronary heart disease with a stable angina of exertion when therapy perindoprily in a complex with amlodipiny is required.

Contraindications

According to the instruction, Prestans is not appointed in a case:

• The Quincke's disease (Quincke's edema) provoked by the previous reception of APF inhibitors in the anamnesis;
• Hereditary or idiopathic Quincke's disease;
• The expressed hypotension (SD is less than 90 mm hg);
• Shock, including cardiogenic;
• Obstructions of an output way of a left ventricle (stenosis of an aorta or other);
• Unstable stenocardia (exception Printsmetal's stenocardia);
• Heart failure after the postponed acute myocardial infarction (the first 28 days);
• Pregnancy and entire period of a lactation;
• Hereditary lactose intolerance, lactose intolerance, glyukozo-galaktozny malabsorption;
• Renal failure (KK is less than 60 ml/min.);
• Age up to 18 years (safety and efficiency were not studied);

According to the instruction, Prestans is not appointed at hypersensitivity to an amlodipin (other derivatives of dihydropyridine), to a perindopril (APF other inhibitors), to the excipients which are a part of drug.

Route of administration of Prestans

According to the instruction, Prestans accept on 1 tablet a day in the morning before food. The ratio of the operating components and duration of therapy are defined by the doctor.

Side effects

According to reviews, Prestans often causes:

• Drowsiness, headache, dizziness;
• Visual disturbance;
• Sonitus;
• Heartbeat, rushes of blood, decrease in the ABP;
• Short wind, cough;
• Abdominal pain, nausea, vomiting, diarrhea, lock;
• Skin itch, rash;
• Spasms of muscles.

Also Prestans, according to reviews, causes sometimes other frustration. In case of manifestation of any side effects urgent consultation of the doctor is necessary.

At arterial hypertension or an ischemic heart disease of Prestans, according to reviews, promotes improvement of health and stabilization of a state for long time.

Storage conditions of Prestans

Престанс it is necessary to store in the place, unavailable to children, at a temperature not above 30 °C, in original packaging, the bottle has to be densely closed. Period of storage 2 years.