Parnavel, 8 mg capsules 30 pcs

Perindopril is an angiotensin-converting enzyme (ACE) inhibitor, or kininase II, related to exopeptidases. It converts angiotensin I to the vasoconstrictor angiotensin II and degrades the vasodilator bradykinin to an inactive heptapeptide. Suppression of ACE activity leads to a decrease in angiotensin II concentration and an increase in plasma renin activity (suppressing the negative feedback of renin release) and a decrease in aldosterone secretion. Since ACE also destroys bradykinin, ACE suppression also leads to an increase in circulating and tissue kallikrein-kinin system activity, with activation of the prostaglandin system.
Perindopril has therapeutic effect due to the active metabolite perindoprilat.
Perindopril reduces both systolic and diastolic blood pressure (BP) in lying and standing position. Perindopril reduces total peripheral vascular resistance (TPR), which leads to a decrease in BP. At the same time, peripheral blood flow is accelerated. However, heart rate (HR) does not increase. Renal blood flow tends to increase, while glomerular filtration rate does not. Maximum antihypertensive effect is achieved 4-6 hours after a single oral perindopril administration; the antihypertensive effect persists for 24 hours.
BP reduction develops rapidly. Stabilization of antihypertensive effect is observed after 1 month of therapy and persists for a long time. Discontinuation of therapy is not accompanied by development of “withdrawal” syndrome.
Perindopril reduces left ventricular myocardial hypertrophy. With long-term use, it reduces the severity of interstitial fibrosis, normalizes myosin isoenzyme profile. Increases the concentration of high-density lipoproteins (HDL), in patients with hyperuricemia reduces the concentration of uric acid.
Perindopril improves elasticity of large arteries, eliminates structural changes in small arteries.
Perindopril normalizes heart function by reducing pre- and post-load.
In patients with chronic heart failure (CHF) against the background of perindopril therapy the following was noted:
– reduction of filling pressure in the left and right ventricles,
– reduction of PPS,
– increase in cardiac output and cardiac index.
The initial dose of perindopril 2 mg in patients with CHF class 1-2 according to NYHA classification was not accompanied by statistically significant BP reduction compared to placebo.

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