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Introduction About ZIMPRIL 4MG TABLET
ZIMPRIL 4MG TABLET contains Perindopril which belongs to the group of medicines called Angiotensin Converting Enzyme Inhibitors. It is used to manage hypertension in adults. Hypertension is a condition in which the force of the blood against blood vessel walls is too high. Symptoms of hypertension includes early morning headaches, irregular heartbeat, vision changes, feeling overtiredness, vomiting, confusion, anxiety, and chest pain. It is also used to manage heart failure (a condition where the pumping of heart is inadequate to meet body’s need which is characterized by shortness of breath, fatigue, fast heartbeat.). It also reduces the risk of cardiac events such as heart attack in patients with stable coronary artery disease (a condition where the blood supply to the heart is reduced or blocked resulting in pain or discomfort in chest, arms or shoulders; weakness, light-headedness and feeling sick), in patients who have the history of heart attack and/or an operation to improve blood supply to heart.
Perindopril works by inhibiting the activity of an enzyme called angiotensin converting enzyme (an enzyme which is responsible for causing constriction of blood vessels), resulting in easy flow of blood around the body. Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (Ex. potassium) in your body prior to the management or at regular intervals along with the management.
ZIMPRIL 4MG TABLET is not recommended for use in patients having kidney artery stenosis. ZIMPRIL 4MG TABLET should be used in caution with patient having aortic stenosis, hypertrophic cardiomyopathy, diabetes, liver, and kidney problems or under dialysis. If you are pregnant or breast-feeding, consult your doctor for advice before taking this medicine. ZIMPRIL 4MG TABLET is not recommended for use in children and adolescents up to the age of 18 years. The most common side effects of taking ZIMPRIL 4MG TABLET are low blood pressure, headache, dizziness, muscle cramps, shortness of breath, cough and headache. Consult your doctor if the symptoms worsen.
Uses Of ZIMPRIL 4MG TABLET
- To manage hypertension (high blood pressure)
- To manage heart failure (a condition where the pumping of heart is inadequate to meet body’s need)
- To reduce the risk of heart attack in patients with stable coronary artery disease (a condition where the blood supply to the heart is reduced or blocked) and in patients who have the history of heart attack and/or in surgeries to improve blood supply to the heart
How ZIMPRIL 4MG TABLET Works
ZIMPRIL 4MG TABLET works by inhibiting the activity of an enzyme called angiotensin converting enzyme (an enzyme which is responsible for causing constriction of blood vessels), resulting in easy flow of blood around the body.
How to use ZIMPRIL 4MG TABLET
Take ZIMPRIL 4MG TABLET as advised by your physician. Take it before meals. Swallow this medicine, do not crush, or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.
Side Effects Of ZIMPRIL 4MG TABLET
Common
- low blood pressure
- dizziness
- feeling of spinning (vertigo)
- tingling or prickling sensation
- vision disturbances
- tinnitus (ringing sensation in the ears)
- cough
- shortness of breath
- gastrointestinal disorders (nausea, vomiting, abdominal pain, altered taste sensation or difficulty of digestion, diarrhoea, constipation)
- allergic reactions like skin rashes, itching
- muscle cramps
- feeling of weakness
- headache
Uncommon
- mood swings
- sleep disturbances
- dry mouth
- intense itching or severe skin rashes
- formation of fluid filled blister over the skin (pemphigoid)
- signs of kidney problems such as loss of appetite, decreased urinary output, fatigue
- impotence
- sweating
- signs of high levels of eosinophils in blood like weight loss, night sweats, cough
- fainting
- fast heartbeat
- signs of vasculitis (inflammation of blood vessels) such as joint pain and swelling, weight loss
- signs of increased sensitivity of the skin to sun like excessive sun rash and sun burn
- joint pain
- muscle pain
- chest pain
- general discomfort
- fever
- low blood sugar level (in diabetic patients)
- signs of high potassium levels like shortness of breath, chest pain, nausea, or vomiting
- signs of low sodium levels like whole body dizziness, fatigue, lethargy, weakness, or thirst
Rare
- signs of inappropriate antidiuretic hormone secretion like dark urine, decreased or absent urine output, feeling sick, muscle cramps, confusion, seizures (jerking movements of hands and legs)
- flushing
- decreased or absent urine output
- symptoms of acute renal failure like decreased urinary output, swelling due to fluid retention, nausea, fatigue, and shortness of breath.
Stop taking ZIMPRIL 4MG TABLET and contact your doctor immediately if you experience any of the following side effects:
- angioedema (painless swelling seen in face, lips, mouth, tongue, or throat)
- severe dizziness or sudden temporary loss of consciousness caused by low blood pressure
- irregular heartbeat or fast heartbeat, chest pain or heart attack
- signs of stroke like difficulty in walking, speaking, and understanding
- sudden wheezing, tightness in chest, difficulty in breathing (bronchospasm)
- inflammation of pancreas which may cause severe abdominal and back pain
- signs of hepatitis like jaundice (yellowing of skin and eyes)
- skin rash with red itchy patches on your face, arms or legs (erythema multiforme)
How To Manage Side Effects
Diarrhea
Drink lots of fluids, such as water or fruit juice to keep yourself hydrated. Do not consume any medicine on your own without consulting your doctor.
Dizziness Or Drowsiness
When you feel dizzy, lie or sit down immediately. If you're experiencing a severe episode of vertigo, lie in a dark and quite place with eyes closed. Vehicle driving should be avoided if you experience frequent dizziness without warning. Talk to your doctor if the symptom worsens.
Nausea And Vomiting
Take this medicine with, or just after meals. Stick to simple meals. Avoid eating oil rich or spicy foods, sugary snacks, and drinks. Avoid drinking too much liquid along with your meals. Consult your doctor if your symptom worsens.
Stomach Pain
Try to rest and relax. Try to have smaller and frequent meals. Keep a warm pad on your stomach. If the symptom does not improve, contact your doctor.
Warning & Precautions
Pregnancy
ContraindicatedZIMPRIL 4MG TABLET is not recommended in early pregnancy and must not be taken when more than three months pregnant, as it may cause serious harm to the baby if used after 3rd month of pregnancy. Consult your doctor before taking ZIMPRIL 4MG TABLET.
Breastfeeding
ContraindicatedZIMPRIL 4MG TABLET is not recommended for use in breastfeeding women. Your doctor may prescribe an alternative medicine especially if you want to breast-feed when your baby is new-born or born prematurely. Consult your doctor for advice before taking ZIMPRIL 4MG TABLET.
Driving and Using Machines
Use with CautionDo not drive or operate any machines if you feel dizziness or weakness due to low blood pressure after taking ZIMPRIL 4MG TABLET. Consult your doctor before taking ZIMPRIL 4MG TABLET.
Alcohol
Consult your doctorAvoid consumption of alcohol as it may increase the risk of low blood pressure, dizziness and lightheaded
Kidney
Consult your doctorZIMPRIL 4MG TABLET is not recommended for use in patients with kidney artery stenosis (narrowing of blood vessels to one or both the kidneys). ZIMPRIL 4MG TABLET should be used in caution with patients having other kidney problems or under dialysis. Consult your doctor before taking ZIMPRIL 4MG TABLET.
Liver
Use with CautionZIMPRIL 4MG TABLET should be used with caution in patients having liver problems. Consult your doctor before taking ZIMPRIL 4MG TABLET.
Allergy
ContraindicatedZIMPRIL 4MG TABLET is not recommended for use if you are allergic to Perindopril or any other ACE inhibitors like captopril, enalapril.
Heart Disease
Use with CautionZIMPRIL 4MG TABLET should be used in caution with patients having aortic stenosis (narrowing of the main blood vessel in heart), hypertrophic cardiomyopathy (condition in which heart muscle become thick abnormally) or any other heart problems. Before taking ZIMPRIL 4MG TABLET consult with your doctor.
Use In Pediatrics
ContraindicatedZIMPRIL 4MG TABLET is not recommended for use in children and adolescents (under 18 years of age). Talk to your doctor before taking ZIMPRIL 4MG TABLET.
Use In Geriatrics
ContraindicatedZIMPRIL 4MG TABLET is used with caution in patients above 60 years of age. Before taking ZIMPRIL 4MG TABLET, consult your doctor.
Others
ZIMPRIL 4MG TABLET is not recommended for use if you have:
- family history of angioedema
Before taking ZIMPRIL 4MG TABLET, inform your doctor if you have:
- primary aldosteronism
- collagen vascular disease such as systemic lupus erythematosus or scleroderma
- to undergo anaesthesia and/or major operation, LDL apheresis (which is removal of cholesterol from your blood by a machine), desensitization management to reduce the effects of an allergy to bee or wasp stings
- recent history of diarrhoea and vomiting
- diabetes
- salt restricted diet or using salt substitutes containing potassium, intolerance to some sugars
- dehydration problems
Interactions
A. Drug - Drug interactions:
Before taking ZIMPRIL 4MG TABLET, inform your doctor if you are taking any of the following medicine:
- angiotensin II receptor blockers used to manage high blood pressure (Ex. Telmisartan, losartan, valsartan)
- aliskiren (medicine used to manage high blood pressure)
- diuretics such as furosemide, hydrochlorothiazide (used to manage oedema or high blood pressure)
- medicines that may increase blood potassium levels such as salt substitutes containing potassium, potassium-sparing diuretics (Ex. amiloride, spironolactone)
- antibiotic trimethoprim (medicine used to manage urinary tract infections)
- immunosuppressive agents such as ciclosporin or tacrolimus (used to manage organ rejection after transplant)
- heparin (medicine used to manage blood clot)
- non-steroidal anti-inflammatory drugs - medicines used to manage pain and inflammation (Ex. aspirin, ibuprofen)
- baclofen (medicine used for muscle spasm)
- medicines containing lithium (used to manage some types of depression)
- antidepressants such as citalopram, fluoxetine, paroxetine (medicine used to manage depression)
- estramustine (medicine used in cancer therapy)
- procainamide (used for management of irregular heartbeat)
- medicines such as ephedrine, noradrenaline or adrenaline used to manage low blood pressure, shock, or asthma
- vasodilators including nitrates like nitro-glycerine, isosorbide (medicine that make the blood vessels become wider)
- medicines which are most often used to manage diarrhoea (Ex. racecadotril)
- medicines used to manage to manage diabetes (insulin or metformin)
- allopurinol (medicine used to manage gout)
- gold salts (used to manage symptoms of rheumatoid arthritis)
- valsartan (medicine used to manage long-term heart failure)
- Mammalian target of rapamycin (mTOR inhibitors) like sirolimus, everolimus (medicines used to avoid rejection of transplanted organs)
Overdosage:
If you or anyone else accidentally take too much of ZIMPRIL 4MG TABLET, consult your doctor immediately or visit the nearby hospital. The most common symptom of overdose is low blood pressure (which can make you feel dizzy, or fainting).
Synopsis
| Drug | : | Perindopril |
| Pharmacological Category | : |
Angiotensin converting enzyme inhibitors |
| Therapeutic Indication | : | Hypertension, management of heart attack and stroke |
| Dosage Forms | : | Tablet |
More Information
- keep ZIMPRIL 4MG TABLET out of reach of children
- Store at room temperature
FAQs About ZIMPRIL 4MG TABLET
Q: Can ZIMPRIL 4MG TABLET be used to manage high blood pressure?
A: ZIMPRIL 4MG TABLET can be considered to manage high blood pressure. It contains perindopril which helps to relax the blood vessels and then normalize the blood pressure. Although, ZIMPRIL 4MG TABLET can manage high blood pressure, you doctor might manage you with other drugs depending upon your condition.
Q: Can ZIMPRIL 4MG TABLET cause low blood pressure (hypotension)?
A: Yes. ZIMPRIL 4MG TABLET can causes fall in blood pressure especially during the first few days of management. Tell your doctor if you experience lightheaded or have any feeling of fainting. Your risk of low blood pressure may be higher if you don’t drink enough fluids and sweat heavily.
Q: What should I avoid while taking ZIMPRIL 4MG TABLET?
A: Potassium supplements, potassium-containing salt substitutes and even high-potassium foods (Ex. Banana, avocado, potato) should be avoided by those taking perindopril, unless directed otherwise by their doctor.
Q: What precautions do I need to follow while taking ZIMPRIL 4MG TABLET?
A: Patients taking ZIMPRIL 4MG TABLET must inform their doctor about their pre-existing disease conditions like kidney, heart, or liver problems. Consult your doctor immediately if you experience any unusual symptoms after taking ZIMPRIL 4MG TABLET.
Q: What happens if I stop taking ZIMPRIL 4MG TABLET?
A: Do not stop taking ZIMPRIL 4MG TABLET without talking to your doctor first. Stopping this medicine suddenly can cause your blood pressure to spike and may increase the risk for heart attack or stroke.
References
1. KD. Tripathi. Drugs Affecting Renin Angiotensin System. Essentials of medical pharmacology. Eighth edition. 2019. Page – 532-533.
2. Andrew Thomson and Mary Greenacre. Perindopril: the evidence of its therapeutic impact in hypertension. NIH National Library of Medicine, National center for biotechnology information. PubMed Central. March 2007. [Accessed 13th May 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3012553/
3. Enisa Hodzic, Ehlimana Pecar, Alen Dzubur, Elnur Smajic, Zorica Hondo, Daniela Delic, and Edhem Rustempasic. Efficacy and Safety of Perindopril in Patients with Essential Hypertension. NIH National Library of Medicine, National center for biotechnology information. PubMed Central. March 2020. [Accessed 13th May 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7219713/
4. Tillomed LaboratoriesLtd. Electronic Medicines Compendium (EMC). [Revised in September 2021] [Accessed 13th May 2022] https://www.medicines.org.uk/emc/files/pil.9913.pdf
5. Patheon Pharmaceuticals, Inc. U.S. Food & Drug Administration [Revised in March 2012] [Accessed 13th May 2022] https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020184s019lbl.pdf
Useful Diagnostic Tests
- kidney function test
- electrolyte test
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