Description

Neomeril (perindopril erbumine) is the tert butylamine salt of perindopril, the ethyl ester of a non-sulfhydryl angiotensin – converting enzyme (ACE) inhibitor.

Composition

Each Neomeril 2 mg  tablet contains :

• Perindopril Erbumine : 2 mg.
• Excipients: S.Q. for one tablet.

Indications

Stable Coronary Artery Disease:

Neomeril tablets are indicated in patients with stable coronary artery disease to reduce the risk of cardiovascular mortality or nonfatal myocardial infarction.

Neomeril can be used with conventional treatment for management of coronary artery disease, such as antiplatelet, antihypertensive or lipid-lowering therapy.

Hypertension:

Neomeril tablets are used for the treatment of patients with essential hypertension, it could be used alone or given with other classes of antihypertensives, especially thiazide diuretics.

Dosage & Administration

Stable Coronary Artery Disease

Neomeril tablets should be given at initial dose of 4 mg once daily for 2 weeks, and then increased as tolerated, to a maintenance dose of 8 mg once daily.

In elderly patients (> 70 yrs), Neomeril tablets should be given as a 2 mg dose once daily in the first week, followed by 4 mg once daily in the second week and 8 mg once daily for maintenance dose if tolerated.

Hypertension

Use in uncomplicated hypertensive patients: in patients with essential hypertension, the recommended initial dose is 4 mg once a day. The dosage may be titrated upward until blood pressure, when measured just before the next dose, is controlled or to maximum of 16 mg per day. The usual maintenance dose range is 4 mg to 8 mg administered as a single daily dose. Neomeril tablets may also be administered in two divided doses.

Use in the elderly patients: the recommended initial daily dosage of Neomeril tablets for the elderly (> 65 years) is 4 mg daily, given in one or two divided doses. The daily dosage may be titrated upward until blood pressure, when measured just before the next dose, is controlled, dosages above 8 mg should be administered with caution and under close medical supervision.

Use in concomitant diuretics: if blood pressure is not adequately controlled with Neomeril alone, a diuretic may be added. In patients currently being treated with a diuretic, symptomatic hypotension occasionally can occur following the initial dose of Neomeril , to reduce such reaction, the diuretic should if possible, be discontinued 2 to 3 days prior to the beginning of Neomeril tablets therapy. Then, if blood pressure is not controlled with Neomeril alone, the diuretic should be resumed, if the diuretic cannot be discontinued, an initial dose of 2 to 4 mg daily in one or in two divided doses should be used with careful medical supervision for several hours and until blood pressure has stabilized. The dosage should then be titrated as described above.

Dose adjustments in renal impairment: for patients with creatinine clearance below (30 mL/min), safety and efficacy of Neomeril have not been established. For patients with creatinine clearance above (30 mL/min), the initial dosage should be 2 mg/day and dosage should not exceed 8 mg/day. During dialysis, Neomeril is removed with the same clearance as in patients with normal renal function.