Introduction
Coveram 4/10 is used to treat hypertension (high blood pressure). This is a combination of two medicines that controls blood pressure when a single medication is not effective. It helps to lower high blood pressure and thus reduces the chances of future heart attack and stroke.
You can take Coveram 4/10 at any time of day, on empty stomach, but it is best to take it at the same time each day. Keep taking it for as long as advised by your doctor. Even if you feel well, do not stop this medicine on your own because high blood pressure often has no symptoms. If you stop taking it, your condition may get worse. Keeping active with regular exercise, reducing your weight and eating a healthy diet will also help control your blood pressure. Follow your doctor's advice while taking this medicine.
It may cause side effects like ankle swelling, headache, cough, weakness, and tiredness. It may also cause dizziness, so do not drive or do anything that requires mental focus until you know how this medicine affects you. This might raise the level of potassium in the blood, hence avoid potassium rich food or supplements. You may be asked for regular monitoring of blood pressure, kidney function, and electrolytes level while on the treatment.
Before taking it, let your doctor know if you have any liver or kidney problems. Pregnant or breastfeeding women should also consult their doctor for advice before taking this medicine. You also need to tell your doctor what other medicines you are taking especially those used to treat high blood pressure or heart conditions.
Uses of Coveram 4/10
- Hypertension (high blood pressure)
Side effects of Coveram 4/10
Common
- Ankle swelling
- Headache
- Tiredness
- Palpitations
- Increased potassium level in blood
- Sleepiness
- Cough
- Taste change
- Flushing (sense of warmth in the face, ears, neck and trunk)
- Decreased blood pressure
- Upset stomach
How to use Coveram 4/10
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Coveram 4/10 is to be taken empty stomach.
How Coveram 4/10 works
Coveram 4/10 is a combination of two medicines: Amlodipine and perindopril which lower blood pressure effectively. It works by relaxing blood vessels so that blood flows more smoothly and the heart can pump blood more efficiently.
Indication
Indicated for the treatment of hypertension in patients whose blood pressure is not adequately controlled on monotherapy or as initial therapy in patients likely to need multiple drugs to achieve blood pressure goals
Administration
Should be taken on an empty stomach.
Adult Dose
Hypertension
Indicated for the treatment of hypertension in patients whose blood pressure is not adequately controlled on monotherapy or as initial therapy in patients likely to need multiple drugs to achieve blood pressure goals
Tablet
4 mg/5 mg PO qDay with or without food
Adjust dose according to blood pressure goals; wait 7-14 days between titration steps
Not to exceed 14 mg/10 mg qDay
Hepatic impairment: There are no data to guide dosing recommendations
Renal Dose
Renal Impairment
CrCl <30 mL/min: Not recommended
CrCl 30-80 mL/min (mild or moderate renal impairment): Do not exceed 7/5 mg
Contraindication
History of idiopathic angioedema. Severe hypotension, shock (e.g. cardiogenic shock), left ventricular outflow tract obstruction (e.g. high grade aortic stenosis), heart failure after acute MI. Pregnancy and lactation. Concomitant use w/ aliskiren esp in patients w/ DM or renal impairment (GFR <30 mL/min/1.73 m2).
Mode of Action
Perindopril, a prodrug of perindoprilat, is an ACE inhibitor which prevents convertion of angiotensin I to angiotensin II, thereby increasing plasma renin activity and decreasing vasoconstriction and aldosterone secretion.
Amlodipine, a dihydropyridine Ca channel blocker, inhibits transmembrane influx of Ca ions into vascular smooth muscle and cardiac muscle thereby causing relaxation and vasodilation. It also directly acts on vascular smooth muscle causing reductions in peripheral vascular resistance and BP.
Precaution
Patient w/ salt or volume depletion, severe obstructive coronary artery disease, renal artery and mitral and severe aortic stenosis, ischemic heart disease or cerebrovascular disease, hypertrophic cardiomyopathy w/ outflow tract obstruction, cardiac failure, collagen vascular disease. Hepatic and renal impairment. Elderly. Patient undergoing major surgery or during anaesthesia; desensitisation treatment (e.g. hymenoptera venom).
Lactation: Unknown if distributed in human breast milk; because of the potential for adverse effects on the nursing infant, decide whether to discontinue nursing or discontinue the drug
Side Effect
1-10%
Peripheral edema (7.2%)
Cough (3.2%)
Headache (2.5%)
Dizziness (2.5%)
Frequency Not Defined
Dermatologic: Rash
Digestive: Nausea, diarrhea
Interaction
Increased hypotensive effects w/ antihypertensive agents (e.g. β-blockers), diuretics, and vasodilators. May increase serum levels and toxicity of lithium. May cause nitritoid reactions w/ Na aurothiomalate. Increased risk of angioneurotic oedema w/ estramustine. May increase hypoglycaemic effect w/ insulin or sulfonamides. Increased antihypertensive effect and risk of orthostatic hypotension w/ TCAs, antipsychotics, anaesthetics, α-blockers. May increase risk of angioedema w/ mammalian target of rapamycin (mTOR) inhibitors (e.g. sirolimus, everolimus, temsirolimus). May cause worsening of renal function and loss of antihypertensive effect w/ NSAIDs. Decreased antihypertensive effects w/ NSAIDs and sympathomimetics.