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Review
. 2022 Mar;22(2):219-230.
doi: 10.1007/s40256-022-00521-0. Epub 2022 Mar 8.

Perindopril/Indapamide/Amlodipine in Hypertension: A Profile of Its Use

Yahiya Y Syed  1
Affiliations
Review

Perindopril/Indapamide/Amlodipine in Hypertension: A Profile of Its Use

Yahiya Y Syed. Am J Cardiovasc Drugs. 2022 Mar.

Erratum in

Abstract

The single-pill combination (SPC) of perindopril (PER)/indapamide (IND)/amlodipine (AML) is a valuable and convenient treatment option for patients with hypertension controlled with two-drug SPC of PER/IND + AML given as two separate pills at the same dose level. PER [an angiotensin-converting enzyme (ACE) inhibitor], IND (a thiazide-like diuretic) and AML (a calcium channel blocker) are well established antihypertensive agents, which have been available for a long time as monotherapies and dual SPCs and have complementary mechanisms of action. Once-daily PER/IND/AML provided effective BP control, with good tolerability, in patients with uncontrolled hypertension in clinical trials and in large observational prospective studies. The efficacy and tolerability of PER/IND/AML was similar to that of PER/IND + AML in a randomized clinical trial. The therapeutic effect of PER/IND/AML was associated with improved health-related quality of life. Thus, switching from the two-pill PER/IND + AML regimen to single-pill PER/IND/AML reduces pill burden and simplifies drug administration, which may improve adherence to treatment, leading to better BP control and clinical outcomes.

Plain language summary

Approximately one-quarter of patients with hypertension require three antihypertensive agents to achieve BP control. However, complex treatment regimens and high pill burden reduce treatment adherence, which in turn leads to poor BP control. Perindopril (PER), indapamide (IND), amlodipine (AML) belong to the core drug classes for the treatment of hypertension. These drugs have been available for a long time as monotherapies and two-drug single-pill combinations. Once-daily PER/IND/AML provides very good BP control in patients with uncontrolled hypertension and is generally well tolerated. The single-pill PER/IND/AML has similar efficacy and tolerability to PER/IND + AML given as two separate pills. Therefore, switching from PER/IND + AML to PER/IND/AML reduces pill burden and simplifies the treatment regimen, which may improve adherence to treatment, leading to better BP control and clinical outcomes. Thus, PER/IND/AML is a valuable and convenient treatment option for patients with hypertension controlled with PER/IND + AML at the same dose level.

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Conflict of interest statement

Yahiya Y. Syed is a salaried employee of Adis International Ltd/Springer Nature, and declares no relevant conflicts of interest. All authors contributed to the review and are responsible for the article content.

Figures

Fig. 1
Fig. 1
Efficacy of perindopril/indapamide/amlodipine against different grades of hypertension in a 3-month prospective observational study (PETRA) [49]. DBP diastolic blood pressure, SBP systolic blood pressure
Fig. 2
Fig. 2
Treatment-emergent adverse events reported in ≥ 1% of patients in any treatment group in a randomized, double-blind trial in patients with hypertension [36]. θ incidence 0%, ↑ increased, P perindopril 5 mg, I indapamide 1.25 mg, A amlodipine 10 mg
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