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Mechanism of action

NOLIPREL A BI FORTE is a combination antihypertensive drug containing Perindopril (an ACE inhibitor) and Indapamide (a diuretic from the group of sulfonamide derivatives). Pharmacological action Noliprel due to a combination of the individual properties of each of the components. The combination of perindopril and indapamide enhances the action of each of them.

Noliprel A forte has a pronounced dose-dependent hypotensive effect on both systolic and diastolic blood pressure in the supine and standing position. The effect of the drug lasts for 24 hours. Persistent clinical effect occurs less than 1 month after the start of therapy and is not accompanied by tachycardia. Discontinuation of treatment is not accompanied by the development of withdrawal syndrome.

Noliprel A forte reduces the degree of left ventricular hypertrophy, improves arterial elasticity, lowers round neck, does not affect lipid metabolism (total cholesterol, HDL, LDL, triglycerides) and does not affect carbohydrate metabolism (including in patients with diabetes).

Indications and usage

Essential arterial hypertension.


Hypersensitivity to perindopril and other ACE inhibitors;
Hypersensitivity to indapamide and sulfonamides;
Angioedema in history (including in patients receiving ACE inhibitors);
Renal failure severe (CC less than 30 ml / min);
Severe liver failure (including with encephalopathy);
Simultaneous administration of drugs that prolong the QT interval;

Dosage and administration

Adults are prescribed orally for 1 pill per day, preferably in the morning, before meals.

If possible, take the drug start with the selection of doses of single-component drugs. In the case of clinical need, consider the possibility of prescribing a combination therapy with the drug Noliprel A forte immediately after monotherapy.

Adverse reactions

Cardiovascular: excessive blood pressure reduction, orthostatic hypotension; in some cases - myocardial infarction, angina, stroke, arrhythmia.

Urogenital: rarely, reduced kidney function, proteinuria (in patients with glomerular nephropathy); in some cases, acute renal failure. A slight increase in the concentration of creatinine in the urine and blood plasma (reversible after discontinuation of the drug) is most likely in cases of renal artery stenosis, treatment of arterial hypertension with diuretic drugs, and the presence of renal failure.Perhaps (usually temporary) increase in the concentration of potassium in the blood plasma.

Nervous system: headache, fatigue, asthenia, dizziness, mood lability, visual disturbances, tinnitus, sleep disturbances, convulsions, paresthesias, anorexia, taste perception disorders; in some cases - confusion.

Respiratory: dry cough; rarely - difficulty breathing, bronchospasm; in some cases, rhinorrhea.

Gastrointestinal: abdominal pain, nausea, vomiting, constipation, diarrhea; rarely, dry mouth; in some cases - cholestatic jaundice, pancreatitis, increased activity of hepatic transaminases, hyperbilirubinemia.

Fluid and electrolyte balance: possible hypokalemia. Part of the drug perindopril, which has the ability to increase the concentration of potassium by inhibiting the renin-angiotensin-aldosterone system, reduces the potassium loss caused by indapamide. It was shown that in patients receiving noliprel, the decrease in potassium concentration was less than 3.4 mmol / l after 12 weeks of therapy in 2% of patients. Basically, the decrease in potassium concentration after 12 weeks of therapy was 0.1 mmol / l.

Hemic and lymphatic: anemia (in patients after kidney transplantation, hemodialysis); rarely - hypohemoglobinemia, thrombocytopenia, decrease in hematocrit; in some cases - agranulocytosis, pancytopenia; hemolytic anemia is possible (against the background of glucose-6-phosphate dehydrogenase deficiency).

Allergic reactions: skin rashes, itching; rarely - urticaria, angioedema; in some cases, erythema multiforme.

Other: rarely - increased sweating, decreased potency.

Special notes

The use of the drug Noliprel can cause a sharp decrease in blood pressure, especially when you first take the drug and during the first 2 weeks of therapy.

Storage conditions

In the dark place at a temperature of no higher than 30 ° C.

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