Perindopril/Amlodipine (Prestalia®): A Review in Hypertension

Abstract

Perindopril, an ACE inhibitor, and amlodipine, a dihydropyridine calcium channel blocker, are established antihypertensive agents with complementary mechanisms of action. Recently, a once-daily, orally-administered, fixed-dose combination (FDC) of perindopril arginine plus amlodipine besylate (Prestalia®; hereafter referred to as perindopril/amlodipine FDC) was approved in the USA for the treatment of hypertension. This article reviews the efficacy and tolerability of perindopril/amlodipine FDC and briefly summarizes the agent’s pharmacologic properties. As demonstrated in short-term randomized controlled trials, perindopril/amlodipine FDC was significantly more effective in reducing blood pressure (BP) than monotherapy with either of the component drugs, and it appeared to be more effective than an up-titration scheme using valsartan and valsartan/amlodipine. The FDC agent was generally well tolerated, with the most common adverse events (peripheral edema, cough, headache, and dizziness) being consistent with the well-defined tolerability profiles of the individual component drugs. Furthermore, perindopril/amlodipine FDC was associated with a numerically lower incidence of peripheral edema compared with amlodipine monotherapy. Thus, perindopril/amlodipine FDC represents a useful option for the treatment of hypertension, including as initial therapy for patients likely to require multiple drugs to achieve their BP targets.

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Acknowledgments

During the peer review process, the manufacturer of perindopril/amlodipine FDC (Prestalia®) was offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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Correspondence to Matt Shirley.

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The preparation of this review was not supported by any external funding.

Conflicts of interest

Matt Shirley and Paul McCormack are salaried employees of Adis/Springer, are responsible for the content, and declare no relevant conflicts of interest.

Additional information

The manuscript was reviewed by: T. H. Le Jemtel, Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, LA, USA; D. M. Riche, School of Pharmacy, University of Mississippi, Jackson, MS, USA.

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Shirley, M., McCormack, P.L. Perindopril/Amlodipine (Prestalia®): A Review in Hypertension. Am J Cardiovasc Drugs 15, 363–370 (2015). https://doi.org/10.1007/s40256-015-0144-1

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Keywords

  • Amlodipine
  • Valsartan
  • Perindopril
  • Indapamide
  • Blood Pressure Goal