Perindopril Arginine + Amlodipine

Perindopril is a nonsulphydryl ACE inhibitor, and it is used to treat hypertension. After it is taken by mouth, it is quickly hydrolysed to perindoprilat, its main active metabolite. ACE catalyses the conversion of angiotensin I to angiotensin II, which is a vasoconstrictor. Angiotensin II also stimulates aldosterone secretion by the adrenal cortex. When ACE activity is inhibited, angiotensin II levels fall, so there is less vasoconstriction and less aldosterone secretion. The fall in aldosterone may cause a small increase in serum potassium. Lower angiotensin II also removes the negative feedback on renal renin secretion, and this raises plasma renin activity. Perindopril may also interfere with the breakdown of bradykinin, a vasodepressor peptide. It is not known whether this effect adds to the therapeutic activity of perindopril. The way perindopril lowers BP appears to come mainly from suppression of the RAAS.

Amlodipine is a dihydropyridine calcium-channel blocker with a long duration of action. It is used for hypertension and angina pectoris. It acts on the myocardial cells, the cells within the specialized conducting system of the heart, and the cells of vascular smooth muscle. Its main result is vasodilation, with reduced peripheral resistance, blood pressure and afterload, increased coronary blood flow and a reflex increase in coronary heart rate. This in turn raises myocardial oxygen supply and cardiac output.