About the medicine

How to use Ipam

Leaflet attached to the packaging: patient information

IPAM, 5 mg + 1.25 mg + 5 mg, film-coated tablets

IPAM, 5 mg + 1.25 mg + 10 mg, film-coated tablets

IPAM, 10 mg + 2.5 mg + 5 mg, film-coated tablets

IPAM, 10 mg + 2.5 mg + 10 mg, film-coated tablets

Perindopril arginine + Indapamide + Amlodipine

You should carefully read the contents of the leaflet before taking the medicine, as it contains important information for the patient.

  • You should keep this leaflet, so that you can read it again if you need to.
  • If you have any doubts, you should consult a doctor or pharmacist.
  • This medicine has been prescribed specifically for you. Do not pass it on to others. The medicine may harm them, even if their symptoms are the same as yours.
  • If you experience any side effects, including those not listed in this leaflet, you should tell your doctor or pharmacist. See section 4.

Table of contents of the leaflet:

  • 1. What is IPAM and what is it used for
  • 2. Important information before taking IPAM
  • 3. How to take IPAM
  • 4. Possible side effects
  • 5. How to store IPAM
  • 6. Contents of the packaging and other information

1. What is IPAM and what is it used for

IPAM is a combination product containing three active substances: perindopril, indapamide, and amlodipine.
This is a blood pressure lowering medicine used to treat high blood pressure (hypertension).
Patients already taking perindopril and indapamide in one medicine and amlodipine in another can take one IPAM tablet instead, which contains these three active substances in the same doses.
Each active substance lowers blood pressure, and together they help control blood pressure in the patient:

  • perindopril belongs to a group of medicines called angiotensin-converting enzyme inhibitors (ACE inhibitors). It works by widening the blood vessels, making it easier for the heart to pump blood through them.
  • indapamide is a diuretic (a medicine that increases the amount of urine produced by the kidneys). Diuretics increase the amount of urine produced by the kidneys. However, indapamide differs from other diuretics because it only causes a slight increase in urine production.
  • amlodipine is a calcium channel blocker (which belongs to a group of medicines called dihydropyridines). It causes the blood vessels to relax, making it easier for blood to flow through them.

2. Important information before taking IPAM

When not to take IPAM:

  • if you are allergic to perindopril or other ACE inhibitors, indapamide or other sulfonamides, amlodipine or other dihydropyridines, or any of the other ingredients of this medicine (listed in section 6);
  • if you have had symptoms such as wheezing, swelling of the face or tongue, intense itching, or severe rash during previous treatment with an ACE inhibitor;

such symptoms may have occurred in you or someone in your family in any other circumstances (a condition called angioedema);

  • if you have severe liver disease or a condition called hepatic encephalopathy (a brain disorder caused by liver disease);
  • if you are suspected of having untreated or uncontrolled heart failure (severe water retention in the body, difficulty breathing);
  • if you are taking medicines that are not anti-arrhythmic drugs, which can cause life-threatening irregular heartbeat (torsades de pointes);
  • if you have narrowing of the aortic valve in the heart (aortic stenosis) or cardiogenic shock (a condition in which the heart is unable to supply enough blood to the body);
  • if you have heart failure after a heart attack;
  • if you have very low blood pressure (hypotension);
  • if you have low potassium levels in the blood;
  • if you have severe kidney disease that reduces blood flow to the kidneys (renal artery stenosis);
  • if you are undergoing dialysis or blood filtration by other methods. Depending on the device used, IPAM may not be suitable for you;
  • if you have moderate kidney disease (this applies to IPAM 10 mg + 2.5 mg + 5 mg and 10 mg + 2.5 mg + 10 mg);
  • after the third month of pregnancy (it is also recommended to avoid taking IPAM in early pregnancy - see the section on pregnancy);
  • if you have diabetes or kidney problems and are being treated with a blood pressure lowering medicine containing aliskiren;
  • if you have taken or are currently taking a combination medicine containing sacubitril and valsartan, used to treat chronic heart failure, as the risk of angioedema (rapid swelling of tissues under the skin in the throat area) increases (see "Warnings and precautions" and "IPAM and other medicines").

Warnings and precautions

If any of the following conditions apply to you, you should consult a doctor or pharmacist before taking IPAM:

  • if you have hypertrophic cardiomyopathy (a heart muscle disease) or renal artery stenosis (narrowing of the blood vessel supplying blood to the kidney);
  • if you have heart failure or any other heart disease;
  • if you have a significant increase in blood pressure (hypertensive crisis);
  • if you have liver disease;
  • if you have collagenosis (a disease of the connective tissue), such as systemic lupus erythematosus or scleroderma;
  • if you have atherosclerosis (hardening of the arteries);
  • if you are going to have parathyroid function tests;
  • if you have gout;
  • if you have diabetes;
  • if you are on a low-salt diet or taking salt substitutes containing potassium (it is essential to have the right potassium level in the blood);
  • if you are taking lithium or potassium-sparing diuretics (such as spironolactone, triamterene), as you should avoid taking them with IPAM (see "IPAM and other medicines");
  • if you are elderly and the dose needs to be increased;
  • if you have had allergic reactions to sunlight;
  • in black patients, angioedema (swelling of the face, lips, mouth, tongue, or throat, which can cause difficulty swallowing or breathing) may occur more frequently, and the medicine may be less effective in lowering blood pressure;
  • if you are undergoing dialysis using high-flux membranes;
  • if you have kidney disease or are on dialysis;
  • if you experience vision loss or eye pain. These may be symptoms of fluid accumulation in the vascular layer of the eye (choroidal effusion) or increased pressure in the eye, which can occur within a few hours or weeks of taking IPAM. Untreated symptoms can lead to permanent vision loss. If you have previously been allergic to penicillin or sulfonamides, you are at greater risk of developing these disorders.

The doctor may recommend regular monitoring of kidney function, blood pressure, and electrolyte levels (such as potassium) in the blood.
See also the section "When not to take IPAM".
The doctor may recommend blood tests to check if there is a decrease in sodium or potassium levels or an increase in calcium levels in the blood.
You should tell your doctor if you are pregnant, planning to become pregnant, or think you may be pregnant. You should not take IPAM during pregnancy and breastfeeding (see the section on pregnancy and breastfeeding).
When taking IPAM, you should inform your doctor or healthcare professional if:

  • you are going to have anesthesia and/or surgery;
  • you have recently had diarrhea or vomiting, or are dehydrated;
  • you are going to have LDL apheresis (a mechanical procedure to remove cholesterol from the blood);
  • you are going to have desensitization treatment to reduce allergic reactions after a bee or wasp sting;
  • you are going to have a test that requires the use of a contrast agent containing iodine (a substance that allows organs such as the kidney or stomach to be seen on an X-ray).

Athletes should be aware that IPAM contains the active substance indapamide, which may cause a positive doping test result.

Children and adolescents

IPAM should not be given to children and adolescents.

IPAM and other medicines

You should tell your doctor or pharmacist about all medicines you are currently taking or have recently taken, as well as any medicines you plan to take.
Patients with diabetes or kidney disease should not take aliskiren (used to treat high blood pressure).
You should avoid taking IPAM with:

  • lithium (used to treat certain mental illnesses, such as mania, manic-depressive illness, and recurrent depression);
  • potassium-sparing medicines (such as triamterene, amiloride), potassium supplements, or salt substitutes containing potassium, and other medicines that may increase potassium levels in the body (such as heparin, a medicine used to thin the blood and prevent blood clots; trimethoprim and co-trimoxazole, also known as a combination medicine containing trimethoprim and sulfamethoxazole, used to treat bacterial infections);
  • dantrolene (given by infusion), also used to treat malignant hyperthermia (a condition characterized by very high fever and muscle stiffness) during anesthesia;
  • estramustine (used to treat cancer);
  • medicines used to treat diarrhea (such as racecadotril) or medicines used to prevent the rejection of a transplanted organ (such as sirolimus, everolimus, temsirolimus, and other medicines belonging to the group of so-called mTOR inhibitors). See the section "Warnings and precautions";
  • a combination medicine containing sacubitril and valsartan (used to treat chronic heart failure). See the sections "When not to take IPAM" and "Warnings and precautions";
  • other medicines used to treat high blood pressure: ACE inhibitors and angiotensin II receptor antagonists (also known as sartans - for example, valsartan, telmisartan, irbesartan).

Taking other medicines may affect treatment with IPAM. Your doctor may recommend changing the dose and/or taking other precautions. You should tell your doctor if you are taking any of the following medicines, as they may require special precautions:

  • other medicines used to treat high blood pressure, including angiotensin II receptor antagonists (also known as sartans - for example, valsartan, telmisartan, irbesartan) or aliskiren (see also the sections "When not to take IPAM" and "Warnings and precautions") or diuretics (medicines that increase urine production);
  • potassium-sparing medicines used to treat heart failure: eplerenone and spironolactone at doses of 12.5 mg to 50 mg per day;
  • anesthetics;
  • iodine-containing contrast agents;
  • bepridil (used to treat angina pectoris);
  • methadone (used to treat addiction);
  • medicines used to treat heart rhythm disorders (such as dofetilide, ibutilide, bretylium, cyzapride, difemanil, procainamide, quinidine, hydroquinidine, disopyramide, amiodarone, sotalol);
  • verapamil, diltiazem (used to treat heart conditions);
  • digoxin or other cardiac glycosides (used to treat heart conditions);
  • antibiotics used to treat bacterial infections (such as rifampicin, erythromycin, clarithromycin, sparfloxacin, moxifloxacin);
  • antifungal medicines (such as itraconazole, ketoconazole, amphotericin B given by infusion);
  • allopurinol (used to treat gout);
  • antihistamines used to treat allergic reactions, such as hay fever (such as mizolastine, terfenadine, or astemizole);
  • corticosteroids used to treat various diseases, including severe asthma and rheumatoid arthritis, as well as non-steroidal anti-inflammatory drugs (such as ibuprofen) or high doses of salicylates (such as acetylsalicylic acid, a substance found in many medicines, used to relieve pain and reduce fever, as well as to prevent blood clots);
  • immunosuppressive medicines (given to control the immune system's response) used to treat autoimmune diseases or after organ transplantation (such as cyclosporine, tacrolimus);
  • tetracosactide (used to treat Crohn's disease);
  • gold salts, especially those given intravenously (used to treat symptoms of rheumatoid arthritis);
  • halofantrine (used to treat certain types of malaria);
  • baclofen (used to treat muscle stiffness in diseases such as multiple sclerosis);
  • medicines used to treat diabetes, such as insulin or metformin;
  • calcium, including calcium supplements;
  • laxatives with a stimulating effect (such as senna);
  • medicines used to treat cancer;
  • vincamine (used to treat cognitive disorders in the elderly, including memory loss);
  • medicines used to treat mental disorders, such as depression, anxiety, schizophrenia (such as tricyclic antidepressants, antipsychotic medicines, antidepressant medicines of the imipramine type, neuroleptics (such as amisulpride, sulpiride, sultopride, tiapride, haloperidol, droperidol));
  • pentamidine (used to treat pneumonia);
  • ritonavir, indinavir, nelfinavir (so-called protease inhibitors used to treat HIV infections);
  • Hypericum perforatum(St. John's Wort);
  • trimethoprim (used to treat infections);
  • medicines used to treat low blood pressure, shock, or asthma (such as ephedrine, noradrenaline, or adrenaline);
  • nitroglycerin and other nitrates or other vasodilators, as they may further lower blood pressure.

IPAM with food and drink

While taking IPAM, you should not consume grapefruits or grapefruit juice, as this may increase the level of the active substance amlodipine, which may lead to an unexpected increase in the blood pressure lowering effect of IPAM.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, you should consult a doctor or pharmacist before taking this medicine.

Pregnancy

You should tell your doctor if you are pregnant, think you may be pregnant, or are planning to become pregnant.
Usually, your doctor will advise you to stop taking IPAM before planned pregnancy or as soon as pregnancy is confirmed, and will recommend taking a different medicine instead of IPAM. You should not take IPAM during early pregnancy and should not take it after the third month of pregnancy, as it may seriously harm your baby.

Breastfeeding

You should tell your doctor if you are breastfeeding or plan to breastfeed. You should not take IPAM while breastfeeding, especially if you are breastfeeding a newborn or premature baby. Your doctor may recommend taking a different medicine.

Driving and using machines

IPAM may affect your ability to drive or use machines. If you experience nausea, dizziness, fatigue, or headache while taking the medicine, you should not drive or use machines and should contact your doctor immediately.

IPAM contains sodium

This medicine contains less than 1 mmol of sodium (23 mg) per tablet, which means it is essentially "sodium-free".

3. How to take IPAM

This medicine should always be taken exactly as prescribed by your doctor or pharmacist. If you are unsure, you should consult your doctor or pharmacist.
The tablet should be swallowed with a glass of water, preferably in the morning, before breakfast. Your doctor will determine the appropriate dose for you. The recommended dose is usually one tablet per day.

Taking a higher dose of IPAM than recommended

Taking too many tablets may cause your blood pressure to drop, even to a dangerous level, which may be accompanied by nausea, vomiting, cramps, dizziness, drowsiness, disorientation, and decreased urine production or absence of urine production. You may feel "empty" in your head, or you may experience fainting or weakness. If your blood pressure drops significantly, you may experience shock, in which case your skin becomes cold and sweaty, and you may lose consciousness. Even 24-48 hours after taking the medicine, you may experience shortness of breath due to excess fluid accumulating in the lungs (pulmonary edema).
If you have taken too many IPAM tablets, you should contact your doctor or go to the emergency department of the nearest hospital immediately.

Missing a dose of IPAM

It is essential to take the medicine every day, as regular treatment ensures more effective action. However, if you miss a dose of IPAM, you should take the next dose at the usual time. Do not take a double dose to make up for the missed dose.

Stopping treatment with IPAM

Treatment of high blood pressure is usually long-term, so before stopping IPAM, you should consult your doctor.
If you have any further doubts about taking this medicine, you should consult your doctor or pharmacist.

4. Possible side effects

Like all medicines, IPAM can cause side effects, although not everybody gets them.

If you experience any of the following serious side effects, you should stop taking IPAM and contact your doctor immediately:

  • sudden onset of wheezing, chest pain, shortness of breath, or difficulty breathing (not very common - may affect up to 1 in 100 people);
  • swelling of the eyelids, face, or lips (not very common - may affect less than 1 in 100 people);
  • swelling of the mucous membrane of the mouth, tongue, or throat, causing severe difficulty breathing (not very common - may affect up to 1 in 100 people);
  • severe skin reactions, including severe rash, hives, redness of the skin all over the body, severe itching, blistering, peeling, and swelling of the skin, and inflammation of the mucous membranes (Stevens-Johnson syndrome, toxic epidermal necrolysis) or other allergic reactions (very rare - may affect up to 1 in 10,000 people);
  • severe dizziness or fainting (common - may affect up to 1 in 10 people);
  • heart attack (very rare - may affect up to 1 in 10,000 people), life-threatening irregular heartbeat (frequency not known);
  • pancreatitis, which can cause severe abdominal pain and very poor general condition (very rare - may affect less than 1 in 10,000 people);
  • muscle weakness, cramps, tenderness, or pain, especially if you feel unwell or have a high temperature, which may be caused by abnormal muscle breakdown (frequency not known).

Side effects, grouped by frequency of occurrence:

  • Very common(affecting at least 1 in 10 people): Edema (fluid retention).
  • Common(affecting less than 1 in 10 people): Low potassium levels in the blood, headache, dizziness of central origin, palpitations (feeling of heartbeat), sudden reddening of the face and neck, dizziness of labyrinthine origin, feeling of tingling or numbness, vision disturbances, double vision, tinnitus (feeling of hearing sounds), feeling of "emptiness" in the head due to low blood pressure, cough, shortness of breath, gastrointestinal disorders (nausea, vomiting, abdominal pain, taste disturbances, indigestion or digestive disorders, diarrhea, constipation, changes in bowel movements), allergic reactions (such as rash, itching), muscle cramps, feeling of tiredness, weakness, drowsiness, swelling of the ankles.
  • Uncommon(affecting less than 1 in 100 people): Mood changes, anxiety, depression, sleep disturbances, tremors, hives, fainting, numbness, irregular or rapid heartbeat, rhinitis (inflammation or congestion of the nasal mucous membranes), hair loss, purpura (red spots on the skin), skin discoloration, itching, sweating, chest pain, muscle or joint pain, back pain, pain, poor general condition, kidney disorders, urinary disorders, need to urinate at night, increased frequency of urination, impotence (inability to achieve or maintain an erection), fever or elevated body temperature, discomfort or enlargement of the breasts in men, weight gain or loss, increased white blood cell count, hyperglycemia (very high blood sugar levels), low sodium levels in the blood, which may cause dehydration and low blood pressure, vasculitis (inflammation of blood vessels), photosensitivity reaction (changes in skin appearance after sun exposure), blistering skin, swelling of the hands or feet, increased creatinine and urea levels in the blood, falls, dryness of the mucous membranes in the mouth.
  • Rare(affecting less than 1 in 1,000 people): Disorientation, abnormal laboratory test results: low chloride levels in the blood, low magnesium levels in the blood, increased liver enzyme activity, high bilirubin levels in the blood; exacerbation of lupus erythematosus (a type of collagenosis). Abnormal electrocardiogram (ECG) readings; in the case of systemic lupus erythematosus, symptoms may worsen. Myopia, blurred vision, decreased vision, or eye pain due to high pressure (possible symptoms of fluid accumulation in the vascular layer of the eye (choroidal effusion) or acute angle-closure glaucoma). Tremors, stiffness, mask-like face, slow movements, and shuffling gait. Cyanosis, numbness, and pain in the fingers of the hands or feet (Raynaud's phenomenon).
  • Very rare(affecting less than 1 in 10,000 people): Decreased white blood cell count, decreased platelet count (which can cause easy bruising and nosebleeds), anemia (decreased red blood cell count), angina pectoris (chest pain, jaw pain, and back pain caused by poor blood flow to the heart), eosinophilic pneumonia (a rare type of pneumonia), gingival hyperplasia (gum overgrowth), severe skin reactions, including severe rash, redness of the skin all over the body, severe itching, blistering, peeling, and swelling of the skin, and inflammation of the mucous membranes, erythema multiforme (rash, often starting with red, itchy spots on the face, arms, or legs), bleeding, sensitive, or swollen gums, liver dysfunction, liver inflammation, severe kidney dysfunction, jaundice (yellowing of the skin), abdominal distension (gastritis), nerve disorders, which can cause weakness, numbness, or tingling, increased muscle tone, hyperglycemia (very high blood sugar levels), high calcium levels in the blood, stroke, possibly due to significant lowering of blood pressure.
  • Frequency not known(cannot be estimated from the available data): Hepatic encephalopathy (a brain disorder caused by liver disease), abnormal ECG readings; in the case of systemic lupus erythematosus, symptoms may worsen. Myopia, blurred vision, decreased vision, or eye pain due to high pressure (possible symptoms of fluid accumulation in the vascular layer of the eye (choroidal effusion) or acute angle-closure glaucoma). Tremors, stiffness, mask-like face, slow movements, and shuffling gait. Cyanosis, numbness, and pain in the fingers of the hands or feet (Raynaud's phenomenon).

Changes in laboratory test results (blood tests) may occur. Your doctor may recommend blood tests to monitor your health.
If you experience any of these symptoms, you should contact your doctor as soon as possible.

Reporting side effects

If you experience any side effects, including those not listed in this leaflet, you should tell your doctor or pharmacist. You can report side effects directly to the Department of Drug Safety Monitoring of the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products
Al. Jerozolimskie 181C
02-222 Warsaw
Phone: +48 22 49 21 301
Fax: +48 22 49 21 309
Website: https://smz.ezdrowie.gov.pl
You can also report side effects to the marketing authorization holder.
By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store IPAM

The medicine should be stored out of sight and reach of children.
Do not use this medicine after the expiry date stated on the carton and blister after EXP. The expiry date refers to the last day of the month.
There are no special storage instructions for the medicine. Store in the original packaging to protect from light and moisture.
Medicines should not be disposed of via wastewater or household waste. You should ask your pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Contents of the packaging and other information

What IPAM contains

  • The active substances of IPAM are: perindopril arginine, indapamide, and amlodipine. Each film-coated tablet IPAM, 5 mg+1.25 mg+5 mg contains 5 mg of perindopril arginine, which corresponds to 3.395 mg of perindopril, 1.25 mg of indapamide, and 5 mg of amlodipine (as amlodipine besylate). Each film-coated tablet IPAM, 5 mg+1.25 mg+10 mg contains 5 mg of perindopril arginine, which corresponds to 3.395 mg of perindopril, 1.25 mg of indapamide, and 10 mg of amlodipine (as amlodipine besylate). Each film-coated tablet IPAM, 10 mg+2.5 mg+5 mg contains 10 mg of perindopril arginine, which corresponds to 6.79 mg of perindopril, 2.5 mg of indapamide, and 5 mg of amlodipine (as amlodipine besylate). Each film-coated tablet IPAM, 10 mg+2.5 mg+10 mg contains 10 mg of perindopril arginine, which corresponds to 6.79 mg of perindopril, 2.5 mg of indapamide, and 10 mg of amlodipine (as amlodipine besylate).
  • The other ingredients of the tablet are: microcrystalline cellulose, calcium carbonate, pregelatinized starch, sodium croscarmellose, magnesium stearate, and anhydrous colloidal silica. IPAM, 5 mg+1.25 mg+5 mg and IPAM, 10 mg+2.5 mg+10 mg: the coating contains macrogol/polyvinyl alcohol copolymer, talc, titanium dioxide (E171), glycerol monocaprylocaprate, and polyvinyl alcohol. IPAM, 5 mg+1.25 mg+10 mg and IPAM, 10 mg+2.5 mg+5 mg: the coating contains macrogol/polyvinyl alcohol copolymer, talc, titanium dioxide (E171), glycerol monocaprylate (type 1), polyvinyl alcohol, yellow iron oxide (E172), black iron oxide (E172), and red iron oxide (E172).

What IPAM looks like and contents of the pack

IPAM, 5 mg+1.25 mg+5 mg: white, oval, film-coated tablets with "TEV" engraved on one side and "2" on the other side. The tablet dimensions are approximately 12.3 mm x 6.5 mm.
IPAM, 5 mg+1.25 mg+10 mg: light beige, round, film-coated tablets with "TEV" engraved on one side and "3" on the other side. The tablet diameter is approximately 9.0 mm.
IPAM, 10 mg+2.5 mg+5 mg: light beige, oval, film-coated tablets with "TEV" engraved on one side and "4" on the other side. The tablet dimensions are approximately 12.3 mm x 6.5 mm.
IPAM, 10 mg+2.5 mg+10 mg: white, round, film-coated tablets with "TEV" engraved on one side and "5" on the other side. The tablet diameter is approximately 9.0 mm.
IPAM is available in blisters of 10, 30, 90, and 100 tablets, in a cardboard box.
Not all pack sizes may be marketed.

Marketing authorization holder

Teva B.V.
Swensweg 5
2031 GA, Haarlem
Netherlands

Manufacturer

Actavis Ltd.
BLB015, BLB016, Bulebel Industrial Estate
Zejtun ZTN3000
Malta
Teva Operations Poland Sp. z.o.o
ul. Mogilska 80
31-546 Kraków
To obtain further information, you should contact the representative of the marketing authorization holder:
Teva Pharmaceuticals Polska Sp. z o.o., ul. Emilii Plater 53, 00-113 Warszawa, tel. (22) 345 93 00

This medicinal product is authorized in the Member States of the European Economic Area under the following names:

Belgium
Perindopril/Indapamide/Amlodipine Teva Generics 5 mg/1.25 mg/5 mg film-coated tablets/comprimés pelliculés/Filmtabletten
Perindopril/Indapamide/Amlodipine Teva Generics 5 mg/1.25 mg/10 mg film-coated tablets/comprimés pelliculés/Filmtabletten
Perindopril/Indapamide/Amlodipine Teva Generics 10 mg/2.5 mg/5 mg film-coated tablets/comprimés pelliculés/Filmtabletten
Perindopril/Indapamide/Amlodipine Teva Generics 10 mg/2.5 mg/10 mg film-coated tablets/comprimés pelliculés/Filmtabletten
Bulgaria
Залпам Плюс 5 mg/1.25 mg/5 mg филмирани таблетки
Zalpam Plus 5 mg/1.25 mg/5 mg film-coated tablets
Залпам Плюс 5 mg/1.25 mg/10 mg филмирани таблетки
Zalpam Plus 5 mg/1.25 mg/10 mg film-coated tablets
Залпам Плюс 10 mg/2.5 mg/5 mg филмирани таблетки
Zalpam Plus 10 mg/2.5 mg/5 mg film-coated tablets
Залпам Плюс 10 mg/2.5 mg/10 mg филмирани таблетки
Zalpam Plus 10 mg/2.5 mg/10 mg film-coated tablets
Croatia
Perindopril arginine/Indapamide/Amlodipine Teva
Articel Trio 5 mg/1.25 mg/5 mg filmom obložene tablete
Articel Trio 5 mg/1.25 mg/10 mg filmom obložene tablete
Articel Trio 10 mg/2.5 mg/5 mg filmom obložene tablete
Articel Trio 10 mg/2.5 mg/10 mg filmom obložene tablete
Czech Republic
Perindopril arginine/Indapamide/Amlodipine Teva
Triperindam 5 mg/1.25 mg/5 mg, 5 mg/1.25 mg/10 mg, 10 mg/2.5 mg/5 mg & 10 mg/2.5 mg/10 mg film-coated tablets
Estonia
Perindopril arginine/Indapamide/Amlodipine Teva
5 mg/1.25 mg/5 mg apvalkotās tabletes
Perindopril arginine/Indapamide/Amlodipine Teva
5 mg/1.25 mg/10 mg apvalkotās tabletes
Perindopril arginine/Indapamide/Amlodipine Teva
10 mg/2.5 mg/5 mg apvalkotās tabletes
Perindopril arginine/Indapamide/Amlodipine Teva
10 mg/2.5 mg/10 mg apvalkotās tabletes
IPAM
Perindopril + Indapamide + Amlodipine
ratiopharm
Perindopril arginină/Indapamidă/Amlodipină Teva
5 mg/1.25 mg/5 mg comprimate filmate
Perindopril arginină/Indapamidă/Amlodipină Teva
5 mg/1.25 mg/10 mg comprimate filmate
Perindopril arginină/Indapamidă/Amlodipină Teva
10 mg/2.5 mg/5 mg comprimate filmate
Perindopril arginină/Indapamidă/Amlodipină Teva
10 mg/2.5 mg/10 mg comprimate filmate
Perindopril arginín/indapamid/amlodipín Teva
5 mg/1.25 mg/5 mg
Perindopril arginín/indapamid/amlodipín Teva
5 mg/1.25 mg/10 mg
Perindopril arginín/indapamid/amlodipín Teva
10 mg/2.5 mg/5 mg Perindopril arginín/indapamid/amlodipín Teva 10 mg/2.5 mg/10 mg
PERINDOPRIL/INDAPAMIDE/AMLODIPINA TEVA
Date of last revision of the leaflet:April 2025
Czech Republic
Croatia
Estonia
Ireland
Latvia
Poland
Portugal
Romania
Slovakia
Italy

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Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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Jonathan Marshall Ben Ami

Family medicine8 years of experience

Dr. Jonathan Marshall Ben Ami is a licensed family medicine doctor in Spain. He provides comprehensive care for adults and children, combining general medicine with emergency care expertise to address both acute and chronic health concerns.

Dr. Ben Ami offers expert diagnosis, treatment, and follow-up for:

  • Respiratory infections (cold, flu, bronchitis, pneumonia).
  • ENT conditions such as sinusitis, ear infections, and tonsillitis.
  • Digestive issues including gastritis, acid reflux, and irritable bowel syndrome (IBS).
  • Urinary tract infections and other common infections.
  • Management of chronic diseases: high blood pressure, diabetes, thyroid disorders.
  • Acute conditions requiring urgent medical attention.
  • Headaches, migraines, and minor injuries.
  • Wound care, health check-ups, and ongoing prescriptions.

With a patient-focused and evidence-based approach, Dr. Ben Ami supports individuals at all stages of life — offering clear medical guidance, timely interventions, and continuity of care.

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Doctor

Salome Akhvlediani

Pediatrics11 years of experience

Dr Salome Akhvlediani is a paediatrician providing online consultations for children of all ages. She supports families with preventive care, diagnosis, and long-term management of both acute and chronic conditions.

Her areas of focus include:

  • Fever, infections, cough, sore throat, and digestive issues.
  • Preventive care – vaccinations, regular check-ups, and health monitoring.
  • Allergies, asthma, and skin conditions.
  • Nutritional advice and healthy development support.
  • Sleep difficulties, fatigue, and behavioural concerns.
  • Ongoing care for chronic or complex health conditions.
  • Guidance for parents and follow-up after medical treatment.

Dr Akhvlediani combines professional care with a warm, attentive approach – helping children stay healthy and supporting parents at every stage of their child’s growth.

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