• Dosage of Serperil in details
• Serperil interactions
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Dosage of Serperil in details

Serperil Dosage

Generic name: Serperil erbumine 2mg

Dosage form: tablet

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Hypertension

Use in Uncomplicated Hypertensive Patients: In patients with essential hypertension, the recommended initial dose is 4 mg once a day. The dose may be titrated, as needed to a maximum of 16 mg per day. The usual maintenance dose range is 4 mg to 8 mg administered as a single daily dose or in two divided doses.

Use in Elderly Patients: The recommended initial daily dosage of Serperil for the elderly is 4 mg daily, given in one or two divided doses. Experience with Serperil is limited in the elderly at doses exceeding 8 mg. Dosages above 8 mg should be administered with careful blood pressure monitoring and dose titration.

Use with Diuretics: In patients who are currently being treated with a diuretic, symptomatic hypotension can occur following the initial dose of Serperil. Consider reducing the dose of diuretic prior to starting Serperil.

Stable Coronary Artery Disease

In patients with stable coronary artery disease, Serperil should be given at an initial dose of 4 mg once daily for 2 weeks, and then increased as tolerated, to a maintenance dose of 8 mg once daily. In elderly patients (greater than 70 years), Serperil should be given as a 2 mg dose once daily in the first week, followed by 4 mg once daily in the second week and 8 mg once daily for maintenance dose if tolerated.

Dose Adjustment in Renal Impairment and Dialysis

Perindoprilat elimination is decreased in renally impaired patients. Serperil is not recommended in patients with creatinine clearance <30 mL/min. For patients with lesser degrees of impairment, the initial dosage should be 2 mg/day and dosage should not exceed 8 mg/day. During dialysis, Serperil is removed with the same clearance as in patients with normal renal function.

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What other drugs will affect Serperil?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Serperil, especially:

• gold injections to treat arthritis;

• lithium;

• NSAIDs (non-steroidal anti-inflammatory drugs)--ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;

• a potassium supplement;

• salt substitutes that contain potassium; or

• a diuretic or "water pill."

This list is not complete. Other drugs may interact with Serperil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Serperil interactions

Diuretics: Patients on diuretics and especially those started recently, may occasionally experience an excessive reduction of blood pressure after initiation of Serperil therapy. The possibility of hypotensive effects can be minimized by either discontinuing the diuretic or increasing the salt intake prior to initiation of treatment with Serperil. If diuretics cannot be interrupted, close medical supervision should be provided with the 1st dose of Serperil, for at least 2 hrs and until blood pressure has stabilized for another hour.

The rate and extent of Serperil absorption and elimination are not affected by concomitant diuretics. The bioavailability of perindoprilat was reduced by diuretics, however, and this was associated with a decrease in plasma ACE inhibition.

Potassium Supplements and Potassium-Sparing Diuretics: Serperil may increase serum potassium because of its potential to decrease aldosterone production. Use of potassium-sparing diuretics (spironolactone, amiloride, triamterene and others), potassium supplements or other drugs capable of increasing serum potassium (indomethacin, heparin, cyclosporine and others) can increase the risk of hyperkalemia. Therefore, if concomitant use of such agents is indicated, they should be given with caution and the patient's serum potassium should be monitored frequently.

Lithium: Increased serum lithium and symptoms of lithium toxicity have been reported in patients receiving concomitant lithium and ACE inhibitor therapy. These drugs should be co-administered with caution and frequent monitoring of serum lithium concentration is recommended. Use of a diuretic may further increase the risk of lithium toxicity.

Gold: Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and hypotension) have been reported rarely in patients on therapy with injectable gold (sodium aurothiomalate) and concomitant ACE inhibitor therapy including Serperil.

Digoxin: A controlled pharmacokinetic study has shown no effect on plasma digoxin concentrations when co-administered with Serperil, but an effect of digoxin on the plasma concentration of Serperil/perindoprilat has not been excluded.

Gentamicin: Animal data have suggested the possibility of interaction between Serperil and gentamicin. However, this has not been investigated in human studies. Co-administration of both drugs should proceed with caution.

Food Interaction:

Oral administration of Serperil with food does not significantly lower the rate or extent of Serperil absorption relative to the fasted state. However, the extent of biotransformation of Serperil to the active metabolite, perindoprilat, is reduced approximately 43%, resulting in a reduction in the plasma ACE inhibition curve of approximately 20%, probably clinically insignificant. In clinical trials, Serperil was generally administered in a nonfastingstate.

References

1. FDA/SPL Indexing Data. "Y5GMK36KGY: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
2. MeSH. "Antihypertensive Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
3. European Chemicals Agency - ECHA. "1H-Indole-2-carboxylic acid, 1-[(2S)-2-[[(1S)-1-(ethoxycarbonyl)butyl]amino]-1-oxopropyl]octahydro-, (2S,3aS,7aS): The European Chemicals Agency (ECHA) is an agency of the European Union which is the driving force among regulatory authorities in implementing the EU's groundbreaking chemicals legislation for the benefit of human health and the environment as well as for innovation and competitiveness.". https://echa.europa.eu/ (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Serperil are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Serperil. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

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Information checked by Dr. Sachin Kumar, MD Pharmacology