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Perindopril (antihypertensive agent)

    Perindopril is a generic antihypertensive drug. It is an angiotensin-converting enzyme (ACE)-inhibitor. By blocking the action of this enzyme, there is less angiotensin II (a vasoconstrictor) produced. This results in the lowering of blood pressure and sodium and water retention.

    Uses

    What is perindopril used for?

    Perindopril lowers blood pressure to treat hypertension, heart failure, and stable coronary artery disease.

    How should I take perindopril?

    Read the directions on the packaging for complete information. Check the label and expiration date.

    For oral dosage forms, swallow it whole without chewing, crushing, or dissolving it in liquid.

    How do I store perindopril?

    Store this product at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer.

    There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

    You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

    Precautions & Warnings

    What should I know before using perindopril?

    Before using this drug, tell your doctor if you are/have:

    • Pregnant or breastfeeding.
    • Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
    • An allergy to any of the ingredients of this product.
    • Any other illnesses, disorders, or medical conditions.

    Is it safe during pregnancy or breastfeeding?

    There is evidence from human studies that shows it can cause fetal harm when taken during pregnancy. Therefore, always consult with your doctor to weigh the potential benefits and risks before taking this medication. You may need to stop taking this drug if you become pregnant.

    This medication is pregnancy risk category D according to the US Food and Drug Administration (FDA).

    FDA pregnancy risk category reference below:

    • A=No risk
    • B=No risk in some studies
    • C=There may be some risk
    • D=Positive evidence of risk
    • X=Contraindicated
    • N=Unknown

    Side Effects

    What side effects can occur from perindopril?

    Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

    • Headache
    • Dizziness
    • Vertigo
    • Paresthesia
    • Vision disturbances
    • Tinnitus
    • Hypotension
    • Cough
    • Dyspnea
    • GI disorders
    • Rash
    • Pruritus
    • Muscle cramps
    • Asthenia

    However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

    Interactions

    What drugs may interact with perindopril?

    This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects.

    To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist.

    Drugs with known interactions:

    • Other antihypertensive agents
    • Diuretics
    • Lithium
    • Potassium-sparing diuretics
    • Potassium-containing preparations
    • NSAIDs
    • Antidiabetics
    • TCAs
    • Antipsychotics

    If you experience an adverse drug interaction, inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

    Does food or alcohol interact with perindopril?

    This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

    What health conditions may interact with perindopril?

    This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have.

    Dosage

    The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

    What is the dose for an adult?

    Hypertension:

    The recommended dose is 4 mg once daily, may be increased to 8 mg once daily after 1 month.

    Elderly: Start treatment at 2 mg, may be progressively increased to 4 mg after 1 month, then 8 mg if needed.

    Symptomatic heart failure

    The recommended dose is 2 mg, may be increased by 2-mg increments ≥2 wk to 4 mg once daily if tolerated.

    What is the dose for a child?

    There is no established pediatric dose. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

    How is perindopril available?

    Perindopril is available in the following dosage forms and strengths:

    • Tablet 2 mg, 4 mg, 8 mg

    What should I do in case of an emergency or overdose?

    In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

    What should I do if I miss a dose?

    If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

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    Sources

    Perindopril https://www.mims.com/philippines/drug/info/perindopril?mtype=generic Accessed July 25, 2021

    Perindopril https://www.nhs.uk/medicines/perindopril/ Accessed July 25, 2021

    Perindopril (Oral Route) https://www.mayoclinic.org/drugs-supplements/perindopril-oral-route/side-effects/drg-20069270?p=1 Accessed July 25, 2021

    Perindopril tablets https://my.clevelandclinic.org/health/drugs/18316-perindopril-tablets Accessed July 25, 2021

    Perindopril. Lexi-Drugs. Lexicomp. Wolters Kluwer Health, Inc. Riverwoods, IL. Accessed July 25, 2021. http://online.lexi.com

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    Written by Stephanie Nera, RPh, PharmD Updated Jul 28, 2021