Perindopril

Uses of Perindopril

Perindopril is an angiotensin-converting enzyme (ACE) inhibitor used for

• Hypertension (High Blood Pressure): Helps lower blood pressure by relaxing blood vessels.
• Heart Failure: Improves the heart’s ability to pump blood.
• Prevention of Cardiovascular Events: Reduces the risk of heart attack, stroke, and other cardiovascular complications in patients with stable coronary artery disease.
• Kidney Protection: May slow kidney damage in certain patients with high blood pressure or diabetes.

Precautions and Warnings

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Angioedema: Although not common, angioedema (a serious allergic reaction that causes the area around the throat and tongue to swell) may occur with ACE inhibitors, including perindopril. If you experience swelling of the face, tongue, or glottis, or experience unexpected abdominal pain that may be accompanied by nausea or vomiting, stop taking perindopril at once and seek immediate medical attention. People who have had angioedema caused by other substances may be at increased risk of angioedema while taking an ACE inhibitor such as perindopril.

Blood counts: This medication can decrease the number of neutrophils (a type of white blood cell that helps fight infection), red blood cells (which carry oxygen), and platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. If you notice any signs of infection (e.g., fever, chills, or sore throat) or unusual bleeding or bruising, contact your doctor immediately.

Cough: People taking perindopril may develop a dry, persistent cough that usually disappears only after stopping or lowering the perindopril dose. Be sure to tell your doctor of any cough which does not seem to be related to a usual cause.

Diabetes: Perindopril may affect blood sugar control. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. You may need to test your blood sugar more often when you first start taking this medication.

Taking perindopril in combination with aliskiren increases the risk of severe low blood pressure, fainting, stroke, and decreasing kidney function. People with diabetes must not take both of these medications.

Drowsiness/reduced alertness: Perindopril can cause dizziness, drowsiness, or fatigue that may reduce alertness, especially when you first start to take this medication. Avoid driving, operating machinery, or performing other potentially hazardous tasks until you have determined how this medication affects you.

Fluid and electrolyte balance: Increases in blood levels of potassium may occur as a result of taking perindopril. This rarely causes problems, but your doctor may want to monitor your potassium levels regularly with blood tests.

Kidney function: Perindopril may affect the function of the kidneys, causing decreased kidney function, kidney failure, or possibly death. The use of diuretics (water pills), nonsteroidal anti-inflammatory drugs (NSAIDs), or aliskiren may further increase risk of kidney problems for people already at risk for this problem. Certain people may be more likely to experience changes in kidney function (e.g., people with narrowed blood vessels in their kidneys, or those with severe congestive heart failure). If you have kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Rarely, people taking this medication experience decreases in liver function, possibly leading to liver failure. Your doctor will do blood tests to monitor this. If you notice any signs of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

Low blood pressure: Occasionally, blood pressure drops too low after perindopril is taken. This usually happens after the first or second dose or when the dose is increased. It is more likely to occur for those who take aliskiren, water pills, have a salt-restricted diet, are on dialysis, are suffering from diarrhea or vomiting, or have been sweating excessively and not taking in enough fluids. To reduce the risk of dizziness, get up slowly from a lying or sitting position. If low blood pressure causes you to faint or feel lightheaded, contact your doctor.

Surgery: Perindopril may increase the blood pressure lowering effects of some medications used in surgery. Make sure to let all health-care providers in your team know that you are taking this medication.

Pregnancy: ACE inhibitors such as perindopril may cause severe harm or death to a developing baby if taken by the mother during pregnancy. This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking perindopril, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of the use of perindopril by children have not been established. Its use by this age group is not recommended.

Seniors: Due to age-related decreases in kidney function, seniors may require lower doses of this medication.

Dosage

To treat high blood pressure or after a heart attack, the usual starting dose of perindopril is 4 mg taken once daily. The dose may be increased after 2 weeks up to a maximum of 8 mg once daily depending on blood pressure control. Perindopril may be used alone or in combination with other medications to reduce blood pressure.

When used to treat congestive heart failure, the starting dose of perindopril is 2 mg. It may then be increased to 4 mg once daily depending on the effect of the medication and side effects.

Side Effects

Common Side Effects:

• Dry, persistent cough.
• Dizziness, especially when standing up.
• Fatigue or weakness.
• Headache.
• Gastrointestinal issues (nausea, diarrhea, or abdominal pain).

Serious Side Effects:

• Angioedema: Swelling of the face, lips, or throat, causing difficulty breathing.
• Severe Hypotension: Dizziness, fainting, or confusion due to low blood pressure.
• Hyperkalemia: Irregular heartbeat, muscle weakness, or tingling sensations.
• Kidney Problems: Decreased urine output or swelling in the legs/feet.
• Liver Issues: Yellowing of the skin or eyes (jaundice), severe abdominal pain, or dark urine.
• Low White Blood Cell Count: Increased susceptibility to infections.