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perindopril (Oral route)

Pronunciation

per-IN-doe-pril

Oral route(Tablet)

Stop perindopril as soon as possible when pregnancy is detected. Medications acting directly on the renin-angiotensin system can cause injury or death to the developing fetus .

Commonly used brand name(s)

In the U.S.

  • Aceon

Available Dosage Forms:

  • Tablet

Therapeutic Class: Antihypertensive

Pharmacologic Class: ACE Inhibitor

Uses For perindopril

Perindopril is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure can reduce the risk of strokes and heart attacks.

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Perindopril works by blocking a substance in the body that causes the blood vessels to tighten. As a result, perindopril relaxes the blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart.

Perindopril is also used in patients with coronary artery disease to prevent heart attacks.

perindopril is available only with your doctor's prescription.

Before Using perindopril

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For perindopril, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to perindopril or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of perindopril in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of perindopril in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking perindopril, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using perindopril with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Aliskiren

Using perindopril with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alteplase, Recombinant
  • Amiloride
  • Azathioprine
  • Azilsartan
  • Candesartan Cilexetil
  • Canrenoate
  • Eplerenone
  • Eprosartan
  • Irbesartan
  • Losartan
  • Olmesartan Medoxomil
  • Potassium
  • Spironolactone
  • Telmisartan
  • Triamterene
  • Valsartan

Using perindopril with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Aceclofenac
  • Acemetacin
  • Amtolmetin Guacil
  • Aspirin
  • Azosemide
  • Bemetizide
  • Bendroflumethiazide
  • Benzthiazide
  • Bromfenac
  • Bufexamac
  • Bumetanide
  • Bupivacaine
  • Bupivacaine Liposome
  • Buthiazide
  • Capsaicin
  • Celecoxib
  • Chlorothiazide
  • Chlorthalidone
  • Choline Salicylate
  • Clonixin
  • Clopamide
  • Cyclopenthiazide
  • Cyclothiazide
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Dipyrone
  • Ethacrynic Acid
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Flurbiprofen
  • Furosemide
  • Gold Sodium Thiomalate
  • Hydrochlorothiazide
  • Hydroflumethiazide
  • Ibuprofen
  • Ibuprofen Lysine
  • Indapamide
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Lithium
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Methyclothiazide
  • Metolazone
  • Morniflumate
  • Nabumetone
  • Naproxen
  • Nepafenac
  • Niflumic Acid
  • Nimesulide
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Phenylbutazone
  • Piketoprofen
  • Piretanide
  • Piroxicam
  • Polythiazide
  • Pranoprofen
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Quinethazone
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sodium Salicylate
  • Sulindac
  • Tenoxicam
  • Tiaprofenic Acid
  • Tolfenamic Acid
  • Tolmetin
  • Torsemide
  • Trichlormethiazide
  • Valdecoxib
  • Xipamide

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of perindopril. Make sure you tell your doctor if you have any other medical problems, especially:

  • Angioedema (swelling of the face, lips, tongue, throat, arms, or legs) with other ACE inhibitors, history of—May increase risk of this condition occurring again.
  • Collagen vascular disease (an autoimmune disease) together with kidney disease—Increased risk of blood problems.
  • Congestive heart failure, severe—Use may lead to kidney problems.
  • Diabetes or
  • Kidney problems—Increased risk of potassium levels in the body becoming too high.
  • Diabetes patients who are also taking aliskiren (Tekturna®) or
  • Hereditary or idiopathic angioedema or
  • Patients with kidney disease who are also taking aliskiren (Tekturna®)—Should not be used in patients with these conditions.
  • Electrolyte imbalance (eg, low sodium in the blood) or
  • Fluid imbalances (caused by dehydration, vomiting, or diarrhea) or
  • Liver disease—Use with caution. May make these condition worse.

Proper Use of perindopril

In addition to the use of perindopril, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that perindopril will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Dosing

The dose of perindopril will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of perindopril. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For high blood pressure:
      • Adults—At first, 4 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 16 mg per day.
      • Older adults—At first, 4 milligrams (mg) per day, taken in one or two divided doses. Your doctor may increase your dose as needed. However, the dose is usually not more than 8 mg per day.
      • Children—Use and dose must be determined by your doctor.
    • For coronary artery disease:
      • Adults—At first, 4 milligrams (mg) once a day. Your doctor may increase your dose as needed and tolerated. However, the dose is usually not more than 8 mg per day.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of perindopril, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using perindopril

It is very important that your doctor check your progress at regular visits to make sure perindopril is working properly. Blood tests may be needed to check for unwanted effects.

Using perindopril while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using perindopril, tell your doctor right away.

perindopril may cause serious types of allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat while you are using perindopril.

Call your doctor right away if you have severe stomach pain (with or without nausea or vomiting). This could be a symptom of intestinal angioedema.

Dizziness, lightheadedness, or fainting may also occur, especially when you get up from a lying or sitting position or if you have been taking a diuretic (water pill). Make sure you know how you react to the medicine before you drive, use machines, or do other things that could be dangerous if you are dizzy or not alert. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

Check with your doctor right away if you become sick while taking perindopril, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water or salt and may lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

Check with your doctor immediately if you have a fever, chills, or sore throat. These could be symptoms of an infection resulting from low white blood cells.

Hyperkalemia (high potassium in the blood) may occur while you are using perindopril. Check with your doctor right away if you have the following symptoms: abdominal or stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, shortness of breath, or weakness or heaviness of the legs. Do not use salt substitutes containing potassium without first checking with your doctor.

Check with your doctor right away if you have upper stomach pain, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem. C

Make sure any doctor or dentist who treats you knows that you are using perindopril. You may need to stop using perindopril several days before having surgery.

Do not take other medicines unless they have been discussed with your doctor. This includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

perindopril Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Body aches or pain
  • chills
  • cough
  • difficulty breathing
  • ear congestion
  • fever
  • headache
  • loss of voice
  • nasal congestion
  • runny nose
  • sneezing
  • sore throat
  • unusual tiredness or weakness
Less common
  • Abdominal or stomach pain
  • bladder pain
  • bloody or cloudy urine
  • change in hearing
  • chest pain
  • cold or flu-like symptoms
  • congestion
  • difficult, burning, or painful urination
  • dryness of the throat
  • earache or pain in the ear
  • ear drainage
  • frequent urge to urinate
  • hoarseness
  • lower back or side pain
  • swelling
  • tender, swollen glands in the neck
  • trouble with swallowing
  • voice changes
  • vomiting
Rare
  • Blurred vision
  • confusion
  • decreased urination
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • dry mouth
  • irregular heartbeat
  • muscle cramps or pain
  • numbness, tingling, pain, or weakness in the hands or feet
  • rapid breathing
  • seizures
  • sunken eyes
  • sweating
  • thirst
  • trembling
  • weakness and heaviness of the legs

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Back pain
  • lack or loss of strength
  • pain or tenderness around the eyes and cheekbones
  • tightness of the chest
Less common
  • Belching
  • bloated
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • diarrhea
  • difficulty moving
  • discouragement
  • excess air or gas in the stomach or intestines
  • feeling sad or empty
  • full feeling
  • hearing loss
  • injury
  • irritability
  • lack of appetite
  • leg pain
  • loss of interest or pleasure
  • muscle aching, stiffness, tension, or tightness
  • nausea
  • neck pain
  • nervousness
  • pain, swelling, or redness in the joints
  • passing gas
  • rash
  • sleepiness or unusual drowsiness
  • stomach discomfort or upset
  • swollen joints
  • trouble concentrating
  • trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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