Drug Interaction Report

Rarely, perindopril may add to the effects of azaTHIOprine on white blood cells, increasing the risk of infections. Contact your doctor immediately if you develop signs and symptoms of infection such as fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Moderate-to-high dietary intake of potassium can cause hyperkalemia in some patients who are using angiotensin converting enzyme (ACE) inhibitors. In some cases, affected patients were using a potassium-rich salt substitute. ACE inhibitors can promote hyperkalemia through inhibition of the renin-aldosterone-angiotensin (RAA) system.

ADJUST DOSING INTERVAL: Administration with food decreased the biotransformation of perindopril to its active metabolite, perindoprilat, resulting in a decrease of perindoprilat bioavailability by 35% and a reduction in the plasma ACE inhibition curve of approximately 20%. When administered as part of a combination product with amlodipine and taken with food, perindopril and perindoprilat absorption rates have decreased by 18% and 14%, respectively, versus fasting. No effect of food on the extent of unmetabolized perindopril absorption has been observed.

MANAGEMENT: It is recommended that patients who are taking ACE inhibitors be advised to avoid moderately high or high potassium dietary intake. Particular attention should be paid to the potassium content of salt substitutes. Some authorities recommend administering perindopril before a meal, preferably in the morning. According to the prescribing information, the combination product containing perindopril and amlodipine may be taken with or without food.