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Generic Name: Perindopril Arginine, Perindopril Erbumine
Class: Angiotensin-Converting Enzyme Inhibitors
VA Class: CV800
Chemical Name: l-arginine (2S,3αS,7αS)-1- [(2S)-2-[[(1S)-1-(ethoxycarbonyl)butyl]amino]propanoyl]octahydro-1H-indole-2-carboxylate
Molecular Formula: C19H32N2O5•C6H14N4O5C19H32N2O5
CAS Number: 612548-45-5


  • May cause fetal and neonatal morbidity and mortality if used during pregnancy.1 42 43 (See Fetal/Neonatal Morbidity and Mortality under Cautions.)

  • If pregnancy is detected, discontinue perindopril as soon as possible.1 43


Nonsulfhydryl ACE inhibitor.1

Uses for Aceon


Management of hypertension (alone or in combination with other classes of antihypertensive agents);1 2 46 500 may be used in fixed combination with amlodipine when such combined therapy is indicated.46

ACE inhibitors are recommended as one of several preferred drugs for the initial management of hypertension; other options include angiotensin II receptor antagonists, calcium-channel blockers, and thiazide diuretics.501 502 503 504 While there may be individual differences with respect to specific outcomes, these antihypertensive drug classes all produce comparable effects on overall mortality and cardiovascular, cerebrovascular, and renal outcomes.500 501 502 504 Individualize choice of therapy; consider patient characteristics (e.g., age, ethnicity/race, comorbidities, cardiovascular risk) as well as drug-related factors (e.g., ease of administration, availability, adverse effects, cost).500 501 502 503 504 515

ACE inhibitors may be preferred in hypertensive patients with heart failure, ischemic heart disease, diabetes mellitus, chronic kidney disease, or cerebrovascular disease or post-MI.500 501 502 504 520 523 524 525 526 527 534 535 536 543

Black hypertensive patients generally tend to respond better to monotherapy with calcium-channel blockers or thiazide diuretics than to ACE inhibitors.1 18 19 39 40 500 501 504 However, diminished response to an ACE inhibitor is largely eliminated when administered concomitantly with a calcium-channel blocker or thiazide diuretic.500 504

The optimum BP threshold for initiating antihypertensive drug therapy is controversial.501 504 505 506 507 508 515 523 530 Further study needed to determine optimum BP thresholds/goals; individualize treatment decisions.501 503 507 515 526 530

JNC 7 recommends initiation of drug therapy in all patients with uncomplicated hypertension and BP ≥140/90 mm Hg;500 JNC 8 panel recommends SBP threshold of 150 mm Hg for patients ≥60 years of age.501 Although many experts agree that SBP goal of <150 mm Hg may be appropriate for patients ≥80 years of age,502 504 505 530 application of this goal to those ≥60 years of age is controversial, especially for those at higher cardiovascular risk.501 502 505 506 508 511 515

In the past, initial antihypertensive drug therapy was recommended for patients with diabetes mellitus or chronic kidney disease who had BP ≥130/80 mm Hg;500 503 current hypertension management guidelines generally recommend a BP threshold of 140/90 mm Hg for these individuals (same as for the general population of patients without these conditions), although a goal of <130/80 mm Hg may still be considered.501 502 503 504 520 530 535 536 541

Heart Failure

Management of heart failure, usually in conjunction with other agents such as cardiac glycosides, diuretics, and β-adrenergic blocking agents (β-blockers).23 24 25 26 27 524 800

Some evidence indicates that therapy with an ACE inhibitor (enalapril) may be less effective than angiotensin receptor-neprilysin inhibitor (ARNI) therapy (e.g., sacubitril/valsartan) in reducing cardiovascular death and heart failure-related hospitalization.702 800

ACCF, AHA, and the Heart Failure Society of America (HFSA) recommend that patients with chronic symptomatic heart failure and reduced left ventricular ejection fraction (LVEF) (NYHA class II or III) who are able to tolerate an ACE inhibitor or angiotensin II receptor antagonist be switched to therapy containing an ARNI to further reduce morbidity and mortality.800

Diabetic Nephropathy

A recommended agent in the management of patients with diabetes mellitus and persistent albuminuria who have modestly elevated (30–300 mg/24 hours) or higher (>300 mg/24 hours) levels of urinary albumin excretion; slows rate of progression of renal disease in such patients.34 35 36 37 38 520 535 536

Aceon Dosage and Administration


BP Monitoring and Treatment Goals

  • Carefully monitor BP during initial titration or subsequent upward adjustment in dosage.500 501

  • When available, use evidence-based dosing information (i.e., dosages shown in randomized controlled trials to reduce complications of hypertension) to determine target dosages; target dosages usually can be achieved within 2–4 weeks but may take up to several months.501

  • If adequate BP response not achieved with a single antihypertensive agent, add a second drug with demonstrated benefit; if goal BP still not achieved with optimal dosages of 2 antihypertensive agents, add a third drug.501 May maximize dosage of the first drug before adding a second drug, or add a second drug before maximizing dosage of the initial drug.501

  • Consider initiating antihypertensive therapy with a combination of drugs if patient's BP exceeds goal BP by >20/10 mm Hg.500 501 503 504

  • Goal is to achieve and maintain optimal control of BP; individualize specific target BP based on consideration of multiple factors, including patient age and comorbidities, and currently available evidence from clinical studies.500 501 (See Hypertension under Uses.)


Oral Administration

Administer orally once or twice daily1 without regard to meals.2 In clinical studies, administration in 2 divided doses was only slightly more effective than once-daily dosing.1


Available as perindopril erbumine; dosage expressed in terms of perindopril erbumine.1

Also available as perindopril arginine (in fixed-combination preparation); dosage expressed in terms of perindopril arginine.46


Perindopril Erbumine Therapy

Initially, 4 mg once daily in patients not receiving a diuretic.1

In patients currently receiving diuretic therapy, discontinue diuretic, reduce diuretic dosage, or increase salt intake, if possible, before initiating perindopril.600 If diuretic therapy cannot be altered, initiate therapy under close medical supervision for at least 2 hours and until BP has stabilized for an additional hour.600

Usual dosage: 4–8 mg once daily.1 2 500

If intolerable adverse effects occur, consider dosage reduction; if adverse effects worsen or fail to resolve, may need to discontinue and switch to another antihypertensive drug class.501

Perindopril Arginine/Amlodipine Fixed-combination Therapy

Fixed-combination perindopril/amlodipine tablets may be used for initial treatment of hypertension in patients likely to require combination therapy with multiple antihypertensive agents to control BP.46 Consider potential benefits and risks of initiating therapy with the fixed combination, including whether the patient is likely to tolerate the lowest available dosage of the combined drugs.46

If patient's baseline BP is 170/105 mm Hg, the estimated probability of achieving SBP control (SBP <140 mm Hg) is 26, 40, or 50% and of achieving DBP control (DBP <90 mm Hg) is 31, 46, or 65% with perindopril erbumine (16 mg daily) alone, amlodipine (10 mg daily) alone, or amlodipine (10 mg daily) combined with perindopril arginine (14 mg daily), respectively.46

If BP is not adequately controlled by monotherapy, can switch to perindopril/amlodipine fixed combination.46

In black patients and patients with diabetes mellitus, addition of perindopril arginine (14 mg daily) to amlodipine (10 mg daily) did not provide additional antihypertensive effects beyond those achieved with amlodipine monotherapy.46

If BP is adequately controlled by monotherapy with amlodipine but edema has developed, can switch to perindopril/amlodipine fixed combination to achieve BP control without edema.46

When used for initial therapy of hypertension in patients likely to require combination therapy with multiple antihypertensive agents, recommended initial dosage is perindopril arginine 3.5 mg and amlodipine 2.5 mg once daily.46

May adjust dosage at intervals of 7–14 days, up to maximum of perindopril arginine 14 mg and amlodipine 10 mg once daily.46

Prescribing Limits



Perindopril erbumine: Maximum 16 mg daily.1

Perindopril arginine: Maximum 14 mg daily (in fixed combination with amlodipine).46

Special Populations

Renal Impairment


Perindopril erbumine: Initially, 2 mg daily in patients with renal impairment (Clcr >30 mL/minute); titrate until BP is controlled or to maximum of 8 mg daily. (See Renal Impairment under Cautions.)1

Perindopril/amlodipine fixed combination: Not recommended in patients with Clcr<60 mL/minute; insufficient data to support dosage recommendations.46

Hepatic Impairment


Perindopril/amlodipine fixed combination: Not recommended in patients with hepatic impairment; insufficient data to support dosage recommendations.46

Geriatric Patients


Perindopril erbumine: Initially, 4 mg daily, given in 1 dose or 2 divided doses.1 Adjust dosage to achieve BP control.1 Administer dosages >8 mg daily with caution and under close medical supervision.1

Perindopril/amlodipine fixed combination: Not recommended in geriatric patients; insufficient data to support dosage recommendations.46

Heart Failure

Perindopril/amlodipine fixed combination: Not recommended in patients with heart failure; insufficient data to support dosage recommendations.46

Cautions for Aceon


  • Known hypersensitivity (e.g., history of angioedema) to perindopril or another ACE inhibitor.1



Fetal/Neonatal Morbidity and Mortality

Possible fetal and neonatal morbidity and mortality when used during pregnancy.1 43 (See Boxed Warning.) Such potential risks occur throughout pregnancy, especially during the second and third trimesters.43

Also may increase the risk of major congenital malformations when administered during the first trimester of pregnancy.42 43

Discontinue as soon as possible when pregnancy is detected, unless continued use is considered lifesaving.1 42 43 Nearly all women can be transferred successfully to alternative therapy for the remainder of their pregnancy.13

Sensitivity Reactions

Anaphylactoid reactions and/or head and neck angioedema possible; angioedema associated with tongue, glottis, or larynx may be fatal.1 If angioedema occurs, promptly discontinue perindopril and observe patient until swelling disappears.1 Immediate medical intervention (e.g., epinephrine) for involvement of tongue, glottis, or larynx.1

Intestinal angioedema possible; consider in differential diagnosis of patients who develop abdominal pain.1

Anaphylactoid reactions reported in patients receiving ACE inhibitors while undergoing LDL apheresis with dextran sulfate absorption or following initiation of hemodialysis that utilized high-flux membrane.1

Life-threatening anaphylactoid reactions reported in at least 2 patients receiving ACE inhibitors while undergoing desensitization treatment with hymenoptera venom.1

Contraindicated in patients with a history of angioedema associated with ACE inhibitors.1

Other Warnings/Precautions

Use of Fixed Combinations

When used in fixed combination with amlodipine, consider the cautions, precautions, contraindications, and interactions associated with amlodipine.46 Consider cautionary information applicable to specific populations (e.g., pregnant or nursing women, individuals with hepatic or renal impairment, geriatric patients) for each drug in the fixed combination.46


Possible symptomatic hypotension, particularly in volume- and/or salt-depleted patients (e.g., those treated with diuretics, undergoing dialysis, with diarrhea or vomiting).1 2 13

Risk of marked hypotension, sometimes associated with oliguria, azotemia, and, rarely, acute renal failure and death in patients with heart failure with or without associated renal insufficiency.1 Severe hypotension may result in MI or stroke in patients with ischemic cardiovascular or cerebrovascular disease.1

Hypotension may occur in patients undergoing surgery or during anesthesia with agents that produce hypotension; recommended treatment is fluid volume expansion.1

To minimize potential for hypotension, correct volume and/or salt depletion (e.g., by withholding diuretic therapy, decreasing diuretic dosage, increasing sodium intake) prior to initiation of perindopril.1 600 (See Dosage under Dosage and Administration.)

In patients at risk of excessive hypotension, initiate therapy under close medical supervision; monitor closely for first 2 weeks following initiation of perindopril or any increase in perindopril or diuretic dosage.1

If excessive hypotension occurs, immediately place patient in supine position and, if necessary, administer IV infusion of 0.9% sodium chloride injection.1 Perindopril therapy usually can be continued following restoration of volume and BP.1

Hematologic Effects

Neutropenia and agranulocytosis reported with captopril; risk appears to depend principally on presence of renal impairment and/or presence of collagen vascular disease (e.g., systemic lupus erythematosus, scleroderma); risk with perindopril is unknown.1

Hepatic Effects

Clinical syndrome that usually is manifested initially by cholestatic jaundice and may progress to fulminant hepatic necrosis (occasionally fatal) reported rarely with ACE inhibitors.1

If jaundice or marked elevation of liver enzymes occurs, discontinue drug and monitor patient.1

Renal Effects

Transient increases in BUN and Scr possible, especially in patients with preexisting renal impairment or those receiving concomitant diuretic therapy.1 Possible increases in BUN and Scr in patients with unilateral or bilateral renal artery stenosis; generally reversible following discontinuance of therapy.1

Possible oliguria, progressive azotemia, and, rarely, acute renal failure and/or death in patients with severe heart failure.1

Closely monitor renal function for the first few weeks of therapy in hypertensive patients with unilateral or bilateral renal-artery stenosis.1 Some patients may require dosage reduction or discontinuance of ACE inhibitor or diuretic.1


Possible hyperkalemia, especially in patients with renal impairment or diabetes mellitus and those receiving drugs that can increase serum potassium concentration (e.g., potassium-sparing diuretics, potassium supplements, potassium-containing salt substitutes).1 (See Specific Drugs under Interactions.)

Monitor serum potassium concentration carefully in these patients.1


Persistent and nonproductive cough; resolves after drug discontinuance.1

Specific Populations


Category C (1st trimester); Category D (2nd and 3rd trimesters).1 (See Boxed Warning.)


Distributed into milk in rats; not known whether perindopril is distributed into milk in humans.1 Caution if used in nursing women.1

Pediatric Use

Safety and efficacy not established in pediatric patients.1

Geriatric Use

Possible lesser effect on BP in those >60 years of age than in younger patients.1 Increased plasma concentrations of perindopril and perindoprilat.1 Dizziness and possibly rash may occur more frequently in geriatric patients.1

Renal Impairment

Deterioration of renal function may occur (see Renal Effects under Cautions).1 Systemic exposure to perindoprilat may be increased with decreasing renal function.1

Initial dosage adjustment recommended in patients with renal impairment.1 (See Renal Impairment under Dosage and Administration.) Safety and efficacy not established and use not recommended in patients with Clcr <30 mL/minute.1 600

Hepatic Impairment

Increased bioavailability of perindoprilat.1

Black Patients

BP reduction may be smaller in black patients compared with patients of other races.1 500 504 (See Hypertension under Uses and see Perindopril Arginine/Amlodipine Fixed-combination Therapy under Dosage and Administration.)

Higher incidence of angioedema reported with ACE inhibitors (as monotherapy) in black patients compared with other races.1 19 500

Common Adverse Effects

Cough, proteinuria, palpitation, sinusitis, viral infection, dyspepsia, fever, upper extremity pain, hypertonia.1

Dizziness reported at a rate similar to that with placebo, but incidence increases with increased dosage, suggesting causal relation to the drug.1

Interactions for Aceon

Specific Drugs





No effect on digoxin concentrations; effect on perindopril/perindoprilat concentrations has not been excluded1


Increased hypotensive effect1

If possible, discontinue diuretic before initiating perindopril1 (see Dosage under Dosage and Administration)

Diuretics, potassium-sparing (amiloride, spironolactone, triamterene)

Enhanced hyperkalemic effect1

Use with caution; monitor serum potassium concentrations frequently1


Possible interaction based on animal data; no studies in humans1

Use with caution1


Increased serum lithium concentrations; possible toxicity1

Use with caution; monitor serum lithium concentrations frequently1

Potassium supplements or potassium-containing salt substitutes

Enhanced hyperkalemic effect1

Use with caution; monitor serum potassium concentrations frequently1

Aceon Pharmacokinetics



Absolute bioavailability of perindopril is 75%; mean bioavailability of perindoprilat is 25%.1

Peak plasma concentrations of perindopril and perindoprilat are achieved within 1 and 3–7 hours, respectively.1


Antihypertensive effects occur promptly, with effects increasing slightly over several weeks.1


Maximal antihypertensive effect (inhibition of 80–90% of ACE activity) persists for about 10–12 hours; at 24 hours, only 60% of ACE activity is blocked.1


Food does not affect rate or extent of absorption of perindopril but reduces bioavailability of perindoprilat by about 35%.1

Special Populations

In patients with hepatic impairment, increased perindoprilat bioavailability.1

In patients with renal impairment, increased perindoprilat concentrations with decreasing renal function.1

In patients >70 years of age, increased plasma perindopril and perindoprilat concentrations (resulting from increased conversion of perindopril to perindoprilat and decreased renal excretion of perindoprilat).1



Appears to cross the blood-brain barrier only slightly in rats.1

Crosses the placenta and is distributed into milk in rats.1

Plasma Protein Binding

Perindopril: 60%.1

Perindoprilat: 10–20%.1



Extensively metabolized in the liver to 6 metabolites, including an active metabolite, perindoprilat.1

Elimination Route

Eliminated principally in urine (as metabolites).1

Removed by renal dialysis.1


Perindopril: 0.8–1 hour.1

Perindoprilat: 3–10 hours.1

Special Populations

In patients with heart failure, decreased clearance and increased AUC of perindoprilat.1





Perindopril erbumine: 20–25°C.1 Protect from moisture.1

Perindopril arginine/amlodipine fixed combination: 25ºC (may be exposed to 15–30ºC); protect from moisture.46


  • Prodrug; not pharmacologically active until hydrolyzed in the liver to perindoprilat.1 2

  • Suppresses the renin-angiotensin-aldosterone system.1

Advice to Patients

  • When perindopril is used in fixed combination with amlodipine, advise patients of important precautionary information about amlodipine.46

  • Risk of angioedema, anaphylactoid reactions, or other sensitivity reactions.1 Importance of reporting sensitivity reactions (e.g., edema of face, eyes, lips, tongue, or extremities; hoarseness; swallowing or breathing with difficulty) immediately to clinician and of discontinuing the drug.1

  • Importance of reporting signs of infection (e.g., sore throat, fever).1

  • Risk of hypotension.1 Importance of informing clinicians promptly if lightheadedness or fainting occurs.1

    Importance of adequate fluid intake; risk of volume depletion with excessive perspiration, dehydration, vomiting, or diarrhea.1

  • Risks of use during pregnancy.1 (See Boxed Warning.)

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs (including salt substitutes containing potassium).1

  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1

  • Importance of advising patients of other important precautionary information.1 (See Cautions.)


Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

Perindopril Arginine Combinations


Dosage Forms


Brand Names




3.5 mg with Amlodipine Besylate 2.5 mg (of amlodipine)



7 mg with Amlodipine Besylate 5 mg (of amlodipine)



14 mg with Amlodipine Besylate 10 mg (of amlodipine)



* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Perindopril Erbumine


Dosage Forms


Brand Names




2 mg*

Aceon (scored)


Perindopril Erbumine Tablets

4 mg*

Aceon (scored)


Perindopril Erbumine Tablets

8 mg*

Aceon (scored)


Perindopril Erbumine Tablets

AHFS DI Essentials. © Copyright 2018, Selected Revisions February 28, 2017. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.


1. Solvay Pharmaceuticals. Aceon (perindopril erbumine) tablets prescribing information. Marietta, GA; 2003 Mar.

2. Todd PA, Fitton A. Perinopril: a review of its pharmacological properties and therapeutic use in cardiovascular disorders. Drugs. 1991; 42:90-114. [PubMed 1718688]

3. Bristol-Myers Squibb. Capoten (captopril) tablets prescribing information. Princeton, NJ; 1996 April.

4. Reviewers’ comments in enalapril/enalaprilat (personal observations).

7. Saunders E. Tailoring treatment to minority patients. Am J Med. 1990; 88(Suppl 3B):21-23S.

8. Chrysant SG, Danisa K, Kem DC et al. Racial differances in pressure, volume and renin interrelationships in essential hypertension. Hypertension. 1979; 1:136-41.

10. Anon. Drugs for hypertension. Med Lett Drugs Ther. 1984; 26:107-12. [PubMed 6150424]

12. Lapostolle F, Borron SW, Bekka R et al. Lingual angioedema after perindopril use. Am J Cardiol. 1998; 81:523. [PubMed 9485152]

13. Bagger JP. Adverse event with first-dose perindopril in congestive heart failure. Lancet. 1997; 349:1671-2. [PubMed 9186393]

14. Izzo JL, Levy D, Black HR. Importance of systolic blood pressure in older Americans. Hypertension. 2000; 35:1021-4. [PubMed 10818056]

15. Frohlich ED. Recognition of systolic hypertension for hypertension. Hypertension. 2000; 35:1019-20. [PubMed 10818055]

16. Bakris GL, Williams M, Dworkin L et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis. 2000; 36:646-61. [PubMed 10977801]

17. Associated Press (American Diabetes Association). Diabetics urged: drop blood pressure. Chicago, IL; 2000 Aug 29. Press Release from web site ().

18. Appel LJ. The verdict from ALLHAT—thiazide diuretics are the preferred initial therapy for hypertension. JAMA. 2002; 288:3039-60. [PubMed 12479770]

19. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002; 288:2981-97. [PubMed 12479763]

22. Novartis. Lotensin (benazepril hydrochloride) tablets prescribing information. East Hanover, NJ: 2001 Jul.

23. Merck & Co. Vasotec tablets (enalapril maleate) prescribing information. Whitehouse Station, NJ; 2002 Jan.

24. Bristol-Myers Squibb. Monopril (fosinopril sodium) tablets prescribing information. Princeton, NJ; 2002 Feb.

25. Merck. Prinivil (lisinopril) tablets prescribing information. Whitehouse Station, NJ; 2002 Jan.

26. AstraZeneca. Zestril (lisinopril) tablets prescribing information. Wilmington, DE: 2002 Jan.

27. Parke Davis. Accupril (quinapril hydrochloride) tablets prescribing information. Morris Plains, NJ; 2001 Mar.

30. Novartis. Diovan (valsartan) tablets prescribing information. East Hanover, NJ; 2002 Aug.

34. Lewis EJ, Hunsicker LG, Bain RP et al. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. N Engl J Med. 1993; 329:1456-62. [PubMed 8413456]

35. Remuzzi G. Slowing the progression of diabetic nephropathy. N Engl J Med. 1993; 329:1496-7. [PubMed 8413463]

36. Kaplan NM. Choice of initial therapy for hypertension. JAMA. 1996; 275:1577-80. [PubMed 8622249]

37. Viberti G, Mogensen CE, Groop LC et al. Effect of captopril on progression to clinical proteinuria in patients with insulin-dependent diabetes mellitus and microalbuminuria. JAMA. 1994; 271:275-9. [PubMed 8295285]

38. Fournier A. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. N Engl J Med. 1994; 330:937. [PubMed 8114873]

39. Wright JT, Dunn JK, Cutler JA et al. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA. 2005; 293:1595-607. [PubMed 15811979]

40. Neaton JD, Kuller LH. Diuretics are color blind. JAMA. 2005; 293:1663-6. [PubMed 15811986]

42. Cooper WO, Hernandez-Diaz S, Arbogast PG et al. Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med. 2006; 354:2443-51. [PubMed 16760444]

43. Food and Drug Administration. FDA public health advisory: angiotensin-converting enzyme inhibitor (ACE inhibitor) drugs and pregnancy. From FDA website ().

44. Sibai BM. Treatment of hypertension in pregnant women. N Engl J Med. 1996; 335:257-65. [PubMed 8657243]

45. US Food and Drug Administration. Dangers of ACE inhibitors during pregnancy. FDA Med Bull. 1992; 22:2.

46. Symplmed, LLC. Prestalia (perindopril arginine and amlodipine besylate) tablets prescribing information. Cincinnati, OH; 2015 Jan.

500. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). Bethesda, MD: National Institutes of Health; 2004 Aug. (NIH publication No. 04-5230.)

501. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311:507-20. [PubMed 24352797]

502. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31:1281-357. [PubMed 23817082]

503. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. 2014; 63:878-85. [PubMed 24243703]

504. Weber MA, Schiffrin EL, White WB et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014; 16:14-26. [PubMed 24341872]

505. Wright JT, Fine LJ, Lackland DT et al. Evidence supporting a systolic blood pressure goal of less than 150 mm Hg in patients aged 60 years or older: the minority view. Ann Intern Med. 2014; 160:499-503. [PubMed 24424788]

506. Mitka M. Groups spar over new hypertension guidelines. JAMA. 2014; 311:663-4. [PubMed 24549531]

507. Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes?. JAMA. 2014; 311:474-6. [PubMed 24352710]

508. Bauchner H, Fontanarosa PB, Golub RM. Updated guidelines for management of high blood pressure: recommendations, review, and responsibility. JAMA. 2014; 311:477-8. [PubMed 24352759]

511. JATOS Study Group. Principal results of the Japanese trial to assess optimal systolic blood pressure in elderly hypertensive patients (JATOS). Hypertens Res. 2008; 31:2115-27. [PubMed 19139601]

515. Thomas G, Shishehbor M, Brill D et al. New hypertension guidelines: one size fits most?. Cleve Clin J Med. 2014; 81:178-88. [PubMed 24591473]

520. American Diabetes Association. Standards of medical care in diabetes--2014. Diabetes Care. 2014; 37 Suppl 1:S14-80.

523. Fihn SD, Gardin JM, Abrams J et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012; 126:e354-471.

524. WRITING COMMITTEE MEMBERS, Yancy CW, Jessup M et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013; 128:e240-327.

525. Smith SC, Benjamin EJ, Bonow RO et al. AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. Circulation. 2011; 124:2458-73. [PubMed 22052934]

526. Kernan WN, Ovbiagele B, Black HR et al. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2014; :. [PubMed 24788967]

527. O'Gara PT, Kushner FG, Ascheim DD et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013; 127:e362-425.

530. Myers MG, Tobe SW. A Canadian perspective on the Eighth Joint National Committee (JNC 8) hypertension guidelines. J Clin Hypertens (Greenwich). 2014; 16:246-8. [PubMed 24641124]

534. Qaseem A, Hopkins RH, Sweet DE et al. Screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2013; 159:835-47. [PubMed 24145991]

535. Taler SJ, Agarwal R, Bakris GL et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for management of blood pressure in CKD. Am J Kidney Dis. 2013; 62:201-13. [PubMed 23684145]

536. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int Suppl. 2012: 2: 337-414.

541. Perk J, De Backer G, Gohlke H et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012; 33:1635-701. [PubMed 22555213]

543. National Kidney Foundation Kidney Disease Outcomes Quality Initiative. K/DOQI Clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease (2002). From National Kidney Foundation website.

600. Xoma. Aceon (perindopril erbumine) tablets prescribing information. Berkeley, CA; 2013 Mar.

701. Ponikowski P, Voors AA, Anker SD et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016; 37:2129-200. [PubMed 27206819]

702. McMurray JJ, Packer M, Desai AS et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014; 371:993-1004. [PubMed 25176015]

703. Ansara AJ, Kolanczyk DM, Koehler JM. Neprilysin inhibition with sacubitril/valsartan in the treatment of heart failure: mortality bang for your buck. J Clin Pharm Ther. 2016; 41:119-27. [PubMed 26992459]

800. Yancy CW, Jessup M, Bozkurt B et al. 2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2016; 134: e282-93.