Perindopril

Perindopril is a prescription medication used to treat Hypertension, and Stable Coronary Artery Disease (CAD). 

• Perindopril is available under the following different brand names: Aceon.  

Adult dosage

Tablet

• 2mg
• 4mg
• 8mg

Hypertension

Adult dosage

• 4-8 mg orally once daily or divided every 12 hours
• Maximum: 16 mg/day orally divided every 12 hours

Stable Coronary Artery Disease (CAD)

Adult dosage

• 4 mg orally once daily for 2 weeks, then increase as tolerated to 8 mg/day orally divided every 12 hours

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

Common side effects of Perindopril include:

• dizziness, 
• back pain, and 
• cough

Serious side effects of Perindopril include:

• hives, 
• severe stomach pain, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• lightheadedness, 
• fever, 
• chills, 
• body aches, 
• flu symptoms, 
• sores in the mouth and throat, 
• little or no urination, 
• swelling, 
• rapid weight gain, 
• nausea, 
• slow or unusual heart rate, 
• weakness, 
• loss of movement, 
• pale skin, 
• easy bruising, 
• unusual bleeding, and
• yellowing of the eyes or skin (jaundice)

Rare side effects of Perindopril include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Perindopril has severe interactions with the following drugs:
  • aliskiren
  • protein a column
  • sacubitril/valsartan
• Perindopril has serious interactions with at least 39 other drugs.
• Perindopril has moderate interactions with at least 103 other drugs.
• Perindopril has minor interactions with at least 29 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Contraindications

• Hypersensitivity to perindopril/other ACE inhibitors
• History of hereditary or angioedema associated with previous ACE inhibitor treatment
• Coadministration of neprilysin inhibitors (e.g., sacubitril) with ACE inhibitors may increase angioedema risk; do not administer ACE inhibitors within 36 hours of switching to or from sacubitril/valsartan
• Bilateral renal artery stenosis
• Do not coadminister with aliskiren in patients with diabetes mellitus or with renal impairment (i.e., GFR less than 60 mL/min/1.73 m²)

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Perindopril?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Perindopril?”

Cautions

• Apheresis (LDL) with dextran sulfate, hypertrophic cardiomyopathy, collagen vascular disease, excessive hypotension - volume depletion, hemodialysis with high flux membrane, aortic stenosis
• ACE inhibition also causes increased bradykinin levels which putatively mediates angioedema
• Coadministration with mTOR inhibitors (eg, temsirolimus) may increased risk for angioedema
• Dual blockade of the renin angiotensin system with ARBs, ACE inhibitors, or aliskiren associated with increased risk for hypotension, hyperkalemia, and renal function changes (including acute renal failure) compared to monotherapy
• Symptomatic hypotension is most likely to occur in patients who have been volume or salt-depleted as a result of prolonged diuretic therapy, dietary salt restriction, dialysis, diarrhea or vomiting; in patients with ischemic heart disease or cerebrovascular disease, an excessive fall in blood pressure could result in a myocardial infarction or a cerebrovascular accident; If excessive hypotension occurs, place patient in a supine position and, if necessary, treat with intravenous infusion of physiological saline; perinopril treatment can usually be continued following restoration of volume and blood pressure
• Discontinue immediately if pregnant (see Contraindications and Black Box Warnings)
• Less effective in blacks
• Renal impairment may occur
• Neutropenia/agranulocytosis reported
• Cough may occur within the first few months
• Cholestatic jaundice may occur
• Renal impairment

Pregnancy and Lactation

• Use in LIFE-THREATENING emergencies when no safer drug is available during pregnancy.
• Discontinue as soon as pregnancy detected; during the second and third trimesters of pregnancy, drugs that act directly on the renin-angiotensin have been associated with fetal injury that includes hypotension, neonatal skull hypoplasia, anuria, reversible or irreversible renal failure, and death.  
• Lactation: not known if distributed into breast milk; use caution.