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Perindopril

Sounds like 'per-in-doe-pril'

Key points about perindopril

Perindopril is used to treat high blood pressure and heart failure and to prevent kidney problems for people with diabetes.
Perindopril is also called Coversyl.
Find out how to take it safely and possible side effects.

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Perindopril has many different effects on your body so it is used to treat a range of conditions. It belongs to a group of medicines called ACE inhibitors.

Perindopril may be used for the following conditions:

High blood pressure – by relaxing and widening your blood vessels it lowers your blood pressure.
Heart failure – to help your heart pump blood more easily. This can help to relieve symptoms such as shortness of breath and swelling in your feet, legs and abdomen (tummy).
Diabetic kidney disease (diabetic nephropathy) – to protect your kidneys and help them to function.
After a heart attack (myocardial infarction) to protect your heart, once you are stable.

Perindopril can work quickly for hypertension (high blood pressure). If you have heart failure it may be a few weeks before you notice an improvement in your symptoms.

Dose

Always take perindopril exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.

In Aotearoa New Zealand perindopril is available as tablets, 2 mg, 4 mg and 8 mg (from December 2022).
The dose of perindopril will be different for different people depending on your condition.
Your doctor will usually start you on a low dose so it doesn't make you feel dizzy. Your dose will be increased slowly over a few weeks depending on how you respond. This allows your body to get used to the medicine and reduces side effects.
Check with your pharmacist if your tablets are different to what you expect.

Keep track of your dose changes

You can use the table below to keep track of dose changes when you start taking perindopril.

Date	Dose



Notes:

How to take perindopril

Timing: Perindopril is usually taken once a day, in the morning. Take your dose at about the same time each day. Your healthcare provider may suggest that you take your first dose before bedtime because it can make you feel dizzy.
Limit or avoid alcohol while you are taking perindopril. Alcohol can increase your chance of side effects such as dizziness and light-headedness.
Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take the next dose at the right time. Don't take double the dose.

If you are pregnant or planning a pregnancy

Perindopril can affect your baby's kidneys, especially if it's taken in the second and third trimesters of pregnancy. This can result in long term damage to your baby's kidneys. If you're already pregnant, talk to your doctor straight away. Usually your doctor will be able to prescribe a different medicine that is safe to take in pregnancy. Perindopril should be stopped by the time you're 12 weeks pregnant at the latest. Use contraception if you're taking perindopril and carefully plan any pregnancy with your GP, pregnancy specialist (obstetrician) or hospital doctor. They will want to review your medical condition and medicine before you get pregnant. Most women stop taking perindopril before getting pregnant, but some may continue until they have a positive pregnancy test and then stop. Your doctor will discuss what's best for you, based on your medical condition and the risks and benefits of perindopril.

Severe allergic reaction to an ACE inhibitor

Perindopril is not suitable if you've had a severe allergic reaction to another ACE inhibitor in the past, eg, swelling of your lips, eyes or tongue (called angioedema).

Here are some things to know when you're taking perindopril. Other things may be important as well, so ask your healthcare provider what you should know about.

Monitoring

Your doctor will arrange for you to have blood tests and blood pressure checks before you start taking perindopril and during your treatment, especially when you first start taking it. This is to check how it is working and to check your kidneys and potassium levels.

Have a sick day plan

If you have diarrhoea (runny poo) or are vomiting (being sick) from a stomach bug, or are dehydrated from another illness, it’s important to let your healthcare provider know. They may advise that you decrease your dose or stop taking your perindopril for a few days, and start again when you feel better.

Be careful when taking some pain relief medicines

ACE inhibitors can be used to protect your kidneys from damage if you have diabetes. However, if you are taking perindopril and diuretics (water pills), the combination of these with NSAIDs (anti-inflammatory pain relief medicine) can be very harmful to your kidneys. It can cause acute kidney injury. This combination is called the ‘dangerous trio’ or ‘triple whammy’. There's a higher risk of harm to your kidneys if you are also an older adult (over 65 years) or if you're dehydrated.

If you're taking an ACE inhibitor with a diuretic, don't use NSAIDs for pain relief. Ask your doctor or pharmacist for a safer option. Read more about NSAIDs and protecting your kidneys.

Examples of diuretics	Examples of NSAIDs
Bendroflumetazide (Arrow-Bendrofluazide) Chlortalidone (Hygroton) Indapamide (Dapa-Tabs) Metolazone (Zaroxolyn) Furosemide (Lasix, Urex Forte) Bumetanide (Burinex) Spironolactone (Spiractin)	Ibuprofen (Nurofen, Brufen SR) Diclofenac (Voltaren) Naproxen (Noflam, Naprosyn) Mefenamic acid (Ponstan) Celecoxib (Celebrex) Tenoxicam (Tilcotil)

Like all medicines perindopril can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects	What should I do?
Dizziness Feeling light-headed Feeling faint when you stand up	This is quite common when you first start taking perindopril and usually goes way with time. These effects put you at risk of falls and injuries, especially if you are an older adult. Be careful when getting up from either lying down or sitting. Stand up slowly. If you do feel dizzy, sit or lie down for a few moments. Tell your doctor if this continues.
Tickle in your throat Dry, irritating cough	This is quite common when you first start taking perindopril and usually goes away with time. Tell your doctor if the cough is troublesome and persistent.
Upset tummy or feeling sick Constipation or diarrhoea	These are common when you first start taking perindopril but should go away with time. Tell your doctor if this continues.
Allergic reaction such as skin rash, itching, swelling of your lips, face and mouth, or difficulty breathing, such as chest tightness or wheezing	Tell your doctor immediately or phone Healthline 0800 611 116.
Signs of problems with your liver, such as yellowing of your skin or eyes, dark pee or pain in your abdomen (tummy)	Tell your doctor immediately or phone Healthline 0800 611 116.
Read more about medicines and side effects and reporting a reaction you think might be a side effect.