Perindopril - an ACE inhibitor

  • Perindopril is used to treat a number of different conditions and is generally well tolerated.
  • The first dose may make you feel dizzy.
  • Some painkillers and indigestion remedies interfere with perindopril, so ask your pharmacist for advice before you buy any medicines.
Type of medicine ACE inhibitor (angiotensin-converting enzyme inhibitor)
Used for Hypertension
Heart failure
To help to prevent problems after heart attacks and procedures to help increase blood flow through the heart
Also called Perindopril arginine, perindopril erbumine, perindopril tert-butylamine
Coversyl® Arginine, Coversyl® Arginine Plus (this contains perindopril arginine with indapamide)
Available as Tablets

Perindopril is used mainly in the treatment of hypertension (high blood pressure) and heart failure (a condition where the pumping action of the heart is reduced). It is also used to help to protect the heart after a heart attack and some procedures.

ACE inhibitors like perindopril prevent your body from creating a hormone known as angiotensin II. They do this by blocking (inhibiting) a chemical called angiotensin-converting enzyme. This relaxes your blood vessels and helps to reduce the amount of water put back into your blood by the kidneys. These actions help to decrease blood pressure. People with high blood pressure often do not feel unwell but, if left untreated, high blood pressure can harm the heart and damage blood vessels, leading to a heart attack or stroke.

In heart failure, there may be too much circulating fluid in your blood vessels. ACE inhibitors help to reduce this. They appear to have a protective effect on the heart and slow the progression of the heart failure.

Perindopril can be used on its own or alongside other medicines.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking perindopril it is important that your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have kidney problems.
  • If you use salt substitutes which contain potassium.
  • If you are dehydrated - for example, if you have had diarrhoea or sickness very recently.
  • If you have been told you have atherosclerosis (a build-up of fatty deposits on the walls of your arteries).
  • If you have peripheral vascular disease (a particular type of poor circulation).
  • If you have a collagen vascular disease, such as systemic lupus erythematosus (SLE) or scleroderma.
  • If you have been told you have cardiomyopathy (cardiac muscle disease), or aortic stenosis (narrowing of the main blood vessel from your heart).
  • If you have ever had angio-oedema (where your face, tongue or throat swells).
  • If you are having desensitisation treatment to protect against bee and wasp stings.
  • If you have dialysis treatment, or treatment to remove cholesterol from your blood by a machine (LDL apheresis).
  • If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
  • If you have ever had an allergic or unusual reaction to any other ACE inhibitor (such as ramipril, lisinopril or enalapril), or to any other medicine.
  • Before you start this treatment, read the manufacturer's printed information leaflet from inside the pack. The leaflet will give you more information about the brand of perindopril you have been given, and a full list of possible side-effects from taking it.
  • Take perindopril exactly as your doctor has told you. The usual dose is one tablet each day. Your dose will also be on the label of the pack.
  • Your doctor may advise you take your very first dose of perindopril at bedtime. This is because you may feel dizzy when you first start taking it.
  • After this first dose, take perindopril each morning, 30 to 60 minutes before food.
  • If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose.
  • Try to keep your regular appointments with your doctor. This is so your progress can be monitored. Your doctor will want you to have some blood tests to check on your kidney function from time to time.
  • It is very important you follow any dietary and lifestyle advice that you may have been given by your doctor, such as eating a healthy diet, not smoking, and taking regular exercise.
  • If you buy any medicines, check with a pharmacist that they are suitable to take with perindopril. This is because some medicines (such as anti-inflammatory painkillers and indigestion remedies) may interfere with these tablets.
  • If you drink alcohol, ask your doctor for advice about taking perindopril and alcohol. Alcohol will increase feelings of light-headedness and may not be recommended for you.
  • If you have diabetes you may need to check your blood glucose more frequently, as these tablets may lower the levels of sugar in your blood. Your doctor will advise you about this.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking perindopril. This is because perindopril taken with an anaesthetic may make your blood pressure drop too low.
  • Treatment with perindopril is usually long-term unless you experience an adverse effect. Continue to take the tablets unless you are advised otherwise.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common perindopril side-effects - these affect less than 1 in 10 people who take this medicine What can I do if I experience this?
Feeling light-headed or dizzy, especially when standing up Getting up more slowly should help. If you begin to feel dizzy, lie down so that you do not faint, then sit for a few moments before standing. If this continues beyond the first few days, speak with your doctor
Dry irritating cough If this continues, speak with your doctor, as an alternative medicine may be better for you
Feeling or being sick, abdominal pain, indigestion, diarrhoea Stick to bland foods - avoid rich and spicy meals
Constipation Try to eat a well-balanced diet and drink plenty of water each day
Headache Ask your pharmacist to recommend a suitable painkiller
Feeling tired, problems with eyesight If this happens, do not drive or use tools or machines until you feel more awake or able to see clearly
Vertigo, tingling feelings, tinnitus (a ringing noise in your ears), itchy skin rash, and muscle cramps Speak with your doctor if any of these become troublesome

Important: if you experience any of the following rare but serious symptoms, stop taking perindopril and contact your doctor for advice straightaway:

  • Any difficulty breathing, or swelling of your face, mouth, tongue or throat. These are signs of an allergic reaction.
  • Any yellowing of your skin or whites of your eyes. These may be signs of jaundice which is a rare side-effect.
  • A severe skin rash.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.
  • Never take more than the prescribed dose. If you suspect that someone has taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
  • This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
  • Never keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
  • If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
  • Manufacturer's PIL, Coversyl® Arginine; Manufacturer's PIL, Coversyl® Arginine, Servier Laboratories Limited, electronic Medicines Compendium. Dated December 2009.

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Dr Hannah Gronow
Document ID:
3369 (v26)
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