Perindopril - an ACE inhibitor

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Perindopril is given to treat a number of different conditions. It is generally well tolerated, although some people can develop a troublesome cough. If this happens to you, let your doctor know.

The first dose of perindopril can make you feel dizzy, so it is best taken at bedtime.

Some painkillers and indigestion remedies interfere with perindopril, so ask your pharmacist for advice before you buy any medicines.

Type of medicine An angiotensin-converting enzyme (ACE) inhibitor
Used for High blood pressure; heart failure; to help protect the heart
Also called Perindopril arginine, perindopril erbumine, perindopril tert-butylamine
Available as Tablets

Perindopril belongs to a class of medicines called angiotensin-converting enzyme inhibitors, or ACE inhibitors. It is prescribed for a number of different reasons. You may have been prescribed it to reduce high blood pressure (hypertension), or to treat heart failure, or to protect your heart and blood vessels from damage following a heart attack or following certain procedures. Your doctor will tell you why it has been prescribed for you.

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 widens your blood vessels and helps to reduce the amount of water put back into your blood by your kidneys.

These actions help to decrease blood pressure in people who have blood pressure which is higher than normal. Although people with high blood pressure often do not feel unwell, if left untreated, high blood pressure can harm the heart and damage blood vessels, leading to a heart attack or stroke.

Heart failure is a condition where your heart does not work as well as it should. Because of this, there may be too much circulating fluid in your blood vessels. Perindopril helps to reduce this. It also appears to have a protective effect on the heart.

You may be prescribed perindopril on its own, or alongside other medicines to help your condition. The brand of perindopril called Coversyl® Arginine Plus contains a medicine called indapamide. This brand is prescribed for people with high blood pressure. Combination brands like this help to reduce the total number of tablets you need to take each day.

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 knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have problems with the way your kidneys work, or any problems with the way your liver works.
  • If you are lacking in fluid in the body (dehydrated) - for example, if you have had diarrhoea or sickness very recently.
  • If you have been told you have a build-up of fatty deposits on the walls of your arteries, a condition called atherosclerosis.
  • If you have a particular type of poor circulation called peripheral arterial disease.
  • If you have collagen vascular disease, this includes conditions such as systemic lupus erythematosus (SLE) and scleroderma.
  • If you have been told you have heart muscle disease (cardiomyopathy), or narrowing of the main blood vessel from your heart (aortic stenosis).
  • If you have ever had a reaction where your face, tongue or throat swells (angio-oedema).
  • If you are having desensitisation treatment to protect against bee and wasp stings.
  • If you are having dialysis treatment, or treatment to remove cholesterol from your blood by a machine (LDL apheresis).
  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • If you have ever had an allergic or unusual reaction to any other ACE inhibitor (such as lisinopril, ramipril or enalapril), or to any other medicine.
  • Before you start this treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about perindopril and will provide you with a full list of side-effects which you may experience from taking it.
  • Take perindopril exactly as your doctor tells you to. You will be asked to take one dose each day.
  • Your doctor will advise you to take your very first dose at bedtime. This is because the first dose can make you feel dizzy.
  • After the first dose, take perindopril in the morning. Swallow the tablet with a drink of water. The ideal time to take your dose is 30-60 minutes before breakfast. This is because more of the dose is absorbed if you take the tablet when your stomach is empty.
  • If you forget to take a dose at your usual time, take it as soon as you remember. If you do not remember until the following day, skip the forgotten dose. Do not take two doses at the same time to make up for a missed dose.
  • Try to keep your regular appointments with your doctor. This is so your progress can be monitored. Your doctor may want you to have some blood tests from time to time to check that your kidneys are working well.
  • Each time you collect a prescription, check to make sure the tablets look the same as you have had before. This is because there are two types of perindopril tablet and several strengths of each type of tablet. If you are unsure about the tablets, or if you have any questions about your prescription, please ask your pharmacist for advice.
  • It is very important that you follow any dietary and lifestyle advice that you are given by your doctor. This may include advice about 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 your treatment.
  • It is likely that your doctor will advise that you do not use salt substitutes while you are taking perindopril. These products have a high content of potassium which could be harmful for you.
  • If you drink alcohol, ask your doctor for advice about drinking alcohol while you are on perindopril. Alcoholic drinks may make you feel light-headed or dizzy, and may not be advisable for you.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking perindopril tablets. This is because some anaesthetics may cause your blood pressure to 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. The table below contains some of the most common ones associated with perindopril. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common perindopril side-effects (these affect less than 1 in 10 people) 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, sit or lie down for a few moments before standing. If this continues beyond the first few days, speak with your doctor. Do not drive or use tools or machines while you feel dizzy
Dry irritating cough If this continues, speak with your doctor, as an alternative medicine may be better for you
Feeling or being sick, tummy (abdominal) pain, indigestion, diarrhoea Stick to simple foods - avoid rich or 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, eyesight problems If this happens, do not drive or use tools or machines until you feel more awake or able to see clearly
Tingling feelings, a ringing noise in your ears (tinnitus), feeling short of breath, changes in the way some things taste, itchy skin rash, muscle cramp 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 the 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 the tablets, speak with your doctor or pharmacist for further advice.

  • 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 you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. 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.

Do not 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

  • Manufacturer's PIL, Coversyl® Arginine; Servier Laboratories Limited, The electronic Medicines Compendium. Dated September 2014.
  • British National Formulary; 68th Edition (Sep 2014) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

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 (v27)
Last Checked:
12/12/2014
Next Review:
11/12/2017
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