Perindopril

Hypertension (high blood pressure)

FDA-approved (as Aceon in the US), alone or combined with other antihypertensives. (2) (3)

Stable coronary artery disease — to reduce the risk of cardiovascular death or non-fatal heart attack

FDA-approved (as Aceon in the US) for this specific risk-reduction use. (2) (3)

Heart failure (outside the United States)

Approved in many countries (where perindopril is marketed as Coversyl) for heart failure, but this is NOT part of the FDA-approved US (Aceon) label. If you are being treated for heart failure with perindopril, confirm with your prescriber which country's approval and product applies to you. (2) (3)

Dry, persistent cough

Incidence: Common (about 12% in hypertension trials)

Dizziness

Incidence: Common (about 8% in hypertension trials)

Back pain

Incidence: Common (about 6% in hypertension trials)

Low blood pressure (hypotension)

Incidence: Common, particularly in coronary artery disease patients

BOXED WARNING (FDA) — serious

Symptoms: BOXED WARNING (FDA): Drugs that act directly on the renin-angiotensin system, including perindopril, can cause injury and death to the developing fetus. When pregnancy is detected, perindopril should be discontinued as soon as possible under medical guidance. This is an FDA boxed warning, the strongest safety warning the FDA requires; it has been checked and added here because the clinician database recorded fetal-harm risk only as ordinary warning text without boxed-warning flagging.

Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (3)

Monitor for signs of angioedema (swelling of face, lips, tongue, or throat) — serious

Symptoms: Monitor for signs of angioedema (swelling of face, lips, tongue, or throat). May increase potassium levels—monitor blood tests regularly. Use caution if you have kidney or liver impairment. May cause dizziness; avoid driving or operating machinery until you know how it affects you.

Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (3)

Contraindications recorded in the clinician database — serious

Symptoms: Contraindications recorded in the clinician database: Contraindications: History of angioedema related to previous ACE inhibitor therapy, hereditary or idiopathic angioedema, pregnancy, hypersensitivity to Perindopril or any ACE inhibitor, and severe renal impairment (especially with dialysis using high-flux membranes). Precautions: Use with caution in patients with renal artery stenosis, aortic stenosis, hypertrophic cardiomyopathy, electrolyte disturbances, or those on diuretics.

Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (3)

Pregnancy

This is covered by the FDA boxed warning above: drugs that act directly on the renin-angiotensin system, including perindopril, can cause injury and death to the developing fetus. When pregnancy is detected, perindopril should be discontinued as soon as possible under medical guidance. The UK/EU product information adds that exposure during the second and third trimesters is specifically linked to fetal harm (reduced kidney function, low amniotic fluid, delayed skull bone formation) and newborn complications (kidney failure, low blood pressure, high potassium); if exposure occurred from the second trimester onward, ultrasound checks of fetal kidney function and skull are recommended, and newborns should be closely monitored for low blood pressure. (2) (3)

Breastfeeding

The UK/EU product information states that because no information is available on perindopril use during breastfeeding, perindopril is not recommended while breastfeeding, and an alternative treatment with a better-established safety profile is preferable — especially while nursing a newborn or preterm infant. Discuss feeding options with your doctor. (2) (3)

Children

Frequency: Not applicable. Weight Based: Not recommended for pediatric use. Max Daily Dose: Not applicable. Max Single Dose: Not applicable. Age Restrictions: Safety not established in children (2) (3)

Renal_impairment

UK/EU product information: dosage adjustment in renal impairment is desirable and depends on the degree of impairment (creatinine clearance); patients on hemodialysis should take their dose after the dialysis session. For hepatic impairment, no dosage adjustment is generally necessary — perindopril clearance is reduced by about half in cirrhosis, but the amount of the active metabolite (perindoprilat) formed is not reduced, so no dose change is required; the clinician database separately lists severe renal impairment on high-flux dialysis membranes as a contraindication, which is retained here. (2) (3)

Hepatic_impairment

UK/EU product information: dosage adjustment in renal impairment is desirable and depends on the degree of impairment (creatinine clearance); patients on hemodialysis should take their dose after the dialysis session. For hepatic impairment, no dosage adjustment is generally necessary — perindopril clearance is reduced by about half in cirrhosis, but the amount of the active metabolite (perindoprilat) formed is not reduced, so no dose change is required; the clinician database separately lists severe renal impairment on high-flux dialysis membranes as a contraindication, which is retained here. (2) (3)

India

• Coversyl2 mg, 4 mg, 8 mg · Servier India Private Limited
• Perindprim4 mg · Steris Healthcare