Coversyl

Indications

Perindopril Arginine is used to treat high blood pressure (hypertension) and stable coronary artery disease, where it lowers the risk of heart attack and other heart problems. It is also used in some patients with heart failure. It may be prescribed alone or in combination with other blood pressure medicines such as Amlodipine or Indapamide.

How It Works

Perindopril is an ACE inhibitor. It blocks angiotensin-converting enzyme, which the body uses to make angiotensin II, a hormone that narrows blood vessels and makes the body hold on to salt and water. With less angiotensin II, blood vessels relax and widen, blood pressure falls and the heart does not have to work as hard. The arginine salt is simply the form in which the medicine is supplied.

Dosage and Administration

• High blood pressure: usually 5 mg once a day, which the doctor may increase to 10 mg once a day after about a month if needed.
• Stable coronary artery disease: usually 5 mg once a day for 2 weeks, then 10 mg once a day.
• Older people, people with kidney problems, those taking diuretics and those with heart failure are usually started on 2.5 mg once a day.
• Take it in the morning, before a meal, with a glass of water, at the same time each day.

Your doctor may adjust the dose according to your blood pressure and blood tests.

Interactions

Potassium supplements, salt substitutes containing potassium, potassium-sparing diuretics such as Spironolactone, Trimethoprim and Heparin can raise blood potassium. NSAIDs such as Ibuprofen can reduce its effect and harm the kidneys. It can raise Lithium levels. Do not combine with Aliskiren in diabetes or kidney disease. Do not take within 36 hours of Sacubitril/Valsartan because of the risk of severe swelling (angioedema). Other blood pressure medicines, diuretics and some antidepressants may lower blood pressure further. It may increase the sugar-lowering effect of insulin and diabetes tablets.

Contraindications

Do not use if you are allergic to Perindopril or any other ACE inhibitor, have had angioedema (swelling of the face, lips, tongue or throat) in the past, are more than 3 months pregnant, take Sacubitril/Valsartan, have diabetes or kidney disease and take Aliskiren, or have narrowing of the arteries to both kidneys.

Side Effects

Common side effects include dry, tickly cough, dizziness, headache, tiredness, light-headedness on standing, stomach upset, muscle cramps and changes in taste. Raised potassium and changes in kidney function can occur and are checked by blood tests.

Get urgent medical help if you develop swelling of the face, lips, tongue or throat, difficulty breathing or swallowing, fainting, chest pain, a severe skin rash, or yellowing of the skin or eyes.

Pregnancy and Lactation

Do not use in pregnancy. It can harm the unborn baby, especially after the first 3 months. If you become pregnant or are planning a pregnancy, tell your doctor straight away so that the medicine can be changed. It is not recommended while breastfeeding, especially for newborn or premature babies; ask your doctor about alternatives.

Precautions and Warnings

• Blood tests for kidney function and potassium are needed before and during treatment.
• The first dose may cause dizziness; sit or lie down if you feel faint.
• Tell your doctor if you are dehydrated, have vomiting or diarrhoea, or are on dialysis or a low-salt diet.
• Tell the doctor or dentist that you take it before surgery or anaesthesia.
• Use with care in kidney disease, narrowing of heart valves and severe heart failure.

Overdose

Overdose can cause very low blood pressure, dizziness, fainting, slow heartbeat and kidney problems. Lie down with legs raised and seek medical help immediately. Treatment in hospital includes IV fluids and monitoring.

Therapeutic Class

Angiotensin-converting enzyme (ACE) inhibitor, antihypertensive

Storage

Store below 30°C in a dry place, away from light, in the original pack to protect from moisture. Keep out of the reach of children.