Perindrop

Indications

Perindopril Erbumine is used in adults to:

• treat high blood pressure (hypertension);
• treat heart failure, usually together with other heart medicines;
• lower the risk of heart attack and other heart problems in people with stable coronary artery disease;
• help prevent another stroke, usually together with Indapamide, in people who have had a stroke or mini-stroke.

How It Works

Perindopril is an angiotensin-converting enzyme (ACE) inhibitor. It blocks the enzyme that makes angiotensin II, a natural substance that tightens 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 can pump more easily.

Dosage and Administration

High blood pressure, adults: usually 4 mg once a day, increased to 8 mg once a day after about a month if needed. Older people and people already taking a water tablet (diuretic) usually start with 2 mg once a day.

Heart failure: start with 2 mg once a day under close supervision, increased to 4 mg as prescribed.

Stable coronary artery disease: 4 mg once a day for 2 weeks, then 8 mg once a day, as prescribed.

Take it once a day in the morning, before a meal. Kidney problems: lower doses are used. Children: not recommended. If a dose is missed, take the next dose at the usual time; do not take two doses together.

These doses apply to Perindopril Erbumine (tert-butylamine salt). Perindopril Arginine products use different numbers, so do not switch between them without advice.

Interactions

• Potassium supplements, salt substitutes containing potassium, Spironolactone, Eplerenone, Amiloride, Trimethoprim and Heparin can raise blood potassium.
• Diuretics such as Furosemide may cause a large drop in blood pressure at the start.
• Pain killers such as Ibuprofen and Diclofenac (NSAIDs) can weaken its effect and harm the kidneys.
• Lithium levels can rise to toxic levels.
• Aliskiren, Losartan, Valsartan and other angiotensin receptor blockers increase the risk of kidney problems and high potassium when combined.
• Sacubitril-Valsartan must not be taken within 36 hours of Perindopril.
• Insulin and diabetes tablets may cause low blood sugar, especially in the first weeks.
• Racecadotril, Sirolimus and Everolimus raise the risk of swelling (angioedema).

Contraindications

Do not use Perindopril Erbumine if you:

• are allergic to Perindopril or any other ACE inhibitor;
• have ever had swelling of the face, lips, tongue or throat (angioedema), from an ACE inhibitor or for any other reason;
• are pregnant or trying to become pregnant;
• have diabetes or kidney problems and take Aliskiren;
• have taken Sacubitril-Valsartan within the last 36 hours;
• have narrowing of the arteries to both kidneys.

Side Effects

Common: dry, tickly cough, dizziness, headache, tiredness, nausea, stomach upset, taste changes, muscle cramps and rash.

Get urgent medical help if you have:

• swelling of the face, lips, tongue or throat, or difficulty swallowing or breathing;
• fainting or severe dizziness;
• chest pain or a fast or irregular heartbeat;
• yellow skin or eyes;
• severe stomach pain;
• passing much less urine than usual;
• fever, sore throat or mouth ulcers that do not go away (possible low white blood cells).

Pregnancy and Lactation

Do not use Perindopril during pregnancy. It can seriously harm the baby, especially after the first 3 months. If you become pregnant, stop taking it and see your doctor as soon as possible to switch to another medicine. It is not recommended while breastfeeding, especially for newborn or premature babies; your doctor can choose a more suitable medicine.

Precautions and Warnings

• The first dose can lower blood pressure a lot, especially if you are dehydrated, on a low-salt diet or take a diuretic; sit or lie down if you feel dizzy.
• Kidney function and blood potassium should be checked regularly.
• Tell your doctor if you have kidney disease, heart valve narrowing, diabetes or a connective tissue disease.
• Tell the surgeon or anaesthetist before any operation, and before dialysis or desensitisation treatment.
• Vomiting or diarrhoea can cause low blood pressure; contact your doctor if this happens.

Overdose

Symptoms may include very low blood pressure, dizziness, fainting, slow or fast heartbeat and kidney problems. Lie down with the legs raised and get emergency medical help.

Therapeutic Class

Antihypertensive; angiotensin-converting enzyme (ACE) inhibitor.

Storage

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