Perindopril is in a class of drugs called angiotensin-converting-enzyme inhibitors (ACE inhibitors). Indications : essential hypertension (to lower high blood pressure), congestive heart failure or CHF ( to decrease the heart’s workload), prevention of stroke recurrence in combination with indapamide in patients with history of cerebrovascular disease, reduction of risk of cardiovascular mortality or non-fatal heart attacks (myocardial infarction or MI) in patients with stable coronary artery disease (stable angina) and those patients with previous history of heart attacks.
Contraindications: Pregnancy (US FDA pregnancy category D), it may harm an unborn baby and do not use during the second and third trimesters of pregnancy (causes fetal injury and fetal death); lactation and children. Do not take perindopril if you are pregnant or planning a pregnancy. It can cause fetal injury and intrauterine fetal death during the second to the third trimester of pregnancy.
Special precautions: Renal failure or renal insufficiency; renovascular hypertension; surgery/anesthesia; elderly patients. Avoid combination with highly permeable membranes (polyacrylonitrile) in hemodialysis.
Serious adverse effects: an allergic reaction (seek emergency consult) such as difficulty breathing, swelling of the throat, lips, tongue, hives, or face also known as angioedema; oliguria or anuria (little or no urine); chest pain; an irregular heart beat or changes in heartbeat, severe dizziness or fainting (syncope) and signs of an infection including a sorethroat or a fever. Other less serious adverse effects are: gastrointestinal tract upset and nausea, dizziness, headaches, fatigue, mood or sleep disturbances, asthenia, taste disorder, muscle cramps, localized skin rashes and dry cough.
It is advisable to maintain proper fluid intake to prevent dehydration due to vomiting , diarrhea, heavy sweating (diaphoresis) while taking perindopril. Severe fluid loss may lead to a very low blood pressure and cause dizziness and fainting. Avoid driving, operating machinery or other activities which requires a fully awake and alert state.
Inform your doctor before intake of perindopril if you have the following conditions:
Kidney disease, liver disease, hyperkalemia (high levels of serum potassium), taking salt substitutes or potassium supplements, diabetes, scleroderma or lupus (SLE), have any history of heart disease or stroke. Symptoms of overdose that needs immediate medical attention may include: extreme dizziness, fainting, weakness and fatigue.
Drug interactions: potassium supplements (e.g. K-Dur); salt substitutes that contain postassium; lithium (e.g. Lithobid, Eskalith); digoxin (Lanoxin); indomethacin (Indocin); heparin; cyclosporine (e.g. Neoral, Sandimmune) and other class of diuretics such as triamterene, spironolactone, amiloride, hydrochlorothiazide(HCTZ), furosemide(Lasix) , bumetanide and indapamide.
Perindopril erbumine tablets is the tert-butylamine salt of perindopril, the ethyl ester of a non-sulfhydryl angiotensin-converting enzyme (ACE) inhibitor. Perindopril erbumine is chemically described as (2S,3aS,7aS)-1-[(S)-N- [(S)-1-Carboxy-butyl]alanyl]hexahydro- 2-indolinecarboxylic acid, 1-ethyl ester, compound with tert-butylamine (1:1). Its molecular formula is C19H32N2O5C4H11N. Tablets is available in 2 mg, 4 mg and 8 mg strengths for oral administration. In addition to perindopril erbumine, each tablet contains the following inactive ingredients: colloidal silica (hydrophobic), lactose, magnesium stearate and microcrystalline cellulose. The 4 and 8 mg tablets also contain iron oxide.
Perindopril has the following structural formula: