Perindopril

Perindopril is an ACE inhibitor. ACE means angiotensin converting enzyme.

Perindopril is used to treat high blood pressure (hypertension) and to help prevent heart attack in people with coronary artery disease.

Perindopril may also be used for reasons not mentioned in this medication guide.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take each dose with a full glass of water. Drink plenty of liquids while you are taking perindopril.

You may take perindopril with or without food.

Your blood pressure will need to be checked often. Your kidney or liver function may also need to be checked.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking perindopril. This can lead to very low blood pressure, electrolyte disorders, or kidney failure.

If you need surgery, tell the surgeon ahead of time that you are using perindopril.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture and heat.

Do not use if you are pregnant. If you become pregnant, stop taking perindopril and tell your doctor right away.

You should not use perindopril if you have ever had angioedema. Do not take perindopril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use perindopril together with any medication that contains aliskiren (a blood pressure medicine).

You should not use this medicine if you are allergic to perindopril or if:

• you have hereditary angioedema;
• you recently took a heart medicine called sacubitril; or
• you are allergic to any other ACE inhibitor, such as benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, quinapril, ramipril, or trandolapril.

Do not take perindopril within 36 hours before or after taking any medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use perindopril with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking perindopril with aliskiren if you have kidney disease.

Tell your doctor if you have ever had:

• kidney disease (or if you are on dialysis);
• liver disease;
• heart disease or congestive heart failure;
• diabetes; or
• a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis.

Do not use if you are pregnant, and tell your doctor right away if you become pregnant. Perindopril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

Get emergency medical help if you notice signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat. You may be more likely to have an allergic reaction if you are African-American.

Perindopril may cause serious side effects. Call your doctor right away if you experience:

• a light-headed feeling, like you might pass out;
• fever, chills, body aches, flu-like symptoms, sores in your mouth and throat;
• little or no urination;
• swelling, rapid weight gain;
• high potassium--nausea, slow or unusual heart rate, weakness, loss of movement;
• pale skin, easy bruising or bleeding; or
• jaundice (yellowing of the skin or eyes).

Common side effects of perindopril may include:

• dizziness;
• back pain; or
• cough.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Usual Adult Dose for Coronary Artery Disease:

Initial dose: 4 mg orally once a day for 2 weeks, then increase to maintenance dose as tolerated.Maintenance dose: 8 mg orally once a dayUse: Treatment of patients with stable coronary artery disease to reduce the risk of cardiovascular mortality or nonfatal myocardial infarction.

Usual Adult Dose for Hypertension:

Initial dose: 4 mg orally once a dayMaintenance dose: 4 to 8 mg orally per day in 1 or 2 divided dosesMaximum dose: 16 mg/dayComments: In patients treated with a diuretic, consider reducing the diuretic dose prior to starting this drug.

Usual Geriatric Dose for Coronary Artery Disease:

Greater than 70 Years:Initial dose:-Week 1: 2 mg orally once a day-Week 2: 4 mg orally once a day, then increase to maintenance dose as tolerated.Maintenance dose: 8 mg orally once a dayUse: Treatment of patients with stable coronary artery disease to reduce the risk of cardiovascular mortality or nonfatal myocardial infarction.

Usual Geriatric Dose for Hypertension:

Initial dose: 4 mg orally per day in 1 or 2 divided dosesComments: Experience with doses above 8 mg is limited; administer with careful blood pressure monitoring and dose titration.

Take the medicine as soon as you can, but skip the missed dose if it is nearly time for your next dose. Do not take two doses at once.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

• Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

• Do not use potassium supplements or salt substitutes, unless your doctor has told you to.

Tell your doctor about all your other medicines, especially:

• lithium;
• a diuretic or "water pill";
• gold injections to treat arthritis; or
• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may affect perindopril, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.