Concise Prescribing Info
Perindopril arginine
HTN. Stable CAD: Reduction of cardiac events risk in patients w/ history of MI &/or revascularisation. 5 mg FC tab: Symptomatic treatment of heart failure.
Dosage/Direction for Use
Individualized dosage. HTN Initially 5 mg once daily in the morning, may be increased to 10 mg once daily after 1 mth. Patient w/ strongly activated renin-angiotensin-aldosterone system (RAAS) Initially 2.5 mg. Patient in concomitant use w/ diuretics that cannot be discontinued Initially 2.5 mg, monitor renal function & serum K levels. Elderly Initially 2.5 mg, may be increased to 5 mg after 1 mth, then to 10 mg if necessary depending on renal function. Stable CAD Initially 5 mg once daily for 2 wk, then increased to 10 mg once daily if well tolerated, depending on renal function. Elderly 2.5 mg once daily for 1 wk, then 5 mg once daily on the following wk, then increased up to 10 mg once daily, depending on renal function. Symptomatic heart failure Initially 2.5 mg in the morning, may be increased to 5 mg once daily after 2 wk if tolerated. Renal impairment: CrCl ≥60 mL/min 5 mg daily, 30-60 mL/min 2.5 mg daily, 15-30 mL/min 2.5 mg every other day, <15 mL/min 2.5 mg on the day of dialysis (take dose after dialysis in haemodialysis patients).
Should be taken on an empty stomach.
Hypersensitivity including angioneurotic oedema-type reactions. DM or kidney problems & concomitant treatment w/ aliskiren. Not recommended in combination w/ K-sparing diuretics, K salts, lithium & estramustine. Pregnancy; not recommended during lactation.
Special Precautions
Immediately discontinue use if swelling of the face, lips, tongue &/or larynx occur. Excessive BP drop following initial dose may be experienced by patients w/ strongly activated RAAS (in particular, renovascular HTN, salt &/or vol depletion, cardiac decompensation or severe HTN. Symptomatic hypotension may occur following initiation of therapy, most likely in patients concurrently treated w/ diuretics; discontinue diuretic treatment 2-3 days before beginning perindopril arginine therapy, if possible; correct conditions at high risk of symptomatic hypotension (eg, salt depletion w/ or w/o hyponatraemia, hypovolaemia or patients who have been receiving vigorous diuretic therapy) prior to therapy & closely monitor BP, renal function & serum K levels. Initiate treatment carefully in patients w/ severe heart failure & in other patients considered to be at high risk (w/ impaired renal function & electrolyte disturbance tendency, in concurrent treatment w/ diuretics &/or w/ vasodilating agents). Aortic stenosis or hypertrophic cardiomyopathy or renal artery stenosis; heart & liver problems; kidney problems or receiving dialysis; suffering from collagen vascular disease eg, SLE or scleroderma; diabetes; salt-restricted diet or use of K-containing salt substitutes; undergoing anesth &/or major surgery, LDL apheresis; treatment that make the patient less sensitive to allergic effects from bee or wasp stings; diarrhoea, vomiting or dehydration; intolerance to some sugars; phenylketonuria. Concomitant use w/ aliskiren-containing products in patients w/ DM or renal impairment (GFR <60 mL/min/1.73 m2); sacubitril/valsartan. May impair ability to drive or use machinery. Not recommended in childn & adolescent.
Adverse Reactions
Headache, dizziness, vertigo, pins & needles, vision disturbances, tinnitus, lightheadedness due to low BP, cough, shortness of breath, GI disorders (nausea, vomiting, abdominal pain, taste disturbances, dyspepsia or digestion difficulty, diarrhoea, constipation), allergic reactions (eg, skin rashes, itching), muscle cramps, feeling weak.
Drug Interactions
Other antihypertensives including aliskiren, diuretics; K-sparing drugs (eg, triamterene, amiloride), K supplements or K-containing salt substitutes, K-sparing drugs used in heart failure treatment (eplerenone & spironolactone at doses between 12.5-50 mg by day); lithium; NSAIDs eg, ibuprofen or high-dose aspirin; antidiabetic drugs (eg, insulin or metformin); baclofen; drugs used for mental disorder treatment (eg, TCAs, antipsychotics); immunosuppressants (eg, ciclosporin, tacrolimus); trimethoprim; estramustine; allopurinol; procainamide; vasodilators including nitrates; heparin; drugs used in the treatment of low BP, shock or asthma (eg, ephedrine, noradrenaline or adrenaline); gold salts, especially w/ IV administration.
ATC Classification
C09AA04 - perindopril ; Belongs to the class of ACE inhibitors. Used in the treatment of cardiovascular disease.
Coversyl FC tab 5 mg
Coversyl FC tab 10 mg
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