Perindopril

Perindopril is a medicine that lowers your blood pressure and makes it easier for your heart to pump blood around your body.

It is part of a group of medicines known as ACE (angiotensin-converting enzyme) inhibitors.

You can only get perindopril on prescription. It comes as tablets.

Perindopril is also known as:

  • Coversyl Arginine
  • Pendrex

It is also available combined with 2 other blood pressure medicines called indapamide and amlodipine.

Uses of perindopril

Perindopril relaxes and widens the blood vessels. This can improve the symptoms of heart failure.

It is widely used to:

  • treat high blood pressure and heart failure
  • reduce the risk of future strokes and heart attacks
  • improve your survival after a heart attack or heart surgery

Get emergency help

You might need emergency help if you have a serious allergic reaction (anaphylaxis), serious side effects or take too much.

If you take too much

Taking too much perindopril can cause dizziness, sleepiness, or a pounding heartbeat.

Immediate action required: Go to your nearest emergency department (ED) straight away or phone your GP if you:

  • take too much perindopril

Do not drive yourself to the ED. Get someone else to drive or call for an ambulance.

Take your remaining medication and any leaflets with you.

Serious allergic reaction

A serious allergic reaction (anaphylaxis) to perindopril is not common.

Immediate action required: Call 112 or 999 or go to your nearest emergency department (ED) if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you are wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

These are warning signs of a serious allergic reaction, such as angioedema.

Serious side effects

Immediate action required: Stop taking perindopril and go to an emergency department (ED) or phone your GP immediately, if you have:

  • weak arms and legs or problems speaking - these can be signs of a stroke
  • yellow skin or eyes
  • paleness, feeling tired, faint or dizzy, or any sign of bleeding, such as bleeding from the gums and bruising easily
  • sore throat and fever and getting infections more easily
  • a faster heart rate, chest pain and tightness in your chest
  • shortness of breath, wheezing and tightening of the chest
  • severe tummy pain
  • swollen ankles, blood in your pee or not peeing at all

Read more about side effects

Check if you can take perindopril

Perindopril is prescribed for adults aged 18 or over, but it is not suitable for everyone.

Check with your GP before starting to take perindopril if you:

  • have had an allergic reaction to perindopril or any other medicine
  • have heart, liver or kidney problems
  • are on a low-salt diet
  • have unstable or low blood pressure
  • have diabetes
  • are having dialysis or any other type of blood filtration
  • have had diarrhoea or vomiting recently
  • are going to have desensitisation treatment
  • have a blood problem such as neutropenia or agranulocytosis
  • are going to have a major operation or a general anaesthetic
  • are pregnant, trying to get pregnant or are breastfeeding

See the patient information leaflet that comes with your medicine for a full list of conditions to check with your GP.

Contraception

Perindopril does not affect contraception.

But talk to your GP if you use hormonal methods of contraception, such as the combined contraceptive pill and contraceptive patch.

These type of contraception are not usually recommended if you're taking perindopril for high blood pressure.

Fertility

Perindopril is unlikely to affect fertility in men or women. But talk to your GP if you are trying to get pregnant.

Pregnancy

Perindopril is not recommended in pregnancy.

Important

Do not take perindopril if you are more than 3 months pregnant. It may cause serious harm to your baby.

Talk to your GP if you are trying to get pregnant or pregnant. Your GP will usually advise you to stop taking perindopril and to take another medicine.

Breastfeeding

Do not take perindopril if you are breastfeeding. Talk to your GP.

Perindopril and diabetes

Check your blood sugar (glucose) more often, particularly in the first few weeks, if you have diabetes.

Perindopril can lower the sugar level in your blood.

Perindopril and surgery

Tell your GP you are taking perindopril if:

  • you are going to be put to sleep for an operation 
  • you are going to have a major operation, such as a Caesarean section, without a general anaesthetic

Perindopril can reduce your blood pressure when it is used with a general anaesthetic.

Your GP may advise you to stop taking it 24 hours before surgery.

When you start taking perindopril

Perindopril can cause blurred vision and make you feel dizzy when you first start taking it.

If this happens:

  • do not drive a car, ride a bike, or use tools or machinery
  • get up very slowly or stay sitting down until you feel better
  • lie down so you do not faint, then sit until you feel better if you begin to feel dizzy

How and when to take perindopril

Always take perindopril exactly as your doctor has told you.

If you're unsure, follow the instructions on the medicine label or check with your GP or pharmacist.

Usually, you’ll take a single dose once a day in the morning before your breakfast.

Take your dose at the same time every day.

Dosage

You'll usually start on a low dose. Usually, your dose will be increased gradually.

Your GP will check your blood pressure and ask about side effects. They can then decide the correct dose of perindopril for you. They may also do some blood tests.

If you forget to take it

If you miss a dose of perindopril, take it as soon as you remember that day.

If you do not remember until the following day, skip the missed dose.

Never take a double dose to make up for a forgotten one.

How long it takes to work

Perindopril starts to work within a few hours to reduce high blood pressure. It might take up to a month for full effect.

If you are taking perindopril for heart failure, it may take weeks, even months, before you feel better.

Keep taking perindopril even if you don't think it is working. It will still be helping you even if you don't notice any change.

How long you'll need to take perindopril

You'll usually need to take perindopril for the rest of your life.

Perindopril is generally safe to take for a long time. There’s no evidence that perindopril is addictive.

Taking perindopril for a long time can sometimes affect your kidneys. Your GP will check how well your kidneys are working with regular blood tests.

Stopping taking perindopril

Talk to your GP if you want to stop. Stopping perindopril may cause your blood pressure to rise. This may increase your risk of heart attack and stroke.

Your GP may be able to prescribe you a different blood pressure-lowering medicine if you are concerned about side effects.

Side effects

Perindopril can cause side effects in some people. These side effects often go away as your body gets used to the medicine.

Talk to your GP or pharmacist if side effects do not go away. Your GP may be able to switch you to a different type of ACE inhibitor.

Side effects include:

  • dry, tickly cough that does not go away
  • feeling dizzy or light headed, especially when you stand up or sit up quickly
  • headache
  • diarrhoea and vomiting
  • a mild skin rash
  • blurred vision

See the patient information leaflet that comes with your medicine for a full list of side effects.

You can report any suspected side effects to the Health Products Regulatory Authority (HPRA).

Taking perindopril with other medicines

Some medicines can interfere with the way perindopril works

Talk to your GP or pharmacist before taking perindopril if you are taking any other medicines. This includes herbal remedies, vitamins or supplements.

Alcohol and perindopril

Do not drink alcohol when you start taking perindopril or after a dose increase. This is so you can see how the medicine affects you.

Alcohol can increase the blood pressure-lowering effect of perindopril. This can make you feel dizzy or light-headed.

Stop drinking alcohol if perindopril makes you feel dizzy.

Avoid salt substitutes

Do not use salt substitutes such as Lo-Salt if you are taking perindopril. Salt substitutes are high in potassium.

When mixed with perindopril they may make the level of potassium in your blood too high. This could affect your heart beat.

Finding your patient information leaflet online

Your patient information leaflet (PIL) is the leaflet that comes in the package of your medicine. 

To find your PIL online, visit the Health Products Regulatory Authority (HPRA) website

  1. In the ‘Find a medicine’ search box, enter the brand name of your medicine. A list of matching medicines appears.
  2. To the right of your medicine, select ‘PIL’. A PDF of the PIL opens in a new window. 

You can also:

  1. Select the brand name of your medicine.
  2. Scroll down to the Documents section.
  3. From the Package Leaflet line, select PDF version. A PDF of the PIL opens in a new window. 

If your PIL is not on the HPRA website, the European Medicines Agency (EMA) website opens in a new window when you select ‘PIL’.

You can find your PIL on the EMA website.

Information:

See the patient information leaflet that comes with your medicine for a full list of side effects.

You can report any suspected side effects to the Health Products Regulatory Authority (HPRA).

Taking perindopril with other medicines

Some medicines can interfere with the way perindopril works

Talk to your GP or pharmacist before taking perindopril if you are taking any other medicines. This includes herbal remedies, vitamins or supplements.

Alcohol and perindopril

Do not drink alcohol when you start taking perindopril or after a dose increase. This is so you can see how the medicine affects you.

Alcohol can increase the blood pressure-lowering effect of perindopril. This can make you feel dizzy or light-headed.

Stop drinking alcohol if perindopril makes you feel dizzy.

Avoid salt substitutes

Do not use salt substitutes such as Lo-Salt if you are taking perindopril. Salt substitutes are high in potassium.

When mixed with perindopril they may make the level of potassium in your blood too high. This could affect your heart beat.

Finding your patient information leaflet online

Your patient information leaflet (PIL) is the leaflet that comes in the package of your medicine. 

Information:

To find your PIL online, visit the Health Products Regulatory Authority (HPRA) website

  1. In the ‘Find a medicine’ search box, enter the brand name of your medicine. A list of matching medicines appears.
  2. To the right of your medicine, select ‘PIL’. A PDF of the PIL opens in a new window. 

You can also:

  1. Select the brand name of your medicine.
  2. Scroll down to the Documents section.
  3. From the Package Leaflet line, select PDF version. A PDF of the PIL opens in a new window. 

If your PIL is not on the HPRA website, the European Medicines Agency (EMA) website opens in a new window when you select ‘PIL’.

You can find your PIL on the EMA website.

Finding your PIL on the EMA website

If your PIL is not on the HPRA website, you will be sent to the European Medicines Agency (EMA) website.

To find your PIL on the EMA website:

  1. In the Medicines search box, enter the brand name of your medicine and the word ‘epar’. For example: ‘Zoely epar’. A list of matching medicines appears.
  2. Select the ‘Human medicine European public assessment report (EPAR)’ for your medicine
  3. From the table of contents, select Product information.
  4. Select the EPAR – Product Information link for your medicine. A PDF opens in a new window. The PIL information is in Annex III of the PDF under ‘labelling and package leaflet’

This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 24 September 2021
Next review due: 24 September 2024

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