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 angiotensin-converting enzyme (ACE) inhibitors.
You can only get perindopril on prescription. It comes as a tablet.
Perindopril is also known as:
- Coversyl Arginine
- Pendrex
Perindopril also comes in a mixed tablet with other medicines for high blood pressure or high cholesterol. The mixed tablets are only available on prescription.
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
Check if you can take perindopril
Perindopril is prescribed for adults age 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 recently had diarrhoea or vomiting
- are going to have desensitisation treatment to reduce allergies
- have a blood problem such as a low white blood cell count (neutropenia or agranulocytosis)
- are going to have a major operation or a general anaesthetic to put you to sleep
- 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.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Perindopril and 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 types of contraception are not usually recommended if you're taking perindopril for high blood pressure.
Perindopril and fertility
Perindopril is unlikely to affect fertility in men or women. But talk to your GP if you are trying to get pregnant. This medicine is not recommended in pregnancy.
Perindopril and pregnancy
Perindopril is not recommended in pregnancy.
It can affect your baby's kidneys, particularly if it's taken in the second and third trimester of pregnancy. This can result in long-term damage to your baby's kidneys.
If you're already pregnant, stop taking perindopril and talk to your doctor straight away
Non-urgent advice: Talk to your GP if you are:
- trying to get pregnant
- pregnant
- breastfeeding
Your GP will usually tell you to stop taking perindopril and to take another medicine.
Perindopril and breastfeeding
Do not take perindopril if you are breastfeeding. Talk to your GP if you are breastfeeding or thinking of breastfeeding.
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 (general anaesthetic) for an operation
- 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 tell 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
How and when to take perindopril
Always take perindopril exactly as your GP tells 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. Swallow perindopril tablets whole with a drink of water.
Take your dose at the same time every day.
Dosage
You'll usually start on a low dose and your GP may increase this 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 blood tests to check how well your kidneys are working and the amount of potassium in your blood.
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.
If you take too much
Taking too much perindopril can cause dizziness, sleepiness, or a pounding heartbeat.
Non-urgent advice: Contact your GP or go to your nearest emergency department (ED) straight away if you:
- take more than your prescribed dose of perindopril
Do not drive yourself to the ED. Get someone else to drive or call for an ambulance.
Take the perindopril packet or the leaflet inside it and any remaining medicine with you.
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 or months, before you feel better.
Keep taking perindopril even if you do not think it is working. It will still be helping you even if you do not 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.
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 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 medicine to lower your blood pressure 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.
Common side effects
There are things you can do to help you cope with some common side effects:
Dry, tickly cough that does not go away
Cough medicines do not usually help coughs caused by perindopril. Sometimes the cough gets better on its own.
Talk to your GP if it carries on, bothers you or stops you from sleeping. Another medicine may be better.
Even if you stop taking perindopril, the cough may take up to a month to go away.
Feeling dizzy or light headed
This is more likely to happen when you start taking perindopril or if you move on to a higher dose. If perindopril makes you feel dizzy when you stand up, try getting up very slowly or stay sitting down until you feel better. If you begin to feel dizzy, lie down so that you do not faint, then sit until you feel better.
Do not drive, ride a bike or use tools or machinery until the dizziness passes.
Headache
Make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your GP if the headaches last longer than a week or are severe.
Diarrhoea and vomiting
Take small, frequent sips of fluids, such as water or squash, to prevent dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea or vomiting without speaking to a pharmacist or GP first.
If you take the combined contraceptive pill or progestogen-only pill and you're getting sick or have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.
If you're getting sick or get diarrhoea from a stomach bug or illness, tell your GP. You may need to stop taking perindopril for a while until you feel better.
A mild skin rash
It may help to take an antihistamine to help ease a rash. You can buy this from a pharmacy. Check with the pharmacist to see which type is suitable for you.
Blurred vision
Do not drive, ride a bike or use tools or machinery while this is happening.
If it lasts for more than 1 or 2 days, contact your GP as they may need to change your treatment.
Muscle cramps
Stretching and massaging the muscle may ease the pain during a cramp.
Serious side effects
Emergency action required: Stop taking perindopril and go to an ED or contact 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, any sign of bleeding, sore throat and fever, and getting infections more easily - these can be signs of a blood or bone marrow disorder
- a faster heart rate and chest pain
- shortness of breath, wheezing and tightness in your chest
- severe tummy pain
- swollen ankles, blood in your pee or not peeing at all
Serious allergic reaction
A serious allergic reaction (anaphylaxis) to perindopril is rare.
Emergency action required: Call 112 or 999 or go to your nearest emergency department (ED) if:
- you get a a rash that is itchy, red, swollen, blistered or peeling
- you are wheezing
- you get tightness in your chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
See the patient information leaflet that comes with your medicine for a full list of side effects.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Report side effects
You can report any suspected side effects to the Health Products Regulatory Authority (HPRA): report an issue - hpra.ie
Taking perindopril with other medicines
Some medicines can affect 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.
Tell your doctor if you're taking any of these medicines:
- anti-inflammatory medicines such as ibuprofen
- medicines to treat low blood pressure, heart failure, asthma or allergies, such as ephedrine, noradrenaline or adrenaline
- medicines to treat high blood pressure, such as aliskeren
- other medicines that can lower your blood pressure, such as some antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), anaesthetics or medicines for an enlarged prostate gland
- medicines that reduce the activity of your immune system, such as ciclosporin and tacrolimus
- medicines that make you pee more (diuretics), such as furosemide
- medicines that can increase the amount of potassium in your blood, such as spironolactone, triamterene, amiloride, potassium supplements, trimethoprim (for infections) or heparin (for preventing blood clots)
- steroid medicines such as prednisolone
- allopurinol, for gout
- procainamide, for heart rhythm problems
- medicines for diabetes
- lithium, for mental health problems
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 effect of perindopril so that it lowers your blood pressure too much. 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.
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.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Report side effects
You can report any suspected side effects to the Health Products Regulatory Authority (HPRA): report an issue - hpra.ie
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.
Fact check
This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).
