Perindopril

Key facts

• Perindopril is an ACE inhibitor that relaxes blood vessels, lowering blood pressure and easing the heart's workload.
• It is taken once daily, usually in the morning, and the first dose can cause a bigger blood-pressure drop than later doses.
• Perindopril must not be used in pregnancy; ACE inhibitors can cause serious fetal kidney damage and death, particularly in the second and third trimesters.
• Rarely, perindopril can cause angioedema, sudden swelling of the face, lips, tongue or throat; this is a medical emergency and can occur at any point during treatment, even years in.

What perindopril treats

Perindopril treats high blood pressure, stable heart failure, and coronary artery disease, where it lowers the risk of a further heart attack. It is also used after a heart attack to help the heart recover and pump more effectively.

How perindopril works

A hormone system in the body produces angiotensin II, a chemical that narrows blood vessels and encourages the body to retain salt and water, raising blood pressure. Perindopril blocks the enzyme that produces angiotensin II, so vessels relax and blood pressure falls, reducing the strain on the heart.

Before you take it

• Do not take perindopril if you are pregnant or trying to become pregnant; a doctor-approved alternative should be started before conception if possible.
• Do not take it if you have had angioedema with any ACE inhibitor before.
• Tell your prescriber about kidney disease, since perindopril can raise blood potassium and, rarely, worsen kidney function; regular blood tests are usually needed.
• Avoid potassium supplements and salt substitutes containing potassium unless your prescriber has approved them, and tell your prescriber about other blood-pressure medicines, diuretics, and NSAIDs, which can all affect how perindopril works.

Side effects

Common effects include a persistent dry cough, dizziness, headache and fatigue.

Seek urgent medical care for:

• Swelling of the face, lips, tongue or throat, or difficulty breathing or swallowing.
• Fainting or a marked drop in blood pressure.
• Signs of high potassium, such as muscle weakness or an irregular heartbeat.
• Reduced urination or swelling of the legs, which can signal worsening kidney function.

Safety essentials

• Perindopril is contraindicated in pregnancy at any stage; confirm you are not pregnant before starting and use reliable contraception if you can become pregnant.
• Angioedema is a medical emergency: if your face, lips or throat swell, stop the medicine and seek emergency care immediately, and do not restart it afterward.
• Kidney function and blood potassium should be checked before starting and periodically during treatment, especially if you have kidney disease or take other potassium-raising drugs.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.