Product Code Database
Perindopril is a medication used to treat high blood pressure, heart failure, or stable coronary artery disease.
As a long-acting ACE inhibitor, perindopril works by inhibiting production of the vasoconstriction hormone, angiotensin, thereby relaxing Blood vessel, increasing urine output, and decreasing blood volume, leading to a reduction of blood pressure. It also increases blood renin activity and decreases aldosterone secretion, causing diuresis and natriuresis.
As a prodrug, perindopril is hydrolyzation in the liver to its active metabolite, perindoprilat. It was patented in 1980 and approved for medical use in 1988. Perindopril is taken in the form of perindopril arginine/amlodipine or perindopril erbumine. Both forms are therapeutically equivalent and interchangeable. The combination perindopril/amlodipine/indapamide is on the World Health Organization's List of Essential Medicines.
Perindopril should not be used during pregnancy, as it may harm the fetus. Some people may have allergic reactions to perindopril, while common side-effects may include cough,
headache, dizziness, diarrhea, or upset stomach.
In Australia during 2023-24, it was the fourth-most prescribed drug.
It may cause allergic reactions, and may have in people with heart, liver or kidney problems.
In Australia, each tablet contains 2.5, 5, or 10 mg of perindopril arginine. Perindopril is also available under the trade name Coversyl Plus, containing 5 mg of perindopril arginine combined with 1.25 mg indapamide and Coversyl Plus LD, containing 2.5 mg of perindopril arginine combined with 0.625 mg indapamide.
The efficacy and tolerability of a fixed-dose combination of 4 mg perindopril and 5 mg amlodipine, a calcium channel antagonist, is used.
Medical uses
Perindopril shares the indications of ACE inhibitors as a class, including essential hypertension, stable coronary artery disease (reduction of risk of cardiac events in patients with a history of myocardial infarction or revascularization), treatment of symptomatic coronary artery disease or heart failure, and diabetic nephropathy.
Combination therapy
With indapamide
In combination with indapamide, perindopril has been shown to significantly reduce the progression of chronic kidney disease and renal complications in patients with type 2 diabetes. In addition, the Perindopril pROtection aGainst REcurrent Stroke Study ( PROGRESS) found that whilst perindopril monotherapy demonstrated no significant benefit in reducing recurrent strokes when compared to placebo, the addition of low dose indapamide to perindopril therapy was associated with larger reductions in both blood pressure lowering and recurrent stroke risk in patients with pre-existing cerebrovascular disease, irrespective of their blood pressure. There is evidence to support the use of perindopril and indapamide combination over perindopril monotherapy to prevent strokes and improve mortality in patients with a history of stroke, transient ischaemic attack or other cardiovascular disease.
With amlodipine
The Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm ( ASCOT-BLA) was a 2005 landmark trial that compared the effects of the established therapy of the combination of atenolol and bendroflumethiazide to the new drug combination of amlodipine and perindopril (trade names Viacoram, AceryCal). The study of more than 19,000 patients worldwide was terminated earlier than anticipated because it clearly demonstrated a statistically significant improvement in mortality and cardiovascular outcomes with the newer treatment. The combination of amlodipine and perindopril remains in the current treatment guidelines for hypertension.
Warning and adverse effects
Perindopril may cause death or of a fetus if taken by the mother during pregnancy. It is poisonous in children and is not prescribed for them.
Precautions
Side effects
Usually mild at the start of treatment, side effects may include cough, fatigue, headache, nausea, or upset stomach, among other minor effects.
Composition
Each tablet contains 2, 4, or 8 mg of the tert-butylamine salt of perindopril. Perindopril is also available under the trade name Coversyl Plus, containing 4 mg of perindopril combined with 1.25 mg indapamide, a thiazide-like diuretic.
Society and culture
Brand names
Perindopril is available under the following brand names among others:
Marketing
In July 2014, the European Commission imposed fines of on Laboratoires Servier and five companies which produce generics due to Servier's abuse of their dominant market position, in breach of European Union Competition law. Servier's strategy included acquiring the principal source of generic production of perindopril and entering into several pay-for-delay agreements with potential generic competitors.
Further reading
External links
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