Perindopril

MIMS class : ACE Inhibitors


Dosage
Adult: PO HTN As erbumine: Initial: 4 mg once daily. Patients w/ renovascular HTN, vol depletion, severe HTN: Initial: 2 mg once daily. Max: 8 mg/day. Patients on diuretics: Withdraw diuretics 2 or 3 days before perindropil therapy. Resume later if required. If diuretic cannot be discontinued, an initial dose of 2 mg once daily. Max: 8 mg/day. Heart failure As erbumine: Initial: 2 mg in the morning. Increase slowly if needed. Maintenance: 4 mg/day. Stable ischaemic heart As erbumine: Initial: 4 mg once daily for 2 wk. Maintenance: 8 or 10 mg once daily.


Administration:
Should be taken on an empty stomach. (Take before meals.)


Conraindication:
History of angioedema related to previous ACE inhibitor treatment. Pregnancy (2nd/3rd trimesters).


Special Precaution:
History of airway surgery. Withdraw if there is significant increase in LFTs. Risk factors for hyperkalaemia; monitor potassium closely. Patients dependent on renin-angiotensin-aldosterone system; consider withdrawal in patients with progressive deterioration in renal function. Collagen vascular disease. Hypovolaemia; monitor BP with the 1st dose. Unilateral renal artery stenosis and pre-existing renal insufficiency; valvular aortic stenosis. Before, during, or immediately after anaesthesia. May impair ability to drive or operate machinery. Lactation.


Adverse Reaction
Headache, dizziness, sleep disorders, depression, fever, nervousness, somnolence; cough, upper respiratory tract infection, sinusitis, rhinitis, pharyngitis; oedema, chest pain, abnormal ECG, palpitation; rash; hyperkalaemia, elevated triglycerides, menstrual disorder; nausea, diarrhoea, vomiting, dyspepsia, abdominal pain, flatulence: UTI, sexual dysfunction; increased LFTs; weakness, musculoskeletal pain, upper and lower extremity pain, hypertonia, paraesthesia; proteinuria; tinnitus, ear infection; viral infection, allergy.
Potentially Fatal: Anaphylactoid reactions, angioedema.


Pregnancy Category
Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).


Source:
http://www.mims.com/Malaysia/drug/info/perindopril/?q=perindopril