Perindopril 2mg Tablets

Perindopril is a prodrug that is hydrolyzed to perindoprilat, an active metabolite. Perindoprilat inhibits angiotensin-converting enzyme (ACE), which prevents the conversion of angiotensin I to angiotensin II. This leads to decreased vasoconstriction, reduced aldosterone secretion (resulting in decreased sodium and water retention), and potentiation of bradykinin (leading to vasodilation). These actions result in reduced peripheral vascular resistance, decreased blood pressure, and reduced cardiac preload and afterload.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of kidney problems, including:
+ Inability to pass urine
+ Changes in urine output
+ Blood in the urine
+ Sudden weight gain
Signs of high potassium levels, such as:
+ Abnormal heartbeat
+ Confusion
+ Weakness, lightheadedness, or dizziness
+ Feeling like passing out
+ Numbness or tingling
+ Shortness of breath
Severe dizziness or fainting
Persistent cough
Severe stomach pain
Severe nausea or vomiting
Liver problems, which may be indicated by:
+ Dark urine
+ Fatigue
+ Decreased appetite
+ Stomach pain or upset
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes (jaundice)
Signs of low white blood cell count, such as:
+ Fever
+ Chills
+ Sore throat

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor or seek medical help:

Cough
Dizziness
Back pain

Reporting Side Effects

This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have a history of angioedema, a severe and potentially life-threatening reaction characterized by symptoms such as swelling of the hands, face, lips, eyes, tongue, or throat, difficulty breathing, swallowing problems, or unusual hoarseness.
If you have kidney disease, as this may affect your ability to take this medication.
If you are currently taking a medication that contains aliskiren and you also have diabetes or kidney problems.
* If you have taken a medication containing sacubitril within the last 36 hours.

This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. They will help you determine if it is safe to take this medication with your existing health conditions and medications. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.

Important Warnings and Precautions

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

Caution with Daily Activities
Until you understand how this medication affects you, avoid driving and other tasks that require alertness. To minimize the risk of dizziness or fainting, rise slowly from a sitting or lying position, and exercise caution when climbing stairs.

Monitoring and Maintenance
Regularly check your blood pressure as directed by your healthcare provider. Additionally, have your blood work and other laboratory tests performed as scheduled by your doctor.

Interactions with Other Substances
If you are taking a salt substitute containing potassium, a potassium-sparing diuretic, or a potassium product, consult with your doctor. Similarly, if you are on a low-salt or salt-free diet, discuss this with your doctor.

Over-the-Counter (OTC) Products and Interactions
If you have high blood pressure and are taking this medication, consult with your doctor before using OTC products that may increase blood pressure, such as cough or cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and certain natural products or aids.

Alcohol Consumption
Discuss your alcohol consumption with your doctor before drinking while taking this medication.

Heat and Fluid Loss
Be cautious in hot weather or during physical activity, and drink plenty of fluids to prevent dehydration. If you experience excessive sweating, fluid loss, vomiting, or diarrhea, inform your doctor, as these conditions may lead to low blood pressure.

Effectiveness and Ethnicity
This medication may be less effective in lowering blood pressure in Black patients. In some cases, an additional medication may be necessary. If you have questions or concerns, discuss them with your doctor.

Angioedema Warning
A severe and potentially life-threatening reaction called angioedema has been reported. The risk of angioedema may be higher in Black patients.

Special Considerations
If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects. Inform your doctor if you are breastfeeding, as you will need to discuss potential risks to your baby.

• Aliskiren (in patients with diabetes or renal impairment (CrCl <60 mL/min))
• Sacubitril/valsartan (Entresto) (concomitant use or within 36 hours of last dose of sacubitril/valsartan due to increased risk of angioedema)

• Potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride) and potassium supplements (increased risk of hyperkalemia)
• Lithium (increased serum lithium levels and toxicity)
• Nonsteroidal anti-inflammatory drugs (NSAIDs) (including selective COX-2 inhibitors) (may reduce antihypertensive effect, increase risk of renal impairment and hyperkalemia)
• mTOR inhibitors (e.g., sirolimus, everolimus, temsirolimus) (increased risk of angioedema)
• Racecadotril (increased risk of angioedema)

• Diuretics (increased risk of symptomatic hypotension, especially with initial doses)
• Other antihypertensive agents (additive hypotensive effect)
• Antidiabetic agents (insulin, oral hypoglycemics) (increased risk of hypoglycemia)
• Gold (parenteral) (nitritoid reactions including flushing, nausea, vomiting, hypotension)
• Tricyclic antidepressants, antipsychotics, anesthetics (increased hypotensive effect)

• Not available

• Angioedema (swelling of face, lips, tongue, glottis, larynx, extremities)
• Persistent dry cough
• Dizziness or lightheadedness (especially upon standing, indicative of hypotension)
• Signs of hyperkalemia (e.g., muscle weakness, fatigue, paresthesias, cardiac arrhythmias)
• Signs of renal dysfunction (e.g., decreased urine output, edema)

Contraindicated during the second and third trimesters of pregnancy due to significant risk of fetal injury and death. Discontinue as soon as pregnancy is detected. Use in the first trimester is generally avoided due to potential risks.

Perindopril and its active metabolite perindoprilat are excreted into breast milk in small amounts. Due to potential for serious adverse effects in the infant (e.g., hypotension, hyperkalemia, renal impairment), use is generally not recommended. Consider an alternative drug with a better safety profile during lactation.

Safety and effectiveness have not been established in pediatric patients. Use is generally not recommended.

No overall differences in safety or effectiveness have been observed between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Start with lower doses (e.g., 2 mg once daily) and titrate slowly, especially in those with impaired renal function. Monitor renal function and potassium closely.

• Perindopril is a prodrug; its active metabolite is perindoprilat.
• First-dose hypotension can occur, especially in patients who are volume-depleted (e.g., on diuretics, salt-restricted diet). Consider discontinuing diuretics 2-3 days prior to initiation if possible, or start with a very low dose (e.g., 2 mg).
• A persistent dry cough is a common side effect of ACE inhibitors, occurring in up to 20% of patients. It typically resolves within days to weeks after discontinuation.
• Monitor for angioedema, a rare but potentially life-threatening side effect. It can occur at any time during therapy.
• Avoid concomitant use with sacubitril/valsartan (Entresto) due to increased risk of angioedema; a 36-hour washout period is required between drugs.
• Hyperkalemia risk is increased with potassium-sparing diuretics, potassium supplements, NSAIDs, and in patients with renal impairment or diabetes.

• Other ACE inhibitors (e.g., lisinopril, enalapril, ramipril)
• Angiotensin Receptor Blockers (ARBs) (e.g., valsartan, losartan, candesartan)
• Calcium Channel Blockers (CCBs) (e.g., amlodipine, nifedipine)
• Thiazide diuretics (e.g., hydrochlorothiazide)
• Beta-blockers (e.g., metoprolol, carvedilol)

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the overdose, including the medication taken, the amount, and the time it occurred.