Dosage & Administration
Stable coronary artery disease: Perindopril 4 once daily for two weeks, then increased to 8 mg once daily, depending on renal function and provided that the 4 mg dose is well tolerated. Elderly patients should receive Perindopril 2 mg once daily for one week, then Perindopril 4 once daily the next week, before increasing the dose up to 8 mg once daily, depending on renal, function. The dose should be increased only if the previous lower dose is well tolerated.
Congestive heart failure: Perindopril should be started under close medical supervision at a starting dose of 2 mg in the morning. If necessary dose may be increased to 4 mg.
Elderly patients: Start treatment at Perindopril 2 mg daily.
Less often: Taste impairment, epigastric discomfort, nausea, abdominal pain and rash. Reversible increase in blood urea and creatinine may be observed. Proteinuria has occurred in some patients.
Rarely: Angioneurotic edema and decrease in hemoglobin, red cells and platelets have been reported.
Pregnancy & Lactation
- Renovascular hypertension
- Renal failure: The dose should be cautiously adjusted in accordance with the creatinine clearance
- Symptomatic hypotension is rarely seen, but is more likely in volume-depleted patients, those receiving diuretics, or with the first two doses
- In diuretic-treated patients: stop the diuretic 3 days before starting Perindopril. A diuretic may later be given in combination if necessary; potassium-sparing diuretics are not recommended
- Combination with neuroleptics or imipramine-type drugs may increase the hypotensive effect. Serum lithium concentrations may rise during lithium therapy
Management: Symptomatic and supportive. IV infusion of NaCl 0.9%. Treatment with angiotensin II infusion and/or IV catecholamines may also be considered. Haemodialysis may be beneficial.