Meds and you

Updated 25 November 2016


Perindopril is an angiotensin-converting enzyme (ACE) inhibitor, prescribed for the treatment of high blood pressure and congestive heart failure.


Perindopril is the active ingredient of Coversyl and Prexum.

Perindopril is also one of multiple active ingredients found in Bipreterax (Perindopril + Indapamide), Coversyl Plus (Perindopril + Indapamide), Preterax (Perindopril + Indapamide) and Prexum Plus (Perindopril + Indapamide).

General Information

Perindopril is an angiotensin-converting enzyme (ACE) inhibitor, prescribed for the treatment of high blood pressure and congestive heart failure, a condition where the heart battles to cope with its workload. It causes blood vessels to relax and widen, thereby reducing high blood pressure.

This medication is not a cure for high blood pressure, but is effective in keeping it under control. For it to be effective, you must take it regularly. High blood pressure declines slowly and it may take a few weeks for perindopril to reach its full effect. Keep taking this medicine during this period, even if you are feeling better or fail to notice any improvement.

Perindopril can be used on its own, or in combination with certain other medication for high blood pressure. It is often effectively combined with diuretics. In black patients perindopril is significantly less effective if not prescribed together with a diuretic.

The first couple of doses of this medication may cause a sudden drop in blood pressure, which may cause dizziness or blackouts when you suddenly get up. It is therefore advised to rest when starting treatment and to lie down for 2 hours afterwards.

The use of perindopril is often associated with a dry and persistent cough. Should you notice an irritating cough while being treated with this drug, it is advised to contact you doctor.

Perindopril should be avoided during pregnancy, especially the second and third trimester. Speak to your doctor about the use of this drug if you are planning to get pregnant as it may cause harm to the unborn baby.

How does perindopril work?

Perindopril works by preventing the conversion of angiotensin I, a chemical in your blood, to a more powerful version, angiotensin II. Angiotensin II has a narrowing effect on blood vessels, thereby increasing blood pressure. Angiotensin II furthermore stimulates the production of aldosterone, a hormone which promotes salt (sodium) retention in the body, an action which increases blood pressure.

By inhibiting the forming of angiotensin II perindopril lowers blood pressure and thereby decreases the workload of the heart.

Fast facts

Drug schedule: Schedule 3

Available as: Perindopril is available as tablets.

What does it do? Lowers blood pressure.

Overdose risk: Medium

Dependence risk: Low

Is perindopril available as a generic? Yes

Is perindopril available on prescription only? Yes

User information

Onset of effect: Within 60 minutes

Duration of action: Up to 24 hours

Dietary advice: Take perindopril one hour prior to a meal on an empty stomach. It is advised to follow a low potassium diet. This includes foods such as tomatoes and bananas.

Stopping this medicine: Use perindopril as prescribed by your doctor, and do not discontinue treatment before speaking to him/her. Suddenly discontinuing the drug may case you blood pressure to increase dangerously. Dosage should be deceased gradually as directed by your doctor.

Prolonged use: No problems are expected. Your doctor may perform periodic blood and urine tests, should the need arise.

Special precautions

Consult your doctor before using this drug if:

  • You have a kidney disease
  • You are allergic to ACE-inhibitor drugs
  • You are taking other medication
  • You are pregnant or planning to become pregnant.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: This medication is not intended for use in children.

Elderly: No special precautions need to be taken.

Driving and hazardous work: Caution is advised, as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.

Alcohol: Avoid concomitant use of alcohol with this medication, as it may worsen the possibility of dizziness.

Possible side effects

Side effect


Consult your doctor



Only if severe

In all cases







Dry cough






Chest pain/palpitations



Altered sense of taste






Muscle cramps



Swelling of face, lips, tongue or throat



Swelling of arms and legs



Difficulty swallowing/breathing




Abdominal pain with/without nausea/vomiting




Drug interactions


Possible allergic reactions


Enhanced blood pressure-lowering effect

Other medication for high blood pressure

Enhanced blood pressure-lowering effect


Increased risk of potassium toxicity


Effect on blood pressure is enhanced.


Increased risk of lithium toxicity

Non-steroidal anti-inflammatory drugs

Effect on blood pressure is impaired.

Potassium supplements

Increased risk of potassium toxicity


May increase blood pressure.

Disease interactions

Consult your doctor before using this drug if you have a kidney disease, a heart condition which your doctor is not aware of, or if you are allergic to ACE-inhibitor drugs.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention. Symptoms of an overdose may include dizziness and/or fainting.

Recommended dosage

High blood pressure: 4-8 mg/day as a single dose.


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