Perindopril | Side Effects, Dosage, Uses & More
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Generic Name:

perindopril, Oral tablet

All Brands

  • Aceon
SECTION 1 of 5

Highlights for perindopril

Oral tablet
1

Perindopril is used to treat hypertension (high blood pressure). It’s also used to lower the risk of a heart attack in people with stable coronary artery (heart) disease.

2

This drug comes in the form of a tablet you take by mouth.

3

Perindopril is available as a brand-name drug called Aceon. It’s also available as a generic drug.

4

You shouldn’t take this drug if you’re pregnant or planning to become pregnant. It can harm or be fatal to your unborn baby.

5

More common side effects of taking this drug include dizziness, weakness, headaches, upset stomach, cough, and low blood pressure.

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects. 

Use during pregnancy warning. You shouldn’t take this drug if you’re pregnant or planning to become pregnant. It can harm or be fatal to your unborn baby. Talk to your doctor about other ways to lower your blood pressure if you become pregnant. If you get pregnant while taking perindopril, tell your doctor right away.

Angioedema (swelling)

This drug can cause sudden swelling of your face, arms, legs, lips, tongue, throat, and intestines (angioedema). This can be fatal. Tell your doctor right away if you have swelling in these areas or abdominal pain. You’ll be taken off of perindopril and possibly given medication to reduce the swelling. Angioedema can happen at any time while you’re taking perindopril.

Low blood pressure (hypotension)

Perindopril can cause low blood pressure, especially during the first few days of starting treatment. Tell your doctor if you feel lightheaded or have any fainting spells. Your risk for low blood pressure may be higher if you:

  • don’t drink enough fluids
  • sweat heavily
  • have diarrhea or are vomiting
  • have heart failure
  • are on dialysis
  • take water pills (diuretics)

Cough

Perindopril may cause a persistent, dry, non-productive cough. It will go away once you stop taking this medication.

Drug features

Perindopril is a prescription drug. It’s available as an oral tablet.

Perindopril is available as a generic drug. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

Perindopril may be used as part of a combination therapy. That means you need to take it with other drugs.

Why it's used

Perindopril is used to treat high blood pressure. Reducing your blood pressure lowers your risk of complications, such as a stroke or a heart attack.

Perindopril is also used to lower your risk of a heart attack if you have stable coronary artery disease.

How it works

Perindopril belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions. 

Perindopril works by helping your blood vessels relax and widen. This lowers your blood pressure.

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perindopril Side Effects

Oral tablet

More Common Side Effects

Some of the more common side effects that can occur with use of perindopril include:

  • dizziness

  • weakness

  • headaches

  • upset stomach

  • stomach pain

  • diarrhea

  • cough

  • back pain

  • low blood pressure, which may make you feel dizzy or faint

If these effects are mild, they may disappear within a few days or a couple of weeks. If they’re more severe or don’t disappear, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life-threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • breathing problems. Symptoms include:

    • trouble breathing or swallowing
    • hoarseness
  • swelling (angioedema). Symptoms include:

    • swelling of your face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • very low blood pressure. Symptoms include:

    • lightheadedness
    • fainting
  • low white blood cell count. This can increase your risk of infections. Symptoms include:

    • fever
    • sore throat
    • chills
  • heart problems. Symptoms include:

    • irregular or rapid heart rate
  • liver damage. Symptoms include:

    • yellowing of your skin and the whites of your eyes
    • nausea
    • vomiting
    • pain in the upper right part of your abdomen
    • fatigue
    • elevated liver enzymes
  • high potassium levels. In most cases, your potassium levels will decrease on their own. However, some people may have dangerously high levels of potassium while taking this drug. Your risk is higher if you have kidney disease, diabetes, or are taking diuretics (water pills). Your doctor may do blood tests to check your potassium levels.

Pharmacist's Advice
Healthline Pharmacist Editorial Team

Perindopril doesn’t cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

perindopril May Interact with Other Medications

Oral tablet

Perindopril can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications that might interact with this drug

Non-steroidal anti-inflammatory drugs (NSAIDs)

Taking NSAIDs with perindopril can increase your risk of kidney problems. Your risk may be higher if you’re a senior, have kidney problems, or are dehydrated.

These drugs include:

  • ibuprofen
  • indomethacin

Water pills (diuretics)

Taking these medicines with perindopril can sometimes increase your risk of low blood pressure.

These drugs include:

  • hydrochlorothiazide
  • furosemide
  • bumetanide
  • chlorthalidone
  • toresemide
  • indapamide

Potassium-sparing diuretics, potassium supplements, and salt substitutes

Taking these medicines with perindopril can increase your risk of high potassium levels in your blood. 

These drugs include:

  • spironolactone
  • triamterene
  • amiloride
  • potassium-containing salt substitutes

Blood thinners

Taking heparin with perindopril can increase your risk of high potassium levels in your blood.

Organ transplant drugs (immunosuppresants)

Taking cyclosporine with perindopril can increase your risk of high potassium levels in your blood. 

Blood pressure medications

Taking these medicines with perindopril can increase your risk of high potassium levels in your blood. 

These drugs include:

  • aliskiren
  • losartan
  • valsartan
  • olmesartan
  • candesartan
  • benazepril
  • captopril
  • enalapril
  • lisinopril

Mood stabilizers

Perindopril may increase the amount of lithium in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with angioedema

If you have a history of hereditary or idiopathic angioedema that’s not related to previous use of drugs similar to perindopril (angiotensin-converting enzyme or ACE inhibitors), you may have a higher risk of this condition while taking this drug.

People with liver failure

Your body may not clear this drug out of your system as well as it should. This could cause higher levels of perindopril in your body, leading to more side effects.

People with kidney problems

Perindopril may decrease how well your kidneys work. Your doctor may have you stop taking this drug if your kidney function gets worsen while you’re taking it.

People with lupus

Perindopril can lower your white blood cell counts. This raises your risk of infections. This is more likely to occur if you have lupus. If you have lupus and take this drug, tell your doctor any time you have a fever or sore throat.

People with scleroderma

Perindopril can lower your white blood cell counts. This raises your risk of infections. This is more likely to occur if you have scleroderma. If you have this condition and take this drug, tell your doctor any time you have a fever or sore throat.

Pregnant women

Perindopril is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

Women who are breast-feeding

It isn’t known if perindopril passes into breast milk. If it does, it may cause side effects in a child who is breast-fed. 

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

For seniors

Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in some people. If you’re a senior, you may need a lower dose or a different schedule.

For children

This drug hasn’t been studied in children and shouldn’t be used in children younger than 18 years.

Allergies

Perindopril can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives

Call 9-1-1 or go to the nearest emergency room if you develop these symptoms.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take perindopril (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Hypertension

Brand: Aceon

Form: Oral tablet
Strengths: 2 mg, 4 mg, and 8 mg

Generic: perindopril

Form: Oral tablet
Strengths: 2 mg, 4 mg, and 8 mg
Adult dosage (ages 18–64 years)

The starting dose is 4 mg taken by mouth once per day. The usual dose is 4–8 mg taken once per day or split into divided doses. Your doctor may change your dose based on your blood pressure. You may take up to a maximum of 16 mg per day.

Child dosage (ages 0–17 years)

This medicine hasn’t been studied in children and shouldn’t be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

The starting dose is 4 mg given once per day or split into two doses. If your doctor increases your dose above 8 mg, they should carefully monitor your blood pressure. Your doctor will increase your dose slowly to reduce your risk of side effects.

Special considerations

Kidney disease: For people with mild to moderate kidney disease, the starting dose is 2 mg taken by mouth once per day. The maximum dose is 8 mg taken by mouth once per day. If you have severe kidney disease, you shouldn’t use this drug.

Stable coronary artery (heart) disease

Brand: Aceon

Form: Oral tablet
Strengths: 2 mg, 4 mg, and 8 mg

Generic: perindopril

Form: Oral tablet
Strengths: 2 mg, 4 mg, and 8 mg
Adult dosage (ages 18–64 years)

The starting dose is 4 mg taken by mouth once per day for 2 weeks. Your doctor may increase your dose up to 8 mg taken once per day if tolerated.

Child dosage (ages 0–17 years)

This medicine hasn’t been studied in children and shouldn’t be used in people younger than 18 years.

Senior dosage (ages 65–70 years)

The starting dose is 4 mg taken by mouth once per day for 2 weeks. Your doctor may increase your dose up to 8 mg taken once per day.

Senior dosage (ages 71 years and older)

The starting dose is 2 mg taken once per day in the first week and 4 mg taken once per day in the second week. Your doctor may increase your dose to 8 mg taken once per day if tolerated.

Special considerations

Kidney disease: For people with mild to moderate kidney disease, the starting dose is 2 mg taken by mouth once per day. The maximum dose is 8 mg taken by mouth once per day. If you have severe kidney disease, you shouldn’t use this drug.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Perindopril comes with serious risks if you don't take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your high blood pressure will stay high. This may lead to serious complications, such as a heart attack or stroke.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, it needs to be taken on a regular basis.

If you take too much

You could have dangerous levels of the drug in your body. This may cause you to have more side effects. These include:

  • very low blood pressure, which may cause dizziness or fainting
  • kidney problems
  • high potassium levels

If you think you’ve taken too much of the drug, act right away. Call your doctor or local poison control center, or go to the nearest emergency room.

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

If you check your blood pressure and it’s lower, that means the drug is working.

Perindopril is used for long-term treatment.

Important considerations for taking perindopril
with or without food You can take perindopril with or without food
crush or cut the tablet You can crush or cut the tablet
storage Store perindopril at room temperature See Details
medication is refillable A prescription for this medication is refillable See Details
travel Travel See Details
self-management Self-management See Details
clinical monitoring Clinical monitoring See Details
not usually stocked Not every pharmacy stocks this drug. When refilling your prescription, be sure to call ahead
Hidden costs Hidden costs See Details
prior authorization needed Insurance See Details

Store perindopril at room temperature

  • Keep it from 68°F to 77°F (20°C to 25°C).
  • Keep it away from light and high temperatures.
  • Don’t freeze this drug.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Your doctor may tell you to check your blood pressure at home in between appointments. You may need to buy a blood pressure monitor to do this.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • kidney function
  • electrolyte levels
  • lithium levels if you’re also taking lithium
  • blood pressure
  • signs of swelling

Hidden costs

You may need to buy a blood pressure monitor to check your blood pressure at home.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

What does the pill look like?

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How Much Does perindopril Cost?

Oral tablet

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Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on October 10, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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