Clinical medicine profile
Perindopril (as arginine salt)
ACE inhibitor
- Route
- ORAL
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
This profile needs source confirmation
A traceable source link is not attached to this profile. Confirm prescribing decisions against the current SmPC and Kenya STG/EML.
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Pregnancy.
- History of ACEI angioedema.
- Bilateral renal artery stenosis.
- Hyperkalaemia.
- Concomitant aliskiren in diabetes (restrictions).
Precautions
- First-dose hypotension in volume-depleted/HF patients.
- Monitor U&E.
- Dry cough common (bradykinin).
- Angioedema emergency.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
Initially 2mg OD in the morning under close supervision. Increased to maintenance dose of 4mg OD after 1-2 weeks only if BP acceptability is established [max 8mg OD].
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Essential monitoring; beneficial long-term in proteinuric CKD if stable creatinine/K.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Rare hepatic reactions; prodrug activation may be reduced in severe liver disease.
Use, effects & interactions
Indications
- Essential hypertension
- stable coronary artery disease
- reduction of risk of cardiac events in patients with a history of myocardial infarction and / or revascularization
- symptomatic heart failure.
- Clinical selection for Perindopril [as tert-butylamine salt] should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: ACE inhibitor.
- Confirm site-specific dose, duration and monitoring before prescribing.
Adverse effects
- Cough, dizziness, hyperkalaemia, raised creatinine.
- Serious: angioedema, severe hypotension, acute renal failure, cholestatic jaundice (rare).
Drug interactions
Open multi-drug checker ↗- Foundational for HFrEF, post-MI, diabetic nephropathy.
- Switch to ARB if intolerable cough without angioedema history.
Mechanism & disposition
It is a long acting ACE inhibitor whose inhibition results is a reduction of angiotensin II in the plasma leading to increased plasma renin activity [by inhibition of the negative feedback of renin release] and reduced secretion of aldosterone.
Read complete mechanism
It is a long acting ACE inhibitor whose inhibition results is a reduction of angiotensin II in the plasma leading to increased plasma renin activity [by inhibition of the negative feedback of renin release] and reduced secretion of aldosterone. Since ACE inactivates bradykinin, inhibition of ACE also results in an increased activity of circulating and local kallikrein-kinin systems [and thus also activation of the prostaglandin system]. The presence of perhydro-indole ring replacing the usual proline group of ACE inhibitors confers a strong affinity for converting enzyme.
Hours; full effect weeks
12–24 hours
ORAL
of active moieties common — adjust in CKD.
Pregnancy, lactation & diet
Contraindicated — teratogenic/fetotoxic.
Captopril/enalapril often preferred if ACEI needed in lactation — check guidance.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| No reviewed brand listings are linked yet. | |||
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.