Coversyl

Perindopril arginine

HTN. Stable CAD: Risk reduction of cardiac events in patients w/ history of MI &/or revascularisation. 5 mg: Symptomatic heart failure.

HTN Initially 5 mg once daily, may be increased to 10 mg once daily after 1 mth. Renovascular HTN, salt &/or vol depletion, cardiac decompensation or severe HTN Initially 2.5 mg, may be increased to 10 mg once daily after 1 mth. Elderly Initially 2.5 mg, may be increased to 5 mg after 1 mth then to 10 mg if necessary. Symptomatic heart failure Initially 2.5 mg, may be increased to 5 mg once daily after 2 wk. Stable CAD Initially 5 mg once daily for 2 wk, then increased to 10 mg once daily. Elderly 2.5 mg once daily for 1 wk, then 5 mg once daily the following wk, may be increased up to 10 mg once daily. CrCl ≥60 mL/min 5 mg daily, >30 to <60 mL/min 2.5 mg daily, >15 to <30 mL/min 2.5 mg every other day, <15 mL/min (haemodialysed patient) 2.5 mg on dialysis day.

Should be taken on an empty stomach: Preferably taken in the morning before a meal.

Hypersensitivity to perindopril arginine & other ACE inhibitor. History of angioedema associated w/ previous ACE inhibitor therapy; hereditary or idiopathic angioedema. Significant bilateral renal artery stenosis or artery stenosis to single functioning kidney. Extracorporeal treatments leading to blood contact w/ -ve charged surfaces. Concomitant use w/ aliskiren-containing products in patients w/ DM or renal impairment (GFR <60 mL/min/1.73 m²); sacubitril/valsartan. 2nd & 3rd trimesters of pregnancy.

Hypersensitivity/angioedema; anaphylactoid reactions during LDL apheresis & desensitisation. Discontinue use if episode of unstable angina pectoris during 1st mth of treatment; jaundice or marked hepatic enzymes elevation occur. Not to be used concomitantly w/ ARBs in patients w/ diabetic nephropathy. Not recommended in dual blockade of the renin-angiotensin-aldosterone system; primary hyperaldosteronism. Symptomatic hypotension in vol-depleted patients eg, diuretic therapy, dietary salt restriction, dialysis, diarrhoea, vomiting, severe renin-dependent HTN; ischaemic heart or cerebrovascular disease. Collagen vascular disease, immunosuppressant therapy; CHF; mitral valve stenosis & left ventricle outflow obstruction; renovascular HTN; DM, dehydration, acute cardiac decompensation, metabolic acidosis; hyperkalaemia; cough. Bilateral renal artery stenosis or artery stenosis to single functioning kidney. Black patients; diabetic patients. Discontinue use 1 day prior to surgery. Not to initiate sacubitril/valsartan until 36 hr after last dose. Not recommended in combination w/ lithium; K-sparing drugs, K supplements or K-containing salt substitutes, aliskiren. Concomitant use w/ NEP inhibitors eg, racecadotril; mTOR inhibitors eg, sirolimus, everolimus, temsirolimus; gliptins eg, linagliptin, saxagliptin, sitagliptin, vildagliptin; allopurinol or procainamide; drugs increasing serum K eg, heparin, co-trimoxazole. Not to be taken by patients w/ galactose intolerance, glucose-galactose malabsorption or total lactase deficiency. May affect ability to drive & use machines. Renal impairment (CrCl <60 mL/min). Preexisting renal impairment; haemodialysis; recent kidney transplantation. Hepatic impairment & failure. Not recommended during 1st trimester of pregnancy & lactation. Not recommended in childn & adolescents <18 yr.

Dizziness, headache, paraesthesia, vertigo; visual disturbances; tinnitus; hypotension; cough, dyspnoea; abdominal pain, constipation, diarrhoea, dysgeusia, dyspepsia, nausea, vomiting; pruritus, rash; muscle cramps; asthenia.

Increased risk of hyperkalaemia w/ aliskiren, K salts or K-sparing diuretics, ACE inhibitors, AIIAs, NSAIDs, heparins, immunosuppressants (eg, ciclosporin, tacrolimus), trimethoprim, co-trimoxazole. Increased risk of hyperkalaemia, worsened renal function, CV morbidity & mortality w/ aliskiren. Increased risk of severe anaphylactoid reactions w/ extracorporeal treatments. Increased risk of angioedema w/ sacubitril/valsartan; racecadotril, mTOR inhibitors (eg, sirolimus, everolimus, temsirolimus), gliptins (eg, linagliptin, saxagliptin, sitagliptin, vildagliptin). Increased risk of angioneurotic oedema w/ estramustine. Reversible increased serum conc & toxicity of lithium. Increased blood-glucose lowering effect of antidiabetic agents eg, insulins, oral hypoglycaemic agents. Increased antihypertensive effect w/ baclofen. Excessive BP reduction w/ non-K-sparing diuretics. Attenuated antihypertensive effects w/ NSAIDs eg, ASA, COX-2 inhibitors, non-selective NSAIDs. Reduced BP w/ nitroglycerin, other nitrates or vasodilators; TCAs, antipsychotics, anaesth. Reduced antihypertensive effects w/ sympathomimetics. Nitritoid reactions w/ injectable gold (Na aurothiomalate).

ACE Inhibitors/Direct Renin Inhibitors

C09AA04 - perindopril ; Belongs to the class of ACE inhibitors. Used in the treatment of cardiovascular disease.

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