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Perindopril
CHF and arrhythmias
Hypertension
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Drug Name:

Perindopril Rx

Generic Name and Formulations:
Perindopril erbumine 2mg, 4mg, 8mg; scored tabs.

Company:
Various generic manufacturers

Therapeutic Use:

Indications for Perindopril:

To reduce risk of cardiovascular mortality or nonfatal MI in patients with stable coronary artery disease.

Adult:

Initially 4mg once daily for 2 weeks, then increase as tolerated; maintenance: max 8mg once daily. Elderly (>70yrs): initially 2mg once daily for 1st week, then 4mg once daily for 2nd week; maintenance: 8mg once daily, if tolerated. Renal impairment: CrCl <30mL/min: not recommended; CrCl ≥30mL/min: initially 2mg/day: max 8mg/day.

Children:

Not established.

Contraindications:

History of ACEI-associated or other angioedema. Concomitant aliskiren in patients with diabetes. Concomitant neprilysin inhibitor (eg, sacubitril); do not give within 36 hours of switching to or from sacubitril/valsartan.

Warnings/Precautions:

Fetal toxicity may develop: discontinue if pregnancy is detected. Salt/volume depletion. Dialysis. Severe CHF. Renal artery or aortic stenosis. Monitor BP, electrolytes, and renal function periodically. Diabetes. Monitor for neutropenia in renal or collagen vascular disease (eg, SLE). Hepatic impairment. Surgery. Discontinue if laryngeal edema, angioedema (have SC epinephrine available), marked elevations of liver enzymes or jaundice occurs. Black patients may have higher risk of angioedema than non-black patients. Elderly. Neonates. Pregnancy (Cat.D); avoid. Nursing mothers.

Interactions:

See Contraindications. Increased risk of angioedema with concomitant neprilysin inhibitor or mTOR inhibitor (eg, temsirolimus). Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Concomitant aliskiren in renal impairment (CrCl <60mL/min): not recommended. Hyperkalemia with K+ supplements, K+ sparing diuretics, K+ containing salt substitutes, others (eg, cyclosporine, indomethacin, heparin). Excessive hypotension with diuretics. May increase lithium levels. May be antagonized by, and renal toxicity potentiated by NSAIDs, including selective COX-2 inhibitors (monitor renal function in elderly and/or volume-depleted). Caution with gentamicin, digoxin. Nitritoid reactions with concomitant injectable gold (eg, sodium aurothiomalate); rare.

Pharmacological Class:

ACE inhibitor.

Adverse Reactions:

Headache, cough, dizziness, back pain, drug intolerance, hypotension, fever; hyperkalemia.

Note:

Formerly known under the brand name Aceon.

How Supplied:

Contact supplier

Indications for Perindopril:

Hypertension.

Adult:

If not on diuretic: initially 4mg once daily; may increase to max 16mg/day. Usual maintenance 4–8mg as a single daily dose or in two divided doses. If on diuretic: consider reducing diuretic dose prior to starting therapy. Elderly: usual max 8mg/day. Renal impairment: CrCl <30mL/min: not recommended; CrCl ≥30mL/min: initially 2mg/day: max 8mg/day.

Children:

Not established.

Contraindications:

History of ACEI-associated or other angioedema. Concomitant aliskiren in patients with diabetes. Concomitant neprilysin inhibitor (eg, sacubitril); do not give within 36 hours of switching to or from sacubitril/valsartan.

Warnings/Precautions:

Fetal toxicity may develop: discontinue if pregnancy is detected. Salt/volume depletion. Dialysis. Severe CHF. Renal artery or aortic stenosis. Monitor BP, electrolytes, and renal function periodically. Diabetes. Monitor for neutropenia in renal or collagen vascular disease (eg, SLE). Hepatic impairment. Surgery. Discontinue if laryngeal edema, angioedema (have SC epinephrine available), marked elevations of liver enzymes or jaundice occurs. Black patients may have higher risk of angioedema than non-black patients. Elderly. Neonates. Pregnancy (Cat.D); avoid. Nursing mothers.

Interactions:

See Contraindications. Increased risk of angioedema with concomitant neprilysin inhibitor or mTOR inhibitor (eg, temsirolimus). Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Concomitant aliskiren in renal impairment (CrCl <60mL/min): not recommended. Hyperkalemia with K+ supplements, K+ sparing diuretics, K+ containing salt substitutes, others (eg, cyclosporine, indomethacin, heparin). Excessive hypotension with diuretics. May increase lithium levels. May be antagonized by, and renal toxicity potentiated by NSAIDs, including selective COX-2 inhibitors (monitor renal function in elderly and/or volume-depleted). Caution with gentamicin, digoxin. Nitritoid reactions with concomitant injectable gold (eg, sodium aurothiomalate); rare.

Pharmacological Class:

ACE inhibitor.

Adverse Reactions:

Headache, cough, dizziness, back pain, drug intolerance, hypotension, fever; hyperkalemia.

Note:

Formerly known under the brand name Aceon.

How Supplied:

Contact supplier

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