An ACE inhibitor
Perindopril
A once-daily ACE inhibitor for high blood pressure and heart failure, and to protect the heart and blood vessels.
What is Perindopril?
Perindopril is an ACE inhibitor used to lower blood pressure, treat heart failure with a weakened pumping action, and protect the heart and blood vessels. It works by relaxing and widening blood vessels so that blood flows more easily.
Education and reference only. This is a plain-language guide to Perindopril — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Perindopril is a widely used ACE inhibitor. It lowers blood pressure, is used in heart failure with a reduced pumping function, and is used to protect the heart and blood vessels in people with established cardiovascular disease. It is a long-term, once-daily tablet that works quietly in the background; the benefit is a reduction in cardiovascular risk and better blood-pressure control over time rather than something you feel each day.
How it works
Perindopril blocks the angiotensin-converting enzyme (ACE), which the body uses to make angiotensin II — a hormone that tightens blood vessels and makes the body hold on to salt and water. With less angiotensin II, blood vessels relax and fluid load falls, so blood pressure drops and the heart has less work to do. The same effect reduces strain on the heart in heart failure and helps protect the circulation over time.
Company & origin
Originated / developed by: Servier.
Perindopril was discovered and developed by the French pharmaceutical company Servier in the 1980s. The ACE inhibitor was first marketed as Coversyl, reaching European markets around 1988.
What it treats
Conditions Perindopril is used for
Practical use
How to take Perindopril
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it at the same time each day, often in the morning, with or without food as advised.
- Take the first dose when you can rest, as it can cause dizziness, especially if you also take a water tablet.
- Expect blood tests to check your kidneys and potassium levels around starting and after dose changes.
- Report a persistent dry, tickly cough, as this is a known effect and may mean a switch is needed.
- Avoid anti-inflammatory painkillers and salt substitutes unless advised, and seek urgent help if your lips, tongue or face swell.
Weighing it up
Advantages & disadvantages of Perindopril
Advantages
- Lowers blood pressure and reduces the risk of heart attack and stroke.
- Improves symptoms and survival in heart failure.
- Helps protect the kidneys in some people, including those with diabetes.
- Taken once a day and well established.
Disadvantages
- Commonly causes a persistent dry cough that some people cannot tolerate.
- Can raise potassium and affect kidney function, so blood tests are needed.
- May cause dizziness, particularly with the first dose or alongside diuretics.
- Rarely causes serious swelling of the face, lips or throat (angioedema).
- Must not be used in pregnancy because of risk to the baby.
Practical use
Good to know
It is taken once a day, often in the morning before food, and is usually started low and built up, with a blood-pressure and blood-test check after starting and after increases. A dry, tickly cough is the best-known nuisance effect and, if troublesome, is usually solved by switching to an ARB. The first dose can cause dizziness, so it is sometimes taken at bedtime to begin with, particularly if you are also on a water tablet. ACE inhibitors must not be used in pregnancy and are switched beforehand if pregnancy is planned. A history of angioedema (sudden swelling of the lips, tongue or throat) means it should never be taken again. Anti-inflammatory painkillers (NSAIDs), especially alongside a water tablet, can stress the kidneys (the "triple whammy").
Who should not take it / use with caution
- People who are pregnant or planning pregnancy — ACE inhibitors are avoided in pregnancy and switched beforehand.
- Anyone who has ever had angioedema (sudden swelling of the face, lips, tongue or throat), including from a previous ACE inhibitor — a reason never to take it again.
- Used with caution in significant narrowing of the kidney arteries, low blood pressure, or a high blood potassium level.
Monitoring
- Blood pressure
- Kidney function and blood potassium before and after starting/increasing
- For cough or any swelling
Side effects
- A persistent dry cough (common and harmless, but can be annoying).
- Dizziness or light-headedness, especially on standing or after the first dose.
- A rise in blood potassium or a change in kidney function (watched with blood tests); rarely, angioedema — sudden swelling of the face or throat needs emergency care.
Key interactions
- NSAID painkillers (e.g. ibuprofen) can reduce its effect and stress the kidneys, especially alongside a diuretic ("triple whammy").
- Potassium supplements, potassium-based salt substitutes and certain diuretics can push blood potassium too high.
- Care with other blood-pressure-lowering medicines, with ARBs, and with lithium.
Available as: Tablets (the medicine comes as different salts, so two products may look like different strengths while delivering a similar effect — follow your own prescription).
Answers
Perindopril: frequently asked questions
Why does perindopril make me cough?
ACE inhibitors can cause a persistent dry, tickly cough in some people because of the way they affect natural chemicals in the airways. It is harmless but can be annoying; if it bothers you, your prescriber can usually switch you to an ARB, which rarely causes a cough.
What is angioedema and why does it matter?
Angioedema is sudden swelling of the face, lips, tongue or throat. With an ACE inhibitor it is rare but a medical emergency, because throat swelling can affect breathing — call 999 if it happens. Anyone who has had it should never take an ACE inhibitor again.
Can I take perindopril if I might become pregnant?
ACE inhibitors can harm a developing baby and are not used in pregnancy. If you are pregnant, think you might be, or are planning to conceive, tell your doctor so you can be switched to a safer alternative beforehand. Use reliable contraception while taking it if pregnancy would be a concern.
Can I take ibuprofen with perindopril?
Occasional use may be fine, but regular anti-inflammatory painkillers (NSAIDs) can reduce perindopril's effect and, especially alongside a water tablet, can harm the kidneys (the "triple whammy"). Check with your pharmacist and prefer paracetamol where suitable.
What is the difference between perindopril, Coversyl and Acertil?
They are the same active ingredient — perindopril is the generic (active-ingredient) name, and Coversyl and Acertil are brand names. The branded versions contain the identical active ingredient; note that perindopril comes as different salts, so always follow your own prescription rather than matching the number on the packet.
The wider class
About ACE inhibitors
Perindopril belongs to the ace inhibitors class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
Browse by body system
Authoritative sources
- BNF: Perindopril.
- electronic Medicines Compendium (SmPC): Perindopril (Coversyl, Acertil).
- NICE CKS: Perindopril.
- NICE: Hypertension and chronic heart failure.
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