Essential hypertension; stable coro- nary artery disease; reduction of risk of cardiac events in patients with a history of myocardial infarction and /or revascularization; symptomatic heart failure
It should be taken in the morning before food. Hypertension: 5mg OD [the dose may be increased to 10mg after 1 month of treatment to improve blood pressure control or in case of concomitant stable coronary artery dis- ease].Stable Coronary Artery Disease: A starting dose of 5mg OD x 2/52 is recommended, then up titration to 10mg OD [depending on acceptabil- ity]. CHF: starting dose of 2.5mg that may be increased to 5mg after 2 weeks once blood pres- sure acceptability has been demonstrated. Elderly patients: Start treatment at 2.5 mg daily. Renal insufficiency: 2.5mg according to creatinine clearance.
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Mode of Action
It is a long acting ACE inhibitor whose inhibition results in a reduction of angiotensin II in the plasma leading to increased plasma renin activity [by inhibition of the negative feedback of renin release]
Perindopril is now available as arginine salt which is more stable under various geographical temperature and humidity zones but heavier than previous salt of the same drug. Arising from this improvement, the weight of perindopril in tablet has increased from 4mg to 5mg and 8mg to10mg respectively. It is important to note that this is not an increase in perindopril content, as changing of perindopril efficacy was not necessary.