Active Ingredient: Perindopril

Indication for Perindopril

Population group: only adults (18 years old or older)
Therapeutic intent: Curative procedure

For this indication, competent medicine agencies globally authorize below treatments:

2.5-5 mg once daily for 1 month and thereafter 2.5-10 mg once daily


Dosage regimens

Oral, between 2.5 milligrams perindopril and 5 milligrams perindopril, once daily at morning, over the duration of 1 month. Afterwards, oral, between 2.5 milligrams perindopril and 10 milligrams perindopril, once daily at morning.

Detailed description

The dose should be individualised according to the patient profile and blood pressure response.

Perindopril may be used in monotherapy or in combination with other classes of antihypertensive therapy.

The recommended starting dose is 5 mg given once daily in the morning.

Patients with a strongly activated renin-angiotensin-aldosterone system (in particular, renovascular hypertension, salt and/or volume depletion, cardiac decompensation or severe hypertension) may experience an excessive drop in blood pressure following the initial dose. A starting dose of 2.5 mg is recommended in such patients and the initiation of treatment should take place under medical supervision.

The dose may be increased to 10 mg once daily after one month of treatment.

Symptomatic hypotension may occur following initiation of therapy with perindopril; this is more likely in patients who are being treated concurrently with diuretics. Caution is therefore recommended since these patients may be volume and/or salt depleted.

If possible, the diuretic should be discontinued 2 to 3 days before beginning therapy with perindopril.

In hypertensive patients in whom the diuretic cannot be discontinued, therapy with perindopril should be initiated with a 2.5 mg dose. Renal function and serum potassium should be monitored. The subsequent dosage of perindopril should be adjusted according to blood pressure response. If required, diuretic therapy may be resumed.

In elderly patients treatment should be initiated at a dose of 2.5 mg which may be progressively increased to 5 mg after one month then to 10 mg if necessary depending on renal function.

Dosage considerations

It is recommended to be taken once daily in the morning before a meal.

Active ingredient


Perindopril is an inhibitor of the enzyme that converts angiotensin I into angiotensin II (Angiotensin Converting Enzyme ACE). The converting enzyme, or kinase, is an exopeptidase that allows conversion of angiotensin I into the vasoconstrictor angiotensin II as well as causing the degradation of the vasodilator bradykinin into an inactive heptapeptide. Inhibition of ACE results in a reduction of angiotensin II in the plasma, which leads 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).

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