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14-September-2008 18:02:40 - Perindopril Perindopril Systematic IUPAC name 1-2-1-ethoxycarbonylbutylamino propanoyl -2,3,3a,4,5,6,7,7a- octahydroindole-2-carboxylic acid Identifiers CAS number 107133-36-8 ATC code C09AA04 PubChem 107807 DrugBank APRD01178 Chemical data Formula C19H32N2O5 Mol. mass 368.468 g/mol Pharmacokinetic data Bioavailability ? Metabolism ? Half life ? Excretion ? Therapeutic considerations Pregnancy cat. ? Legal status Routes ? Coversyl perindopril is a long-acting ACE inhibitor. International nonproprietary name: Perindopril. Contents 1 Indications 2 Dosage and administration 2.1 For Hypertension 2.2 For Stable coronary artery disease 2.3 Congestive heart disease 3 Precautions 4 Side effects 5 Composition 6 Presentation 7 References 8 External links Indications Essential hypertension. Stable coronary artery disease: reduction of risk of cardiac events in patients with a history of myocardial infarction and/or revascularization. Treatment of symptomatic heart disease or failure. Dosage and administration Coversyl perindopril should be taken in the morning before food. For Hypertension 4 mg once daily, then the dose may be increased to 8 mg after 1 month of treatment to improve blood pressure control or in case of concomitant stable coronary artery disease. In Australia perindopril arginine is available as Coversyl, the generic form perindopril erbumine is also available. The two formulations are equivalent and may be freely substituted for each other1. In hypertension, the initiation dose is 5 mg perindopril arginine or 4mg perindopril erbumine once daily, then the dose may be increased to 10 mg perindopril arginine or 8mg perindopril erbumine after 1 month of treatment to improve blood pressure control or in case of concomitant stable coronary artery disease. The Anglo-Scandinavian Cardiac Outcomes Trial showed the benefits of taking the two drugs Coversyl and amlodipine together. The 9000 British patients aged 40 to 79 were involved in the five-year trial. Half were given the new drug combination, the rest were given traditional drugs. Coversyl and amlodipine were found to be so effective that the trial was stopped early so that all patients could receive the combination.23 For Stable coronary artery disease A starting dose of 4 mg for 2 weeks is recommended, then uptitration to 8 mg once daily, depending on acceptability. In Australia and the UK, Coversyl is only available as perindopril arginine. A starting dose of 5 mg for 2 weeks is recommended, then uptitration to 10 mg once daily, depending on acceptability. Congestive heart disease Coversyl perindopril should be started under close medical supervision at a starting dose of 2 mg. This may be increased to 4 mg once blood pressure acceptability has been demonstrated. In Australia, Coversyl perindopril arginine should be started under close medical supervision at a starting dose of 2.5 mg. This may be increased to 5 mg once blood pressure acceptability has been demonstrated. Elderly patients should start treatment at 2 mg daily 2.5 mg daily perindopril arginine in Australia. Contraindications include; children, pregnancy, lactation and situations where a patient has a history of hypersensitivity to Coversyl perindopril. Precautions Assess renal function before and during treatment where appropriate. Renovascular hypertension. Surgery/anesthesia. Renal failure: the dose should be cautiously adjusted in accordance with the creatinine clearance refer to complete data sheet. Symptomatic hypotension is rarely seen, but is more likely in volume-depleted patients, those receiving diuretics, or with the first two doses. In diuretic-treated patients, stop the diuretic 3 days before starting Coversyl perindopril. A diuretic may later be given in combination if necessary; potassium-sparing diuretics are not recommended. Combination with neuroleptics or imipramine-type drugs may increase the hypotensive effect. Serum lithium concentrations may rise during lithium therapy. Side effects Rare and mild, usually at the start of treatment. Cough, fatigue, asthenia, headache, disturbances of mood and/or sleep have been reported. Less often, taste impairment, epigastric discomfort, nausea, abdominal pain, and rash. Reversible increases in blood urea and creatinine may be observed. Proteinuria has occurred in some patients. Rarely, angioneurotic edema and decreases in hemoglobin, red cells, and platelets have been reported. Composition Each tablet contains 2 mg, 4 mg or 8 mg of the tert-butylamine salt of perindopril. Perindopril is also available under the trade name Coversyl Plus, containing 4mg of perindopril combined with 1.25mg indapamide. In Australia, each tablet contains 2.5 mg, 5 mg or 10 mg of arginine. Perindopril is also available under the trade name Coversyl Plus and Coversyl Plus LD, containing 5mg of perindopril combined with 1.25mg indapamide and 2.5mg of perindopril combined with 0.625mg indapamide respectively. Presentation Packs of 30 tablets of Coversyl perindopril 2 mg. Packs of 30 tablets of Coversyl perindopril 4 mg scored. Packs of 30 tablets of Coversyl perindopril 8 mg. Also available under the brand names: Aceon , Acertil , Armix , Coverene , Coverex , Coversum , Prestarium , Prexanil , Prexum and Procaptan References Bounhoure JP, Bottineau G, Lechat P, et al. Value of perindopril in the treatment of chronic congestive heart failure: multicentre double-blind placebo-controlled study. Clin Exp Hypertens. 1989;A11suppl 2:575-586. Lechat P, Granham SP, Desche P, et al. Efficacy and acceptability of perindopril in mild-to-moderate chronic congestive heart failure. Am Heart J. 1993;126:798-806. Morgan T and Anderson A; Clinical efficacy of perindopril in hypertension. Clin Exp Pharmacol Physiol. 1992;19:61-65. Myers MG; on behalf of the perindopril multicentre dose-response study group A dose-response study of perindopril in hypertension: effects on blood pressure 6 and 24h after dosing. Can J Cardiol. 1996;12:1191-1196. The European trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomized, double-blind, placebo controlled, multicentre trial the EUROPA study. The Lancet 2003;362:782-788. ^ Australian Government Department of Health and Ageing 2008. PBS For Health Professionals. Pharmaceutical Benefits Scheme. Retrieved on 2008-09-04. ^ Charlotte Harding 2005. What you need to know about the new wonder drug cocktail for high blood pressure.... JADN Repository. Retrieved on 2007-07-01. ^ Linda Brookes 2003. ASCOT: Anglo-Scandinavian Cardiac Outcomes Trial -- Results From The Lipid-Lowering Arm. Medscape Today. Retrieved on 2007-07-01. External links Official homepage v d e Agents acting on the renin-angiotensin system C09 ACE inhibitors Alacepril Benazepril Captopril Cilazapril Delapril Enalapril Fosinopril Imidapril Lisinopril Moexipril Perindopril Quinapril Ramipril Rentiapril Spirapril Temocapril Trandolapril Zofenopril Angiotensin II receptor antagonists AIIRA Azilsartan Candesartan Eprosartan Irbesartan Losartan Olmesartan Tasosartan Telmisartan Valsartan Renin inhibitors Aliskiren Remikiren Retrieved from http://en..org/wiki/Perindopril Categories: ACE inhibitors Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Italiano Magyar Polski This page was last modified on 4 September 2008, at 07:43
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