Perindopril

ACE Inhibitor·Cardiovascular - Antihypertensives

Hypertension, Heart Failure (HFrEF), prevention of progressive diabetic nephropathy, post-MI remodeling prevention

PBSACEiCoversyl, Perindo2.5 mg tabletS4+1

Max Dose

10 mg/day

Half-life

17 h (Active)

Dry Cough

COMMON

Teratogenic

CRITICAL RISK

Rapid Summary

Overview

Long-acting Angiotensin-Converting Enzyme (ACE) inhibitor. The absolute gold-standard foundational therapy for hypertension, heart failure, and diabetic nephropathy.

Maximum Dose

Max 10 mg/day. Reduce in Renal impairment — Max 2.5 mg/day if eGFR < 30.

Clinical Focus

Absolutely contraindicated in Pregnancy (Category D). Causes severe fetal renal agenesis and skull hypoplasia. Cease immediately on confirmed pregnancy.

Bottom Line

Perindopril is the preferred ACE inhibitor for most cardiovascular and renal-protective indications, but must never be used in Pregnancy and always requires U&E monitoring.

Formulation & Access

Brand Names

Coversyl, Perindo

Oral Routes

Tablets (2.5, 5, 10 mg). Often combined with Amlodipine (Reaptan) or Indapamide (Coversyl Plus).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Hypertension, Heart Failure (HFrEF), prevention of progressive diabetic nephropathy, post-MI remodeling prevention.

Clinical Place

First-line agent for almost all cardiovascular and renal-protective indications.

Quick reference

Class & Role

ACE Inhibitor — first-line antihypertensive, heart failure, renal protection

Route / Formulation

PO tablets: 2.5 mg, 5 mg, 10 mg (Coversyl, Perindo)

Usual Dose & Max

Start 2.5 mg OD, titrate to 5-10 mg OD. Max 10 mg/day.

Key Indication Doses

HF: start 2.5 mg OD, target 10 mg OD. Renal: halve if eGFR 30-60.

Administration

Take same time daily. Swallow whole. No food restriction. Missed dose: skip if < 4 h to next.

Best Uses

Hypertension + diabetic nephropathy, HFrEF, post-MI. Cheap on PBS. Once-daily.

Avoid / Cautions

Pregnancy (Category D), bilateral renal artery stenosis, prior ACEi angioedema, K+ > 5.5 mmol/L.

Key Risks

Dry cough 10-15%, first-dose hypotension, angioedema (rare but fatal), hyperkalaemia.

Key Interactions

Triple Whammy (ACEi + diuretic + NSAID = AKI). K+-sparing diuretics. Aliskiren in diabetes.

Monitoring

U&E at baseline, 1-2 weeks post-start, each dose change, then 6-12 monthly. BP at each visit.

Clinical Pearl

Creatinine rise up to 30% is expected and protective — only stop if > 30% or K+ > 5.5 mmol/L.

Access

Coversyl, Perindo10 mg tablet

Brand: Coversyl, Perindo
Formulation: Tablets (2