Brand Name: Coversyl

Generic Name: Perindopril

Indication: Essential Hypertension, CHF. Prevention of Stroke recurrence in combination with
Indapamide in patients with a history of cerebrovascular disease.
Drug Classification: Antihypertensive (ACE Inhibitor)
Mechanism of Action: A prodrug that is converted by the liver to the active metabolite
perindroprilat, which inhibits ACE activity, thereby preventing conversion of angiotensin
I to angiotensin II, a potent vasoconstrictor. Inhibition of ACE results in decreased
vasoconstriction and decreased aldosterone activity,thus reducing sodium water 4, 4 mg
P.O. once daily. Increase dosage until blood pressure is controlled or to maximum of
1mg/day; usually maintenance dose is 4 to 8 mg oce daily; may be given it two divided
doses. Elderly patients:Initially, 4 mg P.O. daily as one dose or in two divided doses.
Dosage may be increased by more than 8 mg/day only under close medical
supervision.
Special Precaution: Renal failure; renovascular hypertension; surgery/anesth; elderly.
Hemodialysis: avoid combination with highly permeable membranes (polyacrylonitrile)
Pregnancy Risk Category: C (D in second and third trimesters)
Adverse Reaction: CNS: dizziness, asthenia, sleep disorder, paresthesia, depression, somnolence,
nervousness, headache.CV: palpitations, edema, chest pain, abnormal ECG. EENT:
rhinitis, sinusitis, ear infection, pharyngitis, tinnitus. GI: dyspepsia, diarrhea, abdominal
 pain, nausea, vomiting, flatulence. GU: proteinuria, urinarytract infection, male
sexual dysfunction, menstrual disorder. Musculoskeletal: back pain, hyperonia, neck
pain, joint pain, myalgia, arthritis, arm or leg pain Respiratory: cough, upper respiratory
infection SKIN: Rash OTHER: viral infection, injury, seasonal allergy
Contraindications: Contraindicated in patients hypersensitive to drug or other ACE inhibitors
and in those with a history of angioedema secondary to ACE inhibitors. Also
contraindicated in pregnant women.
Form: Tablets 2mg, 4mg, 8 mg
Nursing Responsibility:
 Use cautiously in patients with a history of angioedema unrelated to ACE inhibitor
therapy. Also use cautiously in patients with impaired renal function, heart failure,
ischemic heart disease or renal artery stenosis, and in patients with collagen vascular
disease, such as systemic lupus erythematosus or scleroderma.
 Therapy with thiazide diuretic produces a more favorable response. ACE inhibitors
appear to increase risk of angioedema in black patients.
 Angioedema involving the face extremities, lips, tongue, glottis, and larynx may
occur. Stop drug and observe patient swelling disappear. If swelling is confined to
lips and face, it will probably resolve without treatment, but antihistamines may be
useful in relieving symptoms.
(continuation of Coversyl)
 Excessive hypotension can occur when drug is given with diuretics. If possible, stop
diuretic 2-3 days before starting perindropil to reduce the potential for excessive
hypotension response.
 Monitor patient at risk for hypertension closely during initiation of therapy, for first
2 weeks of treatment, and whenever dosage of perindopril or concomitant diuretic is
increased. In sever hypotension, place patient in a supine position.
 Volume and salt depletion should be corrected before starting drug.
 Monitor potassium level closely.
 Monitor renal function before and periodically throughout therapy.