Warnings and Precautions With Perindopril

Common Warnings and Precautions With Perindopril

Some warnings and precautions with perindopril to be aware of include:
  • There are several medicines that perindopril can interact with (see Drug Interactions With Perindopril).
  • ACE inhibitors are more likely than other drugs to cause allergic reactions. For example, there have been reports of severe allergic reactions occurring in people on perindopril during dialysis. There have also been reports of severe reactions in people getting bee or wasp venom to protect against stings. Make sure to discuss these risks with your healthcare provider. Also, seek emergency medical attention immediately if you notice things such as hives, an unexplained rash, difficulty breathing, or swelling of the face or throat.
  • ACE inhibitors may cause swelling (angioedema) of the head and neck, including the tongue, lips, eyes, or throat. This occurs more frequently in African Americans than in Caucasians. Seek emergency medical care immediately if you notice swelling in the head or neck area, have wheezing, or have difficulty breathing or swallowing.
  • In addition to head and neck angioedema, ACE inhibitors have been known to cause swelling in the intestines. This is known as intestinal angioedema. Symptoms may include, but are not limited to, stomach pain, with or without vomiting. Seek medical attention immediately if you develop any of these symptoms.
  • Perindopril may cause extreme low blood pressure in some people. This is more likely to happen in people who are taking a diuretic, who are on dialysis, who have diarrhea or vomiting, or who sweat a lot. This is why it is important to drink fluids regularly while taking perindopril. If you have any possible symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting, contact your healthcare provider and stop taking the medicine. Also, make sure not to drive, operate any heavy machinery, or perform any other tasks that require alertness before you know how perindopril affects you.
  • Perindopril is a pregnancy Category D medicine, meaning that the drug poses health risks to your unborn child. Let your healthcare provider know if you are pregnant or thinking of becoming pregnant. If you become pregnant while taking perindopril, contact your healthcare provider immediately (see Aceon and Pregnancy).
  • ACE inhibitors, including perindopril, are known to cause a cough. If a cough becomes bothersome, talk to your healthcare provider about alternate options for your condition (see Aceon Cough).
  • While taking perindopril, do not use potassium supplements or salt substitutes with potassium, unless you have discussed this with your doctor. Potassium in the blood can increase to dangerous levels in some people taking perindopril.
  • People on perindopril can be at increased risk of infections. Talk to your healthcare provider if you develop any infections, such as a sore throat or fever.
  • If you are over 65 years old, your healthcare provider may choose to make any necessary dosing adjustments with caution.
  • This medication may cause a decrease in kidney function, especially in people who are elderly, have kidney disease, have severe congestive heart failure (CHF), or are taking nonsteroidal anti-inflammatory drugs (NSAIDs) or diuretics (water pills). Your healthcare provider may choose to monitor your kidney function with a blood test while you are taking it. Contact your healthcare provider if you notice a decrease in urination or swelling in your hands, legs, ankles, or feet, which can be signs of kidney problems.


  • If you have kidney disease or kidney failure, your body may metabolize the perindopril differently than intended. Therefore, your healthcare provider will monitor your situation more closely if this is the case.


  • In clinical studies, ACE inhibitors, including perindopril, have rarely been known to cause liver failure. Contact your healthcare provider immediately if you notice things such as nausea, tiredness, lethargy, itchy or yellowing skin, abdominal pain, or flu-like symptoms.
  • If you are nursing, it is not known whether perindopril passes through your milk. Therefore, if you are nursing, talk with your healthcare provider about whether you should discontinue perindopril or stop breastfeeding.
  • If you have congestive heart failure, your healthcare provider may choose to monitor your progress closely.
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