Side Effects of perindopril: A Synthesis of Findings from 29 Studies

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Original Abstract of the Article

Main Research Findings

Perindopril is an angiotensin-converting enzyme (ACE) inhibitor commonly used for treating hypertension. Research indicates that perindopril effectively manages hypertension and lowers the risk of heart disease and stroke. 20 , 17 , 23 , 22

However, perindopril can cause side effects, which may include cough, dizziness, headache, and fatigue. 1 , 8 Additionally, perindopril can potentially impact kidney function. 14

Reasons for Side Effects

Perindopril's mechanism of action involves inhibiting ACE, which dilates blood vessels and lowers blood pressure. ACE converts angiotensin I into angiotensin II, a substance that constricts blood vessels and elevates blood pressure. By inhibiting ACE, perindopril reduces angiotensin II production, leading to vasodilation and decreased blood pressure.

Perindopril's side effects are often linked to its ACE-inhibiting action, such as rapid blood pressure drops due to vasodilation, cough, taste disturbances, etc. Perindopril can also affect kidney function. A decline in kidney function may result in reduced urine output and edema.

Common Side Effects

Cough

Cough is one of the most frequently reported side effects associated with perindopril. It is believed that perindopril's ACE-inhibiting property hinders the breakdown of bradykinin, a substance that increases in concentration, leading to cough. Bradykinin irritates the mucous membrane of the airways, triggering cough. 1

Dizziness

Perindopril can induce dizziness due to its blood pressure-lowering effect. Dizziness is particularly common when standing up, requiring caution. 8

Headache

Perindopril may cause headaches. Headaches are typically mild and subside within a few days. 8

Fatigue

Perindopril can lead to fatigue. Fatigue is generally mild and resolves within a few days. 8

Kidney dysfunction

Perindopril can potentially worsen kidney function. It is crucial to be particularly cautious for individuals with pre-existing kidney impairment or diabetes. 14

Countermeasures for Side Effects

Cough

If you experience cough after taking perindopril, seek medical advice. In cases of severe cough, it might be necessary to discontinue perindopril. Your doctor may consider prescribing different antihypertensive medications. Cough suppressants may also be recommended. 1

Dizziness

If you experience dizziness from perindopril, rise from a sitting or lying position slowly to avoid falls. If severe dizziness persists, consult your doctor. They may adjust your perindopril dosage or consider alternative antihypertensive treatments. 8

Headache

If you develop headaches due to perindopril, take over-the-counter pain relievers. For persistent or severe headaches, consult your doctor. They might adjust your perindopril dosage or recommend other antihypertensive options. 8

Fatigue

If you experience fatigue from perindopril, ensure adequate rest. For persistent or severe fatigue, seek medical advice. Your doctor might consider lowering your perindopril dosage or prescribe alternative antihypertensive medications. 8

Kidney dysfunction

If you experience kidney dysfunction after taking perindopril, seek medical attention. Your doctor might adjust your perindopril dosage or prescribe alternative antihypertensive medications. They may also recommend dietary or exercise therapy to maintain kidney function. 14

Comparison Between Studies

Commonalities Between Studies

Numerous studies have demonstrated the effectiveness of perindopril in managing hypertension. Additionally, research indicates that perindopril reduces the risk of heart disease and stroke. 20 , 17 , 23 , 22

Differences Between Studies

The frequency and types of side effects reported for perindopril vary across studies. For instance, one study reported cough as the most prevalent side effect, while another study found dizziness to be the most common side effect. 1 , 8

Cautions for Application in Real Life

Perindopril is an effective medication for managing hypertension, but it can have side effects. Before starting perindopril, consult with your doctor and ensure you understand the risks of side effects and potential countermeasures. During perindopril treatment, remember to schedule regular check-ups with your doctor to monitor your blood pressure and side effects.

Limitations of Current Research

The side effects of perindopril are not completely understood. Future research is needed to delve deeper into the mechanisms behind perindopril side effects and to develop strategies for mitigating them. Further research on the long-term safety of perindopril is also essential.

Directions for Future Research

To gain a more comprehensive understanding of perindopril side effects, the following research areas are crucial:

  • Research to elucidate the mechanisms of perindopril side effects
  • Research to develop methods for reducing perindopril side effects
  • Research to evaluate the long-term safety of perindopril

Conclusion

Perindopril is an effective medication for managing hypertension. However, it can cause side effects. Before starting perindopril, consult with your doctor and ensure you understand the risks of side effects and potential countermeasures. During perindopril treatment, remember to schedule regular check-ups with your doctor to monitor your blood pressure and side effects.

Literature analysis of 29 papers
Positive Content
25
Neutral Content
0
Negative Content
4
Article Type
5
1
1
6
29
1.

Angiotensin-converting enzyme inhibitor induced cough compared with placebo, and other antihypertensives: A systematic review, and network meta-analysis.

Author: HuYiyun, LiangLing, LiuShuang, KungJanice Y, BanhHoan Linh

Cardiac mortality and morbidity prevention
Dry cough

Angiotensin converting enzyme inhibitors (ACEIs) are known to cause dry cough. This systematic review and network meta-analysis ranked the risk of cough induced by different ACEIs and compared them to placebo, ARB, or CCB. Moexipril had the highest risk of cough (80.4%), while spirapril had the lowest (12.3%). ACEIs should be avoided in patients at risk of cough, and an ARB or CCB is a possible alternative.

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

2.

Acute bilateral myopia induced by Triplixam: a case report.

Author: JarusevicieneRuta, SirvydyteGinte

Myopia

This case report describes a patient who developed transient myopia after starting treatment with Triplixam, a medication used for systemic hypertension. The myopia resolved after discontinuing the medication, suggesting a possible side effect associated with the drug.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Evaluation of Clinical Acceptability of Perindopril / Indapamide Single-pill Combination in Moderate to Severe Hypertension.

Author: KalraSanjay, SosaleAravind, ShahSiddharth N, JabreGeorges, JosephSofi, RajarshiManjusha

Blood pressure control

European hypertension guidelines recommend using Single Pill Combinations (SPCs) containing two drugs for patients with moderate to severe hypertension, as this leads to more effective and faster blood pressure control. The guidelines also emphasize tighter blood pressure control for patients with cardiovascular risk factors like diabetes mellitus.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

5.

Mucosal delivery systems of antihypertensive drugs: A practical approach in general practice.

Author: BialyLukasz P, WojcikCezary, Mlynarczuk-BialyIzabela

Mucosal antihypertensive delivery

This study explores the possibility of mucosal delivery of antihypertensive drugs as an alternative to oral medication in patients unable to receive oral medication. The authors describe the use of mucosal delivery systems for various antihypertensive drugs including Captopril, Nitrendipine, Metoprolol tartrate, Propranolol and Furosemide, and provide a case report of successful prolonged-term use of these drugs delivered via the mucosal route in a patient with severe hypertension. While the treatment was effective and without side effects, the long-term safety and efficacy of such therapy needs further confirmation through randomized clinical trials.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

[Lipertance® The ASCOT single-pill combination has finally arrived].

Author: RadermeckerR P

Cardiovascular prevention
Dyslipidemia control
Hypertension control

Lipertance is a new drug that combines atorvastatin, perindopril, and amlodipine. These drugs are used to treat high blood pressure and high cholesterol. This study discusses the use of Lipertance for the prevention of cardiovascular disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : French

8.

Side effects and tolerability of combination blood pressure lowering according to blood pressure levels: an analysis of the PROGRESS and ADVANCE trials.

Author: AtkinsEmily R, HirakawaYoichiro, SalamAbdul, WoodwardMark, CooperMark, HametPavel, HarrapStephen, LeesKennedy, LiuLisheng, ManciaGiuseppe, MarreMichel, PerkovicVlado, PoulterNeil, WilliamsBryan, ChalmersJohn, RodgersAnthony

Blood pressure reduction
Dizziness
Hypotension

Combination therapy for blood pressure lowering (BPL) was associated with increased discontinuation due to hypotension in patients with baseline blood pressure less than 120 mmHg, but not in those with higher baseline blood pressure. There were no clear differences in the combined renal outcome across the baseline blood pressure subgroups.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

Blood pressure control and acceptability of perindopril and its fixed dose combinations with amlodipine or indapamide, in younger patients with hypertension.

Author: BansalSandeep, ChauhanD K, RameshD, BarmareShahid, ChakrabortyShaibal

Blood pressure control

This study examined the short-term blood pressure control and acceptability of perindopril, with or without fixed-dose combinations, in younger patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

11.

[First fixed dose combination perindopril arginine-indapamide-amlodipine: new approach in combination therapy in hypertension].

Author: WidimskýJiří

Hypertension control
Improved prognosis

Fixed combination antihypertensive therapy improves compliance, blood pressure control, and prognosis. Triplixam®, a fixed combination of perindopril arginine, indapamide, and amlodipine, has shown significant antihypertensive effects and good tolerance.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Czech

15.

Soluble VEGF receptor-2 may be a predictive marker of anti-angiogenic therapy with clinically available safe agents.

Author: YoshijiHitoshi, NoguchiRyuichi, IkenakaYasuhide, KajiKosuke, ShiraiYusaku, AiharaYosuke, YamaoJunichi, ToyoharaMasahisa, MitoroAkira, SawaiMasayoshi, YoshidaMotoyuki, MoriokaChie, FujimotoMasao, UemuraMasahito, KawarataniHideto, TsujimotoTatsuhiro, FukuiHiroshi

Anti-angiogenic strategy
Inhibited HCC recurrence

This study investigated the use of angiotensin-converting enzyme inhibitor (ACE-I) and vitamin K (VK) as an anti-angiogenic strategy for hepatocellular carcinoma (HCC). The combination treatment suppressed the recurrence of HCC and serum VEGF and sVEGFR-2 levels.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Potentially procholinergic effects of medications commonly used in older adults.

Author: RockwoodKenneth, WalshRyan, MartinEarl, DarveshSultan

Procholinergic effects
Cognitive impairment

A hypothesis was proposed that some drugs commonly used by older adults might have procholinergic effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

ACE inhibitors for the treatment of hypertension drug selection by means of the SOJA method.

Author: EdgarLesley, HoggAnita, ScottMike, TimoneyMark, Mc ElnayJames, MairsJill, JanknegtRobert

Effective blood pressure lowering
Excellent tolerability

This article scores ACE inhibitors available in the United Kingdom using the SOJA method. Ramipril showed the highest score, followed by perindopril, lisinopril, and enalapril. The well-documented effects on clinically relevant end points, such as cardiovascular morbidity and mortality, contributed to the high score for ramipril.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

Efficacy and safety of routine blood pressure lowering in older patients with diabetes: results from the ADVANCE trial.

Author: NinomiyaToshiharu, ZoungasSophia, NealBruce, WoodwardMark, PatelAnushka, PerkovicVlado, CassAlan, CooperMark, GrobbeeDiederick, HametPavel, HarrapStephen, LiuLisheng, ManciaGiuseppe, MogensenCarl-Erik, PoulterNeil, RodgersAnthony, WilliamsBryan, MacMahonStephen, ChalmersJohn,

Blood pressure lowering

This study assessed the efficacy and safety of blood pressure lowering in elderly patients with type 2 diabetes. The researchers found that routine blood pressure lowering was effective in preventing major clinical outcomes in these patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

[An effect of perindopril on the level of tumor necrosis factor-alpha and matrix metalloproteinase-9 in peripheral blood in the acute period of atherothrombotic ischemic stroke and myocardial infarction].

Author: KonstantinovaE V, ShurdumovaM Kh, EreminI I, ShostakN A, SkvortsovaV I

Myocardial infarction prevention
Stroke prevention
Hypotonia

Perindopril, an ACE inhibitor, did not cause side effects in patients with acute atherothrombotic ischemic stroke and myocardial infarction. It may decrease MMP-9 activity and have an anticytokine effect, supporting its role in the secondary prevention of these conditions.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Russian

20.

Blood pressure normalization in a large population of hypertensive patients treated with perindopril/indapamide combination: results of the OPTIMAX trial.

Author: MouradJean-Jacques, NguyenViet, Lopez-SubletMarilucy, WaeberBernard

Normalized blood pressure

The fixed-dose perindopril/indapamide combination normalized blood pressure in a greater proportion of patients than observed in routine practice in Europe.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

21.

[Noliprel efficiency in patients with hypertension].

Author: ChulakovaT Ie

Improved blood pressure
Myocardial remodeling

This study investigated the efficacy and safety of Noliprel, a combination of Perindopril and Indapamid, in treating hypertension. Noliprel demonstrated good antihypertensive activity and had a positive impact on myocardial remodeling.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Ukrainian

23.

Lower target blood pressures are safe and effective for the prevention of recurrent stroke: the PROGRESS trial.

Author: ArimaHisatomi, ChalmersJohn, WoodwardMark, AndersonCraig, RodgersAnthony, DavisStephen, MacmahonStephen, NealBruce,

Reduced BP
Stroke risk reduction
Minor side effects

Lowering blood pressure (BP) in patients with cerebrovascular disease significantly reduces the risk of recurrent stroke, without any evidence of a J-curve relationship between BP level and stroke risk. The study found no patient group in which more intensive BP lowering would not be expected to produce greater risk reductions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

24.

[Evaluation of the antihypertensive efficacy and tolerability of fixed very low-dose perindopril/indapamid combination in patients with mild to moderate hypertension. Results of a Czech and Slovak multicentric study].

Author: WidimskýJ, FedelesováV

Improved diastolic function
Reduced blood pressure
Reduced left ventricle mass

A fixed, low-dose combination of perindopril (2 mg) and indapamide (0.625 mg) is a new and potent antihypertensive compound with very good tolerability without a negative influence on metabolic parameters. Treatment with this combination resulted in the improvement of diastolic function and in the regression of the left ventricle mass.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.

Language : Czech

25.

A randomized, double-blind, controlled, parallel-group comparison of perindopril and candesartan in hypertensive patients with type 2 diabetes mellitus.

Author: DerosaGiuseppe, CiceroArrigo F G, CiccarelliLeonardina, FogariRoberto

Blood pressure control
Metabolic parameter improvement

Perindopril and candesartan were both effective in lowering blood pressure in patients with mild hypertension and type 2 diabetes mellitus. Perindopril showed an improvement on some metabolic parameters compared with candesartan.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

26.

Angiotensin-I-converting enzyme inhibitors may be an alternative anti-angiogenic strategy in the treatment of liver fibrosis and hepatocellular carcinoma. Possible role of vascular endothelial growth factor.

Author: YoshijiHitoshi, KuriyamaShigeki, FukuiHiroshi

HCC treatment
Liver fibrosis treatment

Angiotensin-converting enzyme (ACE) inhibitors, such as perindopril, may provide a new strategy for the treatment of liver fibrosis and hepatocellular carcinoma.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

27.

[Efficacy and tolerance of rilmenidine in patients with mild to moderate hypertension. Results of a Czech and Slovak 6-month multicenter study].

Author: WidimskýJ

Reduced blood pressure
Reduced heart rate
Well-tolerated

Rilmenidine is an effective and well-tolerated treatment for mild to moderate hypertension. 69% of patients showed normalization of blood pressure and 22% showed significant blood pressure decrease after 6 months of treatment.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.

Language : Czech

28.

Perindopril: possible use in cancer therapy.

Author: YoshijiHitoshi, KuriyamaShigeki, FukuiHiroshi

Inhibit angiogenesis
Treat cancer
None reported

Angiogenesis, the formation of new blood vessels, is essential for tumor growth. While antiangiogenic therapy is being developed, perindopril, an ACE inhibitor already in clinical use, has shown potential as an antiangiogenic agent. Perindopril effectively inhibits tumor development and angiogenesis at clinically relevant doses, potentially offering a new strategy for cancer treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

29.

[Hypotension followed the first dose of angiotensin-converting enzyme inhibitor in patients with heart failure (a multicenter clinical trial)].

Author: MoiseevV S, TereshchenkoS N, AleksandriiaL G, KobalavaZh D

Hypotension

Perindopril caused significantly less first-dose hypotension than enalapril in patients with chronic cardiac failure.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Russian

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