Adverse Effects of Perindopril

Common Adverse Effects

The American College of Cardiology notes that cough occurs in 26.9% of patients, representing the most common adverse event and the leading cause of drug discontinuation 1
Dizziness/Syncope is reported in 29-33% of patients, significantly higher than placebo, according to the American Heart Association 1
Hypotension occurs in 15.9% of patients, particularly during initial dosing or dose escalation, as stated by the American College of Cardiology 1
Fatigue is reported in approximately 7% of patients, as noted by the American Heart Association 1
Hyperglycemia is reported in 4.1% of patients, according to the American College of Cardiology 1

The European Society of Cardiology recommends that patients with hypovolemia, recent marked diuresis, or severe hyponatremia (sodium <130 mmol/L) are at highest risk for symptomatic hypotension, which occurs in 0.3% of uncomplicated hypertensive patients 2, 3
The American Heart Association states that increases in serum creatinine occur in 15-30% of patients with severe heart failure, but only 5-15% with mild to moderate symptoms 2
Functional renal insufficiency can occur because glomerular filtration becomes critically dependent on angiotensin II-mediated efferent arteriolar vasoconstriction, as noted by the European Society of Cardiology 2, 3
The European Society of Cardiology recommends monitoring renal function before initiation, 1-2 weeks after each dose increment, and at 3-6 month intervals 4

Angioedema occurs in 0.1-3.8% of patients treated with perindopril, according to the American College of Cardiology 1

The European Society of Cardiology states that bilateral renal artery stenosis is an absolute contraindication for perindopril 4
The American College of Cardiology notes that a history of angioedema during previous ACE inhibitor therapy is an absolute contraindication for perindopril 4

The American Heart Association states that aspirin may attenuate hemodynamic benefits of ACE inhibitors, though clinical significance remains controversial 2, 3
The European Society of Cardiology notes that potassium-sparing diuretics markedly increase the risk of hyperkalemia 3, 5