Home Drug Guide Perindopril Erbumine

Drug Guide

Generic Name

Perindopril Erbumine

Brand Names Aceon

Classification

Therapeutic: Antihypertensive, Cardiac failure agent

Pharmacological: ACE Inhibitor (Angiotensin-Converting Enzyme Inhibitor)

FDA Approved Indications

Management of hypertension
Treatment of stable coronary artery disease and reduction of cardiovascular mortality in patients with previous myocardial infarction

Mechanism of Action

Perindopril inhibits the angiotensin-converting enzyme, which decreases the formation of angiotensin II, leading to vasodilation, decreased blood pressure, and reduced cardiac workload.

Dosage and Administration

Adult: Typically 4 mg once daily, adjustable up to 8 mg daily based on response.

Pediatric: Not indicated for pediatric use.

Geriatric: Start at lower doses due to increased sensitivity.

Renal Impairment: Dose adjustment required; initially 2 mg once daily, titrate as tolerated.

Hepatic Impairment: Use with caution; start at lower doses.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; protein binding approximately 20%.

Metabolism: Partially metabolized in the liver to active metabolite perindoprilat.

Excretion: Excreted mainly by the kidneys.

Half Life: 4-10 hours for perindopril; longer for its active metabolite.

Contraindications

History of angioedema related to previous ACE inhibitor use
Concomitant use with aliskiren in patients with diabetes or renal impairment

Precautions

Pregnancy (category D), use during pregnancy may cause fetal morbidity and mortality
Monitoring kidney function and potassium levels during therapy
Patients with bilateral renal artery stenosis or unilat renal artery stenosis

Adverse Reactions - Common

Cough (Common)
Dizziness (Common)
Headache (Common)
Fatigue (Common)

Adverse Reactions - Serious

Angioedema (Rare)
Hyperkalemia (Rare)
Hypotension (Rare)
Acute renal failure (Rare)

Drug-Drug Interactions

Diuretics, especially potassium-sparing agents
Other antihypertensives, additive hypotensive effect
Antidiabetic agents (may increase risk of hypoglycemia)
Potassium supplements, potassium salts

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, renal function, and serum potassium regularly.

Diagnoses:

Risk for decreased cardiac output
Risk for electrolyte imbalance

Implementation: Administer as prescribed, usually once daily; monitor for signs of hypotension.

Evaluation: Assess blood pressure response and tolerability, adjust dose accordingly.

Patient/Family Teaching

Take medication exactly as prescribed, even if feeling well.
Report signs of angioedema, hyperkalemia, or severe hypotension immediately.
Avoid potassium-rich foods and potassium supplements unless directed by healthcare provider.
Inform healthcare provider of all medications and supplements being taken.

Special Considerations

Black Box Warnings:

Fetal toxicity if used during pregnancy

Genetic Factors: None specific to this drug

Lab Test Interference: May increase serum potassium and serum creatinine; monitor accordingly.

Overdose Management

Signs/Symptoms: Severe hypotension, renal impairment, hyperkalemia.

Treatment: Discontinue drug, provide supportive care, administer vasopressors if needed, and consider dialysis for severe cases.

Storage and Handling

Storage: Store at room temperature away from moisture and heat.

Stability: Stable in original container until expiration date.