Perindopril
Perindopril is an ACE inhibitor (angiotensin-converting enzyme inhibitor) used to treat hypertension, heart failure, and reduce cardiovascular risk. It is a pro-drug that converts to its active form, perindoprilat, which works by blocking ACE, an enzyme responsible for producing angiotensin II—a substance that constricts blood vessels and raises blood pressure.
Perindopril is an ACE inhibitor used to treat high blood pressure and heart conditions by relaxing blood vessels.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- C09AA04
- RxNorm
- 54552
- Generic
- Perindopril
- Class
- atc-c09
- Brands
- Prestalia, Aceon
- Availability
- rx
- Pregnancy
- D
- Lactation
- unsafe
- Routes
- oral
- Forms
- tablet
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 4mg once daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 2mg once daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 2mg once daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
8 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks; ACE inhibitors associated with fetal renal dysfunction
regular fetal monitoring including ultrasound for amniotic fluid volume
Use with caution and monitor for adverse effects.
pregnancy
second third trimesterdiscontinue immediately
contraindicated during 2nd and 3rd trimester; discontinue therapy if pregnancy occurs
fetal monitoring for renal function and growth
Use of this medication in this population requires careful consideration of risks and benefits.
lactation
breastfeedingnot recommended
perindopril is excreted in breast milk; not recommended for breastfeeding mothers
Use with caution and monitor for adverse effects.
geriatric
elderly over 65start at lower dose
initiate therapy at low dose; increased sensitivity to antihypertensive effects due to age-related renal decline
monitor blood pressure and renal function regularly
Use with caution and monitor for adverse effects.
pediatric_age
children adolescentsnot recommended
not recommended for use in children and adolescents under 18 years due to lack of safety and efficacy data
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
renal_impairment
mild renal impairmentmonitor renal function
use with caution; monitor renal function and potassium levels
regular monitoring of serum creatinine and potassium
Use with caution and monitor for adverse effects.
renal_impairment
severe renal impairmentreduce dose
reduce dose in patients with CrCl < 30 mL/min; use with caution
close monitoring of renal function and potassium
Use with caution and monitor for adverse effects.
hepatic_impairment
mild to moderate hepatic impairmentno significant adjustment needed
use with caution; no significant dose adjustment required for mild to moderate impairment
monitor blood pressure and liver function tests
Use with caution and monitor for adverse effects.
Statistics and clinical data
Drug class
Angiotensin-converting enzyme inhibitor for hypertension treatment
Common uses
Primary therapeutic indications
FDA approval year
Initial FDA approval date for Perindopril
Mechanism of action
Pharmacodynamic mechanism
Perindopril is used to treat essential hypertension, stable coronary artery disease, and heart failure. It may also be prescribed to reduce the risk of cardiovascular events such as stroke and heart attack in certain patients.
Perindopril is converted to perindoprilat, its active metabolite, which inhibits ACE (angiotensin-converting enzyme). This reduces the production of angiotensin II, a potent vasoconstrictor, leading to relaxation and widening of blood vessels, which lowers blood pressure.
Perindopril should not be used during pregnancy (especially second and third trimesters) as it may harm the fetus. Common side effects include dry cough, dizziness, and elevated potassium levels. It is often used in combination with other antihypertensive agents, particularly thiazide diuretics.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy