Description
Uses and Administration Of Perindopril in Kenya
Perindopril is an Angiotension-Converting Enzyme inhibitor. It is used in the treatment of hypertension and heart failure in Kenya. Activity is reported to occur within 1 hour of a dose, to be at a maximum at about 4 to 8 hours, and to be maintained for 24 hours. Perindopril is given by mouth and it is recommended that it should be taken before food.
In the treatment of hypertension perindopril is given in an initial dose of 4 mg once daily. Since there may be a precipitous fall in blood pressure in some patients when starting therapy with an ACE inhibitor, the first dose should preferably be given at bedtime. Hypotension is particularly likely in patients with renovascular hypertension, volume depletion, heart failure, or severe hypertension and such patients may be given a lower initial dose of 2 mg once daily. Patients taking diuretics should have the diuretic withdrawn 2 or 3 days before perindopril is started and resumed later if required; if this is not possible, an initial dose of 2 mg once daily may be given. An initial dose of 2 mg once daily may also be used in the elderly. The dose of perindopril may be increased according to response to a maximum of 8 mg daily. In the Kenya a maximum dose of 16 mg daily is allowed in uncomplicated hypertensive patients.
In the management of heart failure, severe first-dose hypotension on introduction of an ACE inhibitor is common in patients on loop diuretics, but their temporary withdrawal may cause rebound pulmonary oedema. Thus treatment should be initiated with a low dose under close medical supervision. Perindopril is given in an initial dose of 2 mg in the morning. The usual maintenance dose is 4 mg daily.
A reduction in dosage may be necessary in patients with impaired renal function.
Adverse Effects and Side Effects of Perindopril
The most common adverse effects are due to the vascular effects of ACE inhibitors group of antihypertensive and include hypotension, dizziness, fatigue, headache, and nausea and other gastrointestinal disturbances. Nevertheless, Perindopril is well tolerated; but, pronounced hypotension may occur at the start of therapy, particularly in patients with heart failure.
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