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Coversyl (Perindropril) is an ACE (Angioensin Converting Enzyme) inhibitor. ACE inhibitors belong to the class of medicines called high blood pressure medicines (antihypertensives). They are used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

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Uses

To help you remember to take your medicine, try to get into the habit of taking it at the same time each day.
For patients taking captopril or moexipril :

For patients taking ramipril capsules: If you have trouble swallowing capsules, you may open the ramipril capsule and mix the medicine with applesauce, water or apple juice. Mix only one dose at a time just before taking it. You may mix a dose ahead of time and save it for no more than 24 hours at room temperature or 18 hours in the refrigerator. If you are unsure about these instructions, ask your doctor or pharmacist.
For patients taking this medicine for high blood pressure :
· In addition to the use of the medicine your doctor has prescribed, treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.
· Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.
· Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

How to take

These medicines are best taken on an empty stomach 1 hour before meals, unless you are otherwise directed by your doctor.

The dose of the ACE inhibitor will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses. If your dose is different, do not change it unless your doctor tells you to do so.
The number of capsules or tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking the ACE inhibitor .

Side effects

The following adverse reactions may occur: headaches, mood and/or sleep disturbances, asthenia, unspecific digestive disorders, dizziness, muscular cramps, localized skin rash, cough, sexual disorders, dry mouth, nausea, diarrhea, orthostatic effects (including hypotension) and palpitation.
Angioneurotic oedema of the face, extremities, lips, tongue and glottis or larynx has been reported with angiotensin converting enzyme-inhibitors. In such cases, PERINDROPRIL should be discontinued and appropriate medical measures taken immediately.
Congestive Heart Failure
Hypotension has been reported in patients commencing treatment with ACE-inhibitors. This usually occurs in patients on multiple or high-dose diuretics with hypovolaemia, hyponatraemia, pre-existing hypotension, patients with unstable cardiac failure, renal impairment, those on high vasodilator therapy, patients aged 70years and over, dietary salt restriction, dialysis, diarrhea and vomiting. If hypotension occurs, the patient should be placed in the supine position and if necessary, given an intravenous infusion of normal saline.

Precaution

Should a woman become pregnant while receiving an ACE-inhibitor, the treatment must be stopped promptly and switched to a different medicine.
Should a woman contemplate pregnancy, the doctor should consider alternative medication.

ACE- inhibitors pass through the placenta and can be presumed to cause disturbance in fetal blood pressure regulatory mechanisms. Oligohydramnios as well as hypotension, oliguria and anuria in newborns have been reported after administration of ACE-inhibitors in the second and third trimester. Cases of defective skull ossification have been observed. Prematurity and low birth mass can occur.

Drug interactions

The combination of PERINDROPRIL with other antihypertensive agents may increase the antihypertensive effect, especially combined with a diuretic: the effects of ACE inhibitors may be potentiated in a situation where hypovolemia may occur. If this is the case, vascular filling by perfusion of isotonic saline solution should be carried out.

Missed dose

If you miss a dose, take as soon as remembered; do not take if it is almost time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

Storage

Store at room temperature between 59 and 86 degrees F (between 15 and 30 degrees C) away from moisture and sunlight. Do not store in the bathroom. Keep away from children and pets.