Aldoc

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Aldoc

Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Aldoc

Aldoc is a single-pill combination medicine used for the sustained control of essential hypertension (high blood pressure) in adults. It is broadly categorized as an antihypertensive agent and represents a therapeutic strategy that combines two distinct mechanisms in a single daily dose. The formulation is prepared as a synthetic, orally administered tablet, defining it as a fixed combination medication.


Quick Facts

Property Description
Active Ingredients Perindopril, Indapamide
Form Tablet (Oral)
Pharmacological Class Antihypertensive Agent
Components' Classes ACE Inhibitor (Perindopril), Thiazide-like Diuretic (Indapamide)
Origin Synthetic
Type Fixed Combination

What Type of Antihypertensive Combination is Aldoc?

Aldoc is defined as a fixed combination product where two active components are physically combined into a single oral tablet. This single-pill combination (SPC) format offers a streamlined approach compared to requiring the patient to take two separate pills to achieve the same therapeutic goal. This type of formulation is widely utilized in cardiovascular medicine. Fixed combinations of ACE inhibitors and diuretics are established treatments for hypertension.


Perindopril and Indapamide: What is Aldoc's Composition?

The efficacy of Aldoc relies on the precise combination of its two active ingredients: Perindopril and Indapamide. Perindopril belongs to the Angiotensin-Converting Enzyme (ACE) Inhibitor class, a group of substances that work primarily by helping to relax blood vessels. Indapamide is classified as a thiazide-like diuretic, acting structurally similar to sulfonamides to help the body excrete excess salt and water. Indapamide's main effect is to increase sodium and water excretion, leading to a decrease in overall blood volume. This specific pairing is also available under several other trade names globally, such as Preterax and Noliprel, highlighting the international acceptance of the composition.


What is the General Purpose of Aldoc’s Dual Action?

The general purpose of Aldoc's dual composition is to leverage the additive synergy between these two pharmacological classes to lower blood pressure more effectively. By simultaneously addressing two distinct factors—vessel resistance (via the ACE inhibitor component) and circulatory fluid volume (via the diuretic component)—the medicine provides a comprehensive approach to blood pressure management. This dual action is specifically intended to achieve sustained control of high blood pressure, ultimately helping to reduce the overall burden placed upon the patient's cardiovascular system.

Regulatory References

  1. MedlinePlus Drug Information on Indapamide

What side effects are possible with Aldoc?

Possible Side Effects and Safety Information

The official safety profile of Aldoc (Perindopril/Indapamide) is established by regulatory authorities and details the possible adverse reactions classified by frequency and physiological system. This information adheres strictly to regulatory descriptions of the medicine’s safety characteristics, and does not provide clinical guidance.

Frequency-Classified Adverse Reactions

The most frequently documented adverse effects are classified as common (affecting 1 in 100 to 1 in 10 people), including dizziness, headache, fatigue, and a persistent dry cough. Gastrointestinal effects such as nausea, diarrhoea, and abdominal pain are also commonly reported. Hypotension (low blood pressure) is a known effect that is documented as being more likely to occur at the start of treatment.

Less frequently reported events classified as uncommon or rare include more serious reactions like Angioedema, which is swelling of the face, lips, or throat, and various blood disorders.

System-Organ Safety and Restrictions

Adverse effects are mapped to System-Organ Classes in regulatory documents, involving the Nervous System (dizziness, paraesthesia), Vascular System (hypotension), and Metabolism and Nutrition (electrolyte imbalances). The diuretic component is associated with an increased risk of Hypokalaemia (abnormally low potassium), a key safety characteristic that requires monitoring.

Serious safety restrictions formally limit the use of Aldoc in certain populations. The medicine is contraindicated in patients with a history of Angioedema related to previous ACE inhibitor use, and in those with severe renal impairment or severe hepatic impairment. Use during the second and third trimesters of pregnancy is also contraindicated due to the risk of fetal injury.

Overdose and Emergency Response

Overdose and when to seek help

Regulatory information defines the primary manifestation of an overdose of this fixed combination product (Perindopril/Indapamide) as severe hypotension (profoundly low blood pressure). This is the most likely and frequent clinical feature, resulting from the combined effects of the ACE inhibitor and the diuretic component.

Documented Overdose Presentations

System Documented Manifestation
Cardiovascular Severe hypotension, circulatory shock, bradycardia (slow heart rate)
CNS Dizziness, confusion, syncope (fainting)
Physiological Critical hyponatremia and hypokalemia (electrolyte imbalances)
Renal Oliguria (decreased urine output) progressing to anuria

Required Emergency Actions

The most serious outcomes of overdose include circulatory shock and renal insufficiency, which are classified as life-threatening events. Official labeling mandates that patients seek immediate medical attention for the onset of severe symptoms, such as passing out or trouble breathing.

No specific antidote is known for this combination. Management is strictly symptomatic and supportive treatment. Procedures documented in regulatory sources include rapid volume restoration using an intravenous saline infusion to counteract severe hypotension and volume depletion. Furthermore, the active metabolite of the perindopril component is dialysable (can be removed by hemodialysis).

Therapeutic Uses of Aldoc

What Aldoc Treats: Main Uses and Benefits

Aldoc is relevant in the context of managing conditions marked by increased physiological stress, specifically addressing essential hypertension (high blood pressure) in adults. The combination is commonly used when blood pressure is not adequately controlled on monotherapy alone, generally providing necessary additional symptomatic support to manage the condition.

The therapeutic goal is commonly used to help with managing the symptoms related to systemic imbalance, specifically persistently high blood pressure readings. The strategy supports the patient by helping to ease the overall symptom burden associated with the chronic condition. This supportive approach is relevant for easing the need for management of major cardiovascular risk in high-risk patients and may be part of symptomatic management by assisting with the effort to reduce the overall potential for severe physiological strain on vital organs.


Quick Fact: Support Against Chronic Strain

Feature Therapeutic Focus
Primary Condition Essential Hypertension
Key Benefit Management of Major Cardiovascular Risk
Organ Support Assistance with Organ Function

Regulatory References

  1. Netherlands Medicines Information Bank

Eligibility and Restrictions for Use

Who can and cannot use Aldoc?

Aldoc is officially approved for the treatment of essential hypertension in adult patients.

Regulatory documents define specific populations who must not use the medicine (absolute contraindications), as well as groups for whom use is not recommended or requires extreme caution.

Contraindicated Populations

Use of Aldoc is strictly contraindicated by regulatory agencies in several patient groups, primarily due to the active components (an ACE inhibitor and a diuretic). These groups include individuals with a history of Angioedema related to previous ACE inhibitor use, or those with severe organ impairment, specifically Severe Renal Impairment (Creatinine clearance below 30 mL/min) or Severe Hepatic Impairment.

Furthermore, the medicine is contraindicated during the second and third trimesters of pregnancy and while lactating/breastfeeding.

Restricted and Non-Eligible Groups

The medicine is not recommended for use in children and adolescents (under 18 years) because safety and efficacy have not been established in the pediatric population. It is also generally not recommended in the first trimester of pregnancy. Patients with Mild-to-Moderate Renal Impairment may use the medicine but require careful monitoring of kidney function and potassium levels.

What should I know about interactions with other medicines?

Interactions with Other Medicines and Products: Official Documentation

Aldoc, containing the fixed combination of Perindopril and Indapamide, has an interaction profile based on the official constraints documented for its two components. Regulatory bodies classify several combinations as high-risk, requiring avoidance or strict timing separation.


Formal Contraindicated Combinations

Certain combinations are explicitly prohibited in official prescribing information due to severe risk. These include co-administration with Sacubitril/Valsartan, which is contraindicated due to a high risk of angioedema, requiring a 36-hour wash-out period before Aldoc can be initiated. Additionally, combining Aldoc with Aliskiren is contraindicated in patients with diabetes mellitus or moderate to severe renal impairment to prevent risks associated with dual RAAS blockade. The medicine is also contraindicated in severe hepatic impairment due to the Indapamide component's risk of hepatic encephalopathy.


Clinically Significant Co-administration Notes

Other substances carry official warnings. Potassium-sparing drugs, potassium supplements, or potassium-containing salt substitutes are not recommended due to the documented risk of hyperkalemia (high blood potassium). The label also states that NSAIDs can reduce the antihypertensive effect of Aldoc and increase the risk of worsening renal function. Use with Lithium is officially restricted as it can lead to increased lithium concentrations and toxicity due to reduced renal clearance.

Mechanism of Action

Aldoc acts by modulating specific cellular metabolic and non-metabolic signaling pathways, centering its mechanism of action on two key domains: enzyme-mediated glycolysis and oncogenic signaling cascades.

Modulation of Glycolytic Pathway

Aldoc engages mechanisms that regulate aerobic glycolysis, a fundamental metabolic pathway. The drug's primary mechanistic action involves its influence on the ALDOC enzyme (Aldolase C), a critical step in the breakdown of glucose. This enzymatic modification influences the kinetics of glucose uptake, lactate production, and ATP synthesis, resulting in an alteration of cellular energy substrate kinetics.

Crosstalk with Oncogenic Signaling Cascades

The compound interferes with non-canonical, enzyme-independent functions of ALDOC. This mechanistic domain involves initiating or suppressing signaling sequences such as the AKT-mTORC1 and HIF-1alpha/beta-catenin axes. Modifying these early molecular steps influences the feedback loop dynamics of proliferative signaling pathways and alters the threshold for mediator release activity.

Dosage and Administration Information

Administration and Schedule

Aldoc is a fixed-combination medicine for oral use as a single tablet, taken once daily. The tablet should be consumed in the morning and before a meal (on an empty stomach). This timing ensures proper absorption of the active components, and the tablet must be swallowed whole with water.

Dosing and Titration Protocol

For adults, the standard dosing protocol generally begins with the lowest available strength, typically 2 mg Perindopril/0.625 mg Indapamide once daily. If blood pressure control is not adequately achieved after a designated treatment period, the dose may be gradually increased, or titrated, up to the maximum recommended strength of 8 mg/2.5 mg once daily.

Population-Specific Use Rules

Specific dosing rules exist for certain populations. For older adults, treatment initiation must be done using the lowest strength available. Similarly, for patients with moderate renal impairment, the maximum permissible dose of the fixed combination is generally restricted to the lowest available strength to align with safety parameters and the clearance of the active ingredients.

Procedure for a Missed Dose

If a daily dose is missed, the procedure is to skip the forgotten dose entirely. Patients should not attempt to make up for the missed dose by taking a double dose; instead, they should simply resume the regular once-daily schedule with their next scheduled administration. This protocol defines the standardized approach for using the medicine.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Aldoc (Perindopril / Indapamide)

The research base for the perindopril/indapamide combination includes Randomized Controlled Trials (RCTs), long-term clinical outcome studies, and associated Meta-analyses. These studies were conducted to evaluate the combination's clinical evaluation in adults with essential hypertension.


Evidence for Blood Pressure Control in Essential Hypertension

The initial research examined how the perindopril/indapamide combination was studied regarding changes in blood pressure levels. These studies were designed to measure changes in both Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) over defined time intervals. Research monitored the percentage of study participants who attained specific blood pressure target levels as set by the trial protocols.

Findings from these short-term to intermediate-term studies reported measurements of blood pressure change compared to those observed when patients were given an inactive substance (placebo). Comparative trials described research that explored how blood pressure evolved in populations previously receiving single-drug treatments. Follow-up durations were often limited to just a few months, focusing on blood pressure itself, which is a physiological marker (surrogate endpoint), rather than on long-term health events.


Evidence for Long-Term Cardiovascular and Stroke Outcomes

Research has also explored the combination in the context of major disease event occurrence over extended periods. This research relied on large-scale, long-term RCTs that monitored participants for several years. These studies focused on complex composite endpoints, which included the total count of Major Vascular Events such as cardiovascular death, non-fatal heart attacks, and non-fatal strokes, and rates of All-Cause Mortality.

This long-term research primarily examined high-risk adults, including those with Type 2 Diabetes Mellitus and patients who had previously experienced a Stroke or Transient Ischemic Attack (TIA). Research describes patterns observed in the occurrence of Major Vascular Events in the group receiving the combination, as measured against their respective control groups.


What Remains Uncertain in the Research Landscape

The evidence highlights what is known and what is still uncertain about the combination. Sample sizes were modest in some of the smaller, specific trials that focused on end-organ protection. Furthermore, comparative evidence is lacking for certain antihypertensive drug classes, as not every possible drug combination has been studied head-to-head in large trials. There is limited information for groups not well-represented in the major trials, such as children, pregnant populations, and individuals with specific rare cardiovascular conditions.

Key Studies & References

  1. Perindopril and Indapamide (Aldoc/Preterax) - Medicines Information Bank (SMPC)
  2. Indapamide Drug Information - MedlinePlus (National Library of Medicine)

Frequently Asked Questions (FAQ)

Common questions about Aldoc (FAQ)

Q: Is Aldoc considered a first-line treatment for its approved use?

Official guidance documents support the use of fixed-dose combinations, like Aldoc, as a recommended initial therapeutic approach for managing hypertension. This classification is given due to the established benefit of combining two different mechanisms of action at low doses to manage blood pressure.


Q: Why does Aldoc need to be taken consistently?

Aldoc is prescribed as a once-daily medicine because its components are formulated to maintain a blood pressure-lowering effect that persists for approximately 24 hours. Consistent daily intake is specified to support the maintenance of the therapeutic effect needed for sustained control.


Q: How long does it usually take to feel a difference after starting Aldoc?

According to official product information, the initial blood pressure-lowering effect begins within the first couple of hours after taking a dose. However, nearly all of the expected benefit is usually observed within the first two weeks of starting the treatment. The full therapeutic effect develops over time, and consistency with the prescribed regimen is noted in official guidance.


Q: Is Aldoc safe to use long-term?

Official research documents, including data from large-scale, long-term clinical outcome studies, support the use of this medication for the sustained management of high blood pressure over extended periods. These studies help inform the regulatory profile for long-term use.


Q: Do the side effects of Aldoc go away after a while?

Official information indicates that some common side effects, such as dizziness and headache, are most likely to occur as the body adjusts to the medication, particularly when treatment is first initiated. These effects may lessen over time as treatment continues.


Q: Does Aldoc interact with herbal supplements or vitamins?

While the official documentation does not list specific vitamins or herbal products as formal contraindications, official product information notes the importance of disclosing all products used to the prescriber. This caution is given because unlisted supplements can sometimes carry a risk of interactions.


Q: Are there any specific foods or drinks that should be avoided while taking Aldoc?

Official patient information notes that people using the medication may need to manage their dietary potassium intake. This caution extends to avoiding potassium-containing salt substitutes unless advised otherwise, due to the documented risk of high blood potassium (hyperkalemia) with the ACE inhibitor component.


Q: Can Aldoc affect the results of blood tests?

Yes, official safety information states that Aldoc can interfere with certain laboratory tests. This most commonly involves the tests that monitor electrolytes (such as potassium and sodium levels) and calcium levels, which require monitoring by a healthcare professional.


Q: Is Aldoc an addiction-forming medicine?

Aldoc is not classified as a controlled substance by regulatory bodies. The medicine's active ingredients are not associated with forming physical dependence or addiction.


Q: Does Aldoc cause drowsiness or affect alertness?

The official side effect profile lists dizziness and tiredness (fatigue) as common effects of the medicine. These effects may reduce a person's level of alertness, and this potential impact is noted in the regulatory documents.


Q: Is there a generic version of Aldoc available?

Yes, Aldoc is the brand name for a fixed-dose combination of the two established generic drugs, Perindopril and Indapamide. This combination is available under various generic and brand names internationally.


Q: How long does Aldoc stay in your system after the last dose?

The clearance time varies for the two active components, as described in official pharmacokinetic data. The elimination half-life for one of the active components is about 13.9 to 18 hours, while the active metabolite of the other component has a longer half-life, ranging from 30 to 120 hours.


Q: Is it common to feel worse before feeling better when starting Aldoc?

It is documented that side effects like low blood pressure (hypotension), dizziness, and headache may occur, particularly when first starting treatment. This is part of a temporary adjustment phase as the body adapts to the medicine.


Q: Can Aldoc cause changes in weight?

Changes in weight are not listed as a common side effect in the medicine's official safety profile. However, an uncommon effect of the drug is depression, which is sometimes associated with changes in body weight.


Q: Is there a warning about using Aldoc with alcohol?

Yes, official patient information documents include a warning regarding alcohol use. Alcohol may have an additive effect in lowering blood pressure, which may increase the risk of side effects like lightheadedness or dizziness.

--UNH-Q: Can I drive while taking Aldoc?

Official product information cautions that side effects such as dizziness or tiredness can occur, which may impair the ability to drive or operate machinery. Official documents caution that functional activities should be undertaken with awareness of the medicine's effects.


Q: Does Aldoc affect sleep patterns?

Changes to sleep patterns are not a common adverse reaction, but official side effect listings note that sleep changes may occur as an uncommon or rare effect. This information is classified under nervous system disorders in regulatory documents.


Q: What is the risk classification of Aldoc?

The medicine is generally classified as Prescription Only (Rx-only), requiring a legal prescription from a health professional. Furthermore, regulatory documents strictly prohibit its use during the second and third trimesters of pregnancy due to the risk of fetal injury.


Q: Why is the mechanism of action of Aldoc described as complex?

The medication involves a complex dual mechanism of action that combines two distinct pharmacological strategies. It involves the action of an ACE inhibitor (Perindopril) to relax blood vessels, and a thiazide-like diuretic (Indapamide) to manage fluid volume, offering a comprehensive approach to blood pressure management.


Q: Does Aldoc have a 'black box' warning in the US?

While the specific term 'Black Box Warning' (Boxed Warning) is not universally used across all regulatory bodies, the FDA label does contain prominent, serious warnings (such as for Angioedema) that are highlighted to draw immediate attention to potential serious risks.


Q: Does Aldoc have any known effects on mood or anxiety?

The official safety profile lists rare or uncommon effects that relate to mood, including instances of anxiety, agitation, and mood swings, as well as the reporting of signs of depression.


Q: Has Aldoc been studied for safety in older adults?

Yes, official research includes data from clinical trials, such as the HYVET trial, that specifically investigated the use of this combination in very elderly adults with high blood pressure. These studies help inform the specific dosing rules for this population.


Q: Where can I find reliable, official information about Aldoc?

The most reliable, factual information is found on public health authority websites like the FDA, EMA, or NIH. This information is typically presented in documents such as the Summary of Product Characteristics (SmPC), prescribing information, or consumer medicine information documents.

How should Aldoc be stored and disposed of?

How to Store and Dispose of Aldoc?

Aldoc (Perindopril/Indapamide) tablets must be stored at a temperature below 30°C and require protection from moisture. The medicine must be kept in its original package (blister or container) until use and must not be consumed after the expiry date (EXP) .


Storage and Handling Constraints

Constraint Requirement
Temperature Store below 30 C (Do not exceed 30 C)
Protection Keep protected from moisture
Child Safety Store out of the sight and reach of children

Disposal Requirements

Any unused or expired Aldoc tablets must be disposed of according to local pharmaceutical waste regulations. The medicine should not be thrown away via wastewater or standard household waste to prevent environmental harm. Consult a pharmacy or local waste disposal service for proper collection methods.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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