Acertil

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Medically reviewed

Rosario Oropesa

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 Acertil

This section provides a factual overview of the identity, composition, and general purpose of the medicine Acertil (Perindopril).

Property Description
Active ingredient Perindopril
Form Film-coated tablets
Pharmacological Class ACE Inhibitor (Angiotensin-Converting Enzyme Inhibitor)
General Purpose To manage and support healthier blood pressure levels
Origin Synthetic

What Type of Medicine is Acertil?

Acertil is a well-recognized prescription-only medicine, often identified by its synonym, Coversyl, and is classified as an antihypertensive agent used to support the body’s cardiovascular system. It belongs to the pharmacological class of Angiotensin-Converting Enzyme (ACE) Inhibitors, which is clinically recognized for its essential role in modulating the Renin-Angiotensin-Aldosterone System (RAAS), a crucial hormonal pathway for blood pressure regulation. This medicine is specifically designated for use in adult patients.

Active Ingredient, Form, and Origin

The single active ingredient in this medication is the synthetic compound Perindopril, which is supplied for oral intake primarily as film-coated tablets. Perindopril functions as a pro-drug, chemically inactive until it is metabolized by the liver into its active form, Perindoprilat. Acertil formulations typically utilize either the tert-butylamine or arginine salts of Perindopril. Perindopril is used for its actions to widen blood vessels and reduce the heart's workload.

Acertil's General Purpose and Benefit

The essential purpose of Acertil is to maintain healthier blood pressure levels by facilitating the widening of blood vessels, an effect known as vasodilation. This physiological action reduces the peripheral vascular resistance in the circulatory system. By decreasing this resistance, the medicine lessens the physical strain on the heart muscle and helps the heart operate more efficiently, providing an overarching benefit to the entire cardiovascular system, especially in managing long-term blood flow issues.

Regulatory References

  1. MedlinePlus Drug Information

What side effects are possible with Acertil?

Possible Side Effects and Safety Information

Acertil (Perindopril) is associated with adverse reactions that are classified according to their frequency in clinical studies, as documented in official regulatory sources. These effects are grouped by the body's systems they influence.


Frequency-Classified Adverse Reactions

Classification Examples of Reactions (Official Labeling)
Common (1% to 10%) Non-productive cough, dizziness, headache, asthenia (weakness), nausea, vomiting, abdominal pain, diarrhea, and muscle cramps.
Uncommon (0.1% to 1%) Syncope (fainting), dry mouth, urticaria (hives), and initial onset of renal impairment.
Very Rare (< 0.01%) Pancreatitis, hepatitis, stroke, myocardial infarction, and erythema multiforme.

Serious Adverse Reactions and Safety Constraints

The most serious safety concern listed in regulatory documents is Angioedema, which involves potentially fatal swelling of the face, lips, tongue, or larynx. This reaction may occur at any time during treatment. Severe Symptomatic Hypotension (very low blood pressure) is another recognized risk, particularly at the start of therapy or during dose increases.

Official labeling includes specific restrictions:

  • Fetal Toxicity: Acertil carries a serious warning against use during the second and third trimesters of pregnancy, as it is associated with fetal injury and death.
  • Contraindications: The medicine is restricted for patients with a history of Angioedema related to prior use of an ACE inhibitor. Additionally, it is contraindicated with specific combinations, such as a neprilysin inhibitor (e.g., Sacubitril/Valsartan) and in certain patients using Aliskiren (due to increased risk of hyperkalemia, hypotension, and renal impairment).
  • Population Notes: Safety and efficacy are not established for the pediatric population. Dosage adjustment is required for patients with renal impairment, where there is an increased risk of Hyperkalemia (high potassium levels), a documented safety concern. The risk of Hypotension is also noted to be higher in the initial phase of treatment.

Overdose and Emergency Response

Overdose and When to Seek Help

The official regulatory profile for Acertil overdose concentrates on the severe physiological effects documented in government prescribing information. The most likely manifestation is profound hypotension (severely low blood pressure), which carries the risk of progressing to circulatory shock.

Life-Threatening Manifestations

A critical documented risk associated with overdose is the potential for angioedema (swelling) involving the tongue, glottis, or larynx. This condition is life-threatening because it can lead to immediate airway obstruction.

Emergency Actions Required

Immediate medical attention is required for any suspected overdose or for any manifestation of angioedema. In cases where airway compromise is evident, regulatory guidelines mandate the prompt administration of specific emergency therapy, which may include agents such as subcutaneous epinephrine solution.

Official Supportive Measures

Management of overdose is defined as symptomatic and supportive. For severe hypotension, official procedures include placing the patient in the supine position and, if necessary, administering an intravenous infusion of sodium chloride 0.9% solution to expand fluid volume. Furthermore, the active metabolite, perindoprilat, is known to be removable by haemodialysis, a procedural option documented in the regulatory profile. Individuals with pre-existing volume or salt depletion are noted to be at increased risk of experiencing severe hypotensive effects.

Therapeutic Uses of Acertil

Quick Facts: Uses of Acertil

  • High Blood Pressure (Hypertension): Helps to manage elevated blood pressure levels.
  • Stable Coronary Artery Disease: Used to assist in reducing the likelihood of certain cardiac events.
  • Symptomatic Heart Failure: May be used as part of a regimen to manage symptoms of heart failure.

Acertil (perindopril) is a prescription medication indicated for the management of specific cardiovascular conditions. Its primary use is in the long-term treatment of essential hypertension, commonly referred to as high blood pressure. Maintaining appropriate blood pressure levels is necessary for reducing the risk of associated complications, such as stroke or heart attack.

Additionally, this agent is employed to help manage symptomatic heart failure, generally as an adjunctive therapy used alongside other medications, such as diuretics. Treatment should be initiated under the guidance of a healthcare professional.

A key therapeutic application is in patients with stable coronary artery disease (CAD). In this context, the medication is used to assist in reducing the likelihood of future cardiac events, including non-fatal myocardial infarction. This use is based on its established profile in cardiovascular risk reduction.

Regulatory References

  1. EMA therapeutic overview

Eligibility and Restrictions for Use

Eligibility Map: Who Can and Cannot Use Acertil — Official Regulatory Information

This map outlines the official population eligibility and non-eligibility requirements for Acertil (Perindopril), based strictly on authoritative governmental regulatory documents.


Eligibility Scope

Classification Population or Condition
Allowed Adult Patients (Generally approved for use in adult populations)
Contraindicated Hypersensitivity to any ACE inhibitor; History of Angioedema (Hereditary, idiopathic, or related to previous ACE inhibitor use).
Contraindicated Pregnancy during the Second and Third Trimesters.
Contraindicated Concomitant use with Sacubitril/Valsartan or with Aliskiren in patients with Diabetes Mellitus or renal impairment.
Contraindicated Severe Renal Impairment (Creatinine Clearance < 30 mL/min) or Severe Hepatic Impairment.
Not Recommended Children and Adolescents (Safety and efficacy not established).
Not Recommended Breastfeeding patients.
Restricted Use Patients with Bilateral Renal Artery Stenosis or Collagen Vascular Disease (e.g., lupus) with kidney impairment.

Eligibility Classifications (High-Level)

  • Eligibility severity classification (as defined in official documents): Contraindicated (Absolute prohibition) and Not Recommended (Regulatory caution due to unestablished data or risk).
  • Eligibility-context constraints (as defined in official documents): Constraints relate to patient history (Angioedema), physiological state (Pregnancy), and comorbid conditions (Severe Renal/Hepatic Impairment).

Resulting eligibility structure: Official regulatory documents strictly define who can and cannot use Acertil by establishing absolute exclusions based on patient history, concomitant therapy, and physiological states. Use is permitted primarily for adult populations that do not possess any of the documented contraindications.

What should I know about interactions with other medicines?

Formally Contraindicated Combinations

Certain combinations are explicitly prohibited due to the severity of the interaction outcome, as stated in regulatory labels. Co-administration with Sacubitril/Valsartan is contra-indicated due to the significantly increased risk of angioedema. A mandatory 36-hour separation period must be observed when initiating either medicine after the other. Use is also contra-indicated with Aliskiren in patients with diabetes mellitus or moderate-to-severe renal impairment (GFR < 60 mL/min/1.73 m²). Furthermore, Acertil is prohibited during certain extracorporeal treatments, such as dialysis with high-flux membranes, due to the risk of severe anaphylactoid reactions.


Interactions Requiring Restriction or Caution

Co-administration with agents that increase serum potassium is not recommended due to the risk of severe hyperkalaemia. These agents include Potassium-Sparing Diuretics (e.g., Spironolactone, Triamterene) and Potassium Supplements/Salt Substitutes. Combination with Angiotensin II Receptor Blockers (ARBs) is also not recommended, as this dual blockade is associated with a higher frequency of hypotension, hyperkalaemia, and worsening renal function. Co-administration with Lithium is not recommended due to official reports of increased serum concentrations and toxicity. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) may cause a diminished antihypertensive effect and renal function deterioration. The risk of angioedema is officially increased with co-use of mTOR inhibitors (e.g., Sirolimus). The regulatory label also notes that hepatic impairment and renal impairment decrease the clearance of the active metabolite, Perindoprilat.

Mechanism of Action

How Acertil Works: Mechanism of Action

Core Action: Modulating the Renin-Angiotensin System

Acertil (perindopril) is an ACE inhibitor that acts within domains involving enzyme-mediated signaling. Its key mechanism is competitive inhibition of the Angiotensin-Converting Enzyme (ACE). This action prevents the conversion of Angiotensin I to the vasoconstrictive peptide, Angiotensin II. This modifies early molecular steps that shape systemic physiological outcomes, resulting in the modulation of overactive vasoconstrictive responses.


Physiological Consequence: Reduced Vascular Resistance

By reducing Angiotensin II, Acertil lessens the stimulus for aldosterone release, a hormone that promotes salt and water retention. The drug also engages mechanisms that influence the breakdown of bradykinin, a natural vasodilator. This dual action alters the signaling equilibrium within targeted pathways, leading to measurable physiological changes: the widening of blood vessels and reduced fluid volume. This mechanistic cascade contributes to the reduction of overall Systemic Vascular Resistance (SVR), which subsequently decreases ventricular wall tension.

Dosage and Administration Information

How to Use Acertil (Perindopril)

The official instructions for Acertil (Perindopril) establish a standardized, long-term protocol for administration, dosing, and schedule, based strictly on its oral tablet form.


Administration and Frequency

Acertil is supplied as a film-coated tablet intended for oral intake. The typical dosing schedule requires the medicine to be taken once daily. While some international prescribing information recommends administration in the morning before a meal, the medication can generally be taken with or without food.


Official Dosing Regimens

Indication Initial Dose (Once Daily) Maintenance Dose Range Maximum Daily Dose
Essential Hypertension 4 mg 4 mg to 8 mg 16 mg
Stable Coronary Artery Disease 4 mg for two weeks 8 mg 8 mg

These dosages represent the official regimen for adults and are subject to titration. Treatment for stable coronary artery disease, for instance, involves a gradual increase from the initial 4 mg dose to the 8 mg maintenance dose after the first two weeks.


Population-Specific Use and Adjustments

Official instructions mandate dose modifications for specific patient populations. For patients with renal impairment, the starting dose must be reduced to 2 mg per day, with a maximum dose of 8 mg per day, provided the patient’s kidney function meets specified criteria. Similarly, older adults aged 70 years or more with coronary artery disease are given a lower initial dose of 2 mg daily, followed by 4 mg daily in the second week, before considering the standard maintenance dose.

Recent Clinical Evidence

Research evidence / Overview of studies for Acertil


Evidence for use in High Blood Pressure (Essential Hypertension)

The research base for Acertil's evaluation in high blood pressure includes various large-scale research efforts, such as Randomized Controlled Trials (RCTs) and long-term observational studies. Research examined changes in both Systolic and Diastolic Blood Pressure (BP) levels. Studies consistently reported measurements of decreases in both systolic and diastolic BP compared to baseline measurements. In trials that followed patients for several years, findings also described a pattern of differences in the rate of recorded major cardiovascular events between the group receiving the study medication and the placebo group. The blood pressure response may be less pronounced in certain demographic groups.

Evidence for use in Stable Coronary Artery Disease

Research exploring Acertil's evaluation in patients with stable coronary artery disease (CAD) relies heavily on large, long-term, Randomized, Double-blind, Placebo-controlled Trials. These studies focused on adult patients whose CAD was already documented. The research examined a primary composite endpoint, which tracked cardiovascular death, non-fatal heart attack, and resuscitated cardiac arrest. Studies reported that the recorded number of these major cardiovascular events differed between the treatment group and the placebo group over observation periods lasting more than four years. The majority of patients in the key research were male, and those with pre-existing, overtly symptomatic heart failure were often excluded.

Evidence in Special Populations and Uncertainties

Research has explored the use in special patient groups, including those aged 70 years and older and individuals with co-existing conditions like diabetes. However, data for certain groups remain insufficient. Specifically, comparative evidence is lacking for children and adolescents. While the evidence base is comprehensive, some sample sizes were modest in comparative trials. The precise mechanisms contributing to the long-term event differences, beyond simple blood pressure lowering, are a subject of continuous scientific investigation.

Frequently Asked Questions (FAQ)

Common questions about Acertil (FAQ)


Q: How quickly does Acertil usually start to work?

A: According to official pharmacokinetics data, the active form of the medicine, perindoprilat, typically reaches its highest concentration in the bloodstream within three to seven hours after taking a dose. For the medicine to reach stable, continuous levels in the body, consistent daily administration over three to six days is generally required.


Q: What happens if I stop taking Acertil suddenly?

A: Regulatory summaries indicate that abruptly discontinuing this type of blood pressure medicine may lead to a rise in blood pressure. Because of this potential effect, official guidance states that treatment should not be stopped suddenly. Changes to the medication regimen require consultation with a prescribing healthcare professional.


Q: What are the long-term effects of taking Acertil?

A: Official information describes Acertil as a medication that is generally appropriate for chronic, long-term use for its approved cardiovascular conditions. Research summaries indicate that use over several years has been associated with differences in the recorded rate of major cardiovascular events when compared to a placebo group.


Q: What is the interaction risk of drinking alcohol while taking Acertil?

A: Alcohol can increase the blood pressure-lowering effect of Acertil, which is described as an additive interaction. Official interaction information notes that combining the two may increase the risk of experiencing symptoms like dizziness, lightheadedness, or even fainting. This risk is often noted to be higher when a person first starts taking the medicine.


Q: How often are people usually monitored while taking Acertil?

A: Official guidance indicates that monitoring is required, especially during the initial phases of treatment, when the dose is adjusted, or for patients with kidney concerns. This monitoring typically involves blood tests to check both kidney function and serum potassium levels, as high potassium is a documented safety concern for this medicine.


Q: What should I do if I forget to take my Acertil dose?

A: Patient resources from regulatory agencies suggest that if a dose is missed, the dose may be taken as soon as it is remembered that day. If it is already close to the time for the next scheduled dose, the missed dose should be skipped entirely, and the regular schedule should be resumed. Official resources advise that a double or extra dose should not be taken to compensate for a forgotten one.


Q: Is it normal to have a slight headache when starting Acertil?

A: Yes, regulatory documents list headache as a common adverse reaction that was noted in clinical studies. Patient information resources suggest that this, along with dizziness, is often more likely to occur when treatment is first initiated or when the dosage is increased.


Q: Can Acertil cause stomach upset or nausea?

A: Official documents confirm that both nausea and abdominal pain are listed as common adverse reactions, meaning they occurred in 1% to 10% of participants in clinical studies. Vomiting is also listed as a common effect associated with the use of this medicine.


Q: Does Acertil interfere with sleep?

A: Insomnia or general sleep interference is not universally listed as a common side effect in all official documents. However, patient resources acknowledge that the dry cough—a common side effect of the medicine—could potentially disrupt a person’s sleep.


Q: What are the signs that Acertil is actually working?

A: For its primary use, this medicine often doesn't produce any immediate physical signs that a patient can feel once it begins working. The effectiveness of the medication is typically assessed and confirmed by a healthcare professional through regular, objective measurements of the patient's blood pressure.


Q: Are there any specific genetic groups for whom Acertil is less effective?

A: Research summaries have examined differences in how the medicine affects various patient groups. Official documents state that the blood pressure response to this class of medication may be less pronounced in certain demographic groups, an observation that remains a complex topic of scientific investigation.


Q: What happens if a person taking Acertil becomes dehydrated?

A: Official warnings state that symptomatic hypotension, which is very low blood pressure, is a recognized risk with Acertil. This risk is noted to be higher in situations that lead to dehydration, such as excessive sweating or persistent, severe vomiting or diarrhea.


Q: How long does Acertil stay in your system?

A: Official pharmacokinetics data states that the drug's active form, perindoprilat, has an elimination half-life of approximately 25 to 30 hours. The half-life refers to the time it takes for half of the active substance to be removed from the body.


Q: Can Acertil affect laboratory test results?

A: Yes, regulatory documents note that Acertil can influence laboratory blood test results. Specific concerns include the potential for increased serum potassium levels (hyperkalemia) and, in rare instances, affecting some blood cell counts, such as low neutrophil levels.


Q: Why do some people take Acertil in the evening?

A: While standard instructions generally suggest morning intake, clinical research has investigated the timing of dosing for this type of blood pressure medicine. Some studies suggest that taking it in the evening may help achieve a more sustained 24-hour blood pressure reduction, particularly during the night.


Q: What is the difference between Acertil and its generic version?

A: Regulatory bodies classify a generic version as having the same active ingredient, strength, and dosage form as the brand-name drug (Acertil). The generic product must also meet strict bioequivalence standards, which ensures it acts the same way in the body and achieves the same therapeutic effect.


Q: Is a maximum duration of use established for Acertil?

A: Official dosing guidelines describe a long-term treatment protocol for its approved conditions, without establishing a formal maximum duration of use. Clinical studies have successfully tracked the medicine's effects over observation periods spanning several years to establish its long-term use.

How should Acertil be stored and disposed of?

How to Store and Dispose of Acertil?

The storage and disposal of Acertil (Perindopril) must follow official guidelines to maintain its stability and ensure environmental safety.

Requirement Official Regulatory Statement
Storage Temperature Do not store mathbfabove 30 C [1]. Store at controlled room temperature [4].
Environmental Protection Store in the mathbforiginal package to protect from mathbfmoisture and mathbflight [1, 2].
Child Safety mathbfKeep out of the sight and reach of children [1, 4].
Disposal Method Dispose of unused or expired medicine according to mathbflocal requirements [1, 4].

All medicines must be kept in their original container, protected from moisture and excessive heat, as defined by pharmaceutical stability standards. Used or unused tablets must not be thrown away in household trash or disposed of via wastewater, but should be managed through approved drug take-back or collection programs [1, 5].

[1] Summary of Product Characteristics (SmPC) / [2] European Public Assessment Report (EPAR) / [4] NIH/MedlinePlus / [5] FDA

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

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