Perilan

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Perilan

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Medically reviewed

Marina Burgos

Last updated on 10/01/2026

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 Perilan

What is Perilan? Definitive Identity and Classification

Property Description
Active ingredient Perindopril (Prodrug)
Form Oral Tablet
Pharmacological class Angiotensin-Converting Enzyme (ACE) Inhibitor
General purpose Antihypertensive Agent
Origin Synthetic Organic Compound

What Type of Medicine is Perilan (Perindopril)?

Perilan is a prescription-only medication that utilizes the active ingredient Perindopril, which is classified as an Angiotensin-Converting Enzyme (ACE) Inhibitor. This compound is a synthetic organic agent and is recognized for its long-acting profile. Perindopril functions as a prodrug, meaning the administered compound must be converted within the liver into its active metabolite, Perindoprilat, to exert its therapeutic effects. This pharmacological profile supports its use in managing high pressure.

Composition and Physical Form of Perindopril Tablets

The medicine is supplied primarily for the oral route in the form of a tablet, where the active substance, Perindopril, is chemically stabilized as a specific salt, such as Perindopril erbumine or Perindopril arginine. Beyond the active substance, the tablet formulation includes standard, inert pharmaceutical excipients necessary for its solid structure. The drug is available both as a single entity and often exists as a fixed-dose combination product, which integrates it with other medicines to offer synergistic cardiovascular benefits. Use of the medication is associated with cardiovascular protection in high-risk patients.

General Purpose and Benefit of an ACE Inhibitor

The general purpose of Perindopril is to function as an antihypertensive agent, specifically by promoting vasodilation (the widening of blood vessels) and reducing resistance within the circulatory system. This mechanism is achieved through the compound's effect of inhibiting the ACE enzyme, which consequently lowers the production of Angiotensin II, a powerful natural vasoconstrictor. This specific pharmacological action is the cornerstone of its use in managing typical scenarios involving elevated pressure. The overall benefit of this action is the sustained lowering of blood pressure, which reduces the physical strain and workload placed upon the heart and promotes overall cardiovascular stability.

Regulatory References

  1. NIH Clinical Study

What side effects are possible with Perilan?

Possible Side Effects and Safety Information

The official safety profile of Perindopril (Perilan) is structured by regulatory bodies to outline the range of documented adverse reactions and use limitations. Adverse reactions are classified by frequency, based on clinical trial data and post-marketing reports.


Frequency-Classified Adverse Reactions

Classification Examples of Documented Reactions
Common (occurs in 1 to 10 users out of 100) Persistent, nonproductive cough; headache; dizziness; weakness/fatigue; back pain.
Uncommon (occurs in 1 to 10 users out of 1,000) Muscle cramps; visual disturbances; mild skin rash.
Rare to Very Rare (less frequent) Angioedema (swelling); severe blood dyscrasias; elevations in liver enzymes and bilirubin.

Serious Adverse Reactions and Safety Constraints

The most clinically significant documented warning is Angioedema, which involves potentially life-threatening swelling of the face, tongue, glottis, or larynx. Other serious reactions documented in official labeling include symptomatic hypotension (severe low blood pressure) and acute renal failure.

Safety limitations define populations for whom the medicine is contraindicated. It is prohibited for use in patients with a history of Angioedema related to previous ACE inhibitor therapy or those with hereditary Angioedema. It is also contraindicated for use during the second and third trimesters of pregnancy due to the risk of fetal injury or death.

Time- and Population-Related Safety Patterns

Regulatory documents note that symptomatic hypotension is more likely to occur upon the initiation of therapy. Furthermore, specific safety considerations apply to certain groups: patients with renal impairment face an increased risk of hyperkalemia (high serum potassium), and regulatory data suggests the incidence of Angioedema may be higher in Black patients.

Overdose and Emergency Response

The official regulatory documentation for Perilan (Perindopril) defines an overdose profile centered on the predictable extension of its circulatory effects. The primary documented manifestation is severe hypotension (markedly low blood pressure), often accompanied by signs such as dizziness, light-headedness, and mental confusion. Gastrointestinal disturbances, including nausea and cramps, have also been officially documented.

Severe or life-threatening outcomes can result, specifically including anuria (absence of urine output) that may progress to acute renal failure, alongside the risk of profound circulatory collapse. Population-specific notes indicate that both elderly patients and those with existing renal impairment may exhibit increased sensitivity in overdose situations.

Immediate medical attention must be sought if an overdose is suspected. Government regulatory statements explicitly require calling emergency services immediately if the individual has collapsed, experienced a seizure, has trouble breathing, or cannot be awakened. The medication must be discontinued promptly.

Management is defined as strictly symptomatic and supportive, as no specific antidote is known. Officially described procedures to assist with management include gastric lavage or the administration of activated charcoal to help eliminate unabsorbed drug. In cases of marked hypotension, patients must be placed in a supine position. Furthermore, the active metabolite, Perindoprilat, is documented as being removable by hemodialysis.

Therapeutic Uses of Perilan

Main Uses of Perilan

Perilan is primarily used to manage symptoms associated with certain gastrointestinal motility disorders. Its therapeutic action focuses on the coordination and acceleration of movement within the upper digestive tract. It is most commonly used for the following conditions:

Gastroparesis

Perilan is used to treat symptoms of gastroparesis, a condition where the stomach takes too long to empty its contents. This delayed emptying can lead to several persistent symptoms, including:

  • Nausea and vomiting
  • A feeling of fullness shortly after starting a meal
  • Upper abdominal bloating and discomfort
  • Loss of appetite

By facilitating the movement of food from the stomach into the small intestine, Perilan helps reduce the frequency and severity of these gastric symptoms.

Gastroesophageal Reflux Disease (GERD)

In some instances, Perilan is used to manage symptoms of gastroesophageal reflux disease, particularly when other standard treatments have not provided sufficient relief. It helps strengthen the lower esophageal sphincter and increases the rate of stomach emptying, which minimizes the amount of time acid and stomach contents can reflux back into the esophagus.

Benefits and Mechanism of Action

The primary benefit of Perilan is the restoration of regular digestive rhythm. It functions as a dopamine antagonist with prokinetic properties, meaning it works in two distinct ways:

Enhancement of Digestive Motility

Perilan stimulates the muscles of the gastrointestinal tract. By increasing the frequency and strength of contractions in the stomach and small intestine, it ensures that food and waste move through the system more efficiently. This mechanical assistance is beneficial for individuals whose digestive systems are naturally sluggish or impaired by underlying health conditions.

Anti-Nausea Effects

Beyond its physical effect on the stomach muscles, Perilan also acts on the area of the brain responsible for triggering the sensation of nausea. This dual action makes it particularly effective for patients who experience digestive distress accompanied by a persistent urge to vomit.

Regulatory References

  1. NIH DailyMed Drug Label for Perindopril Erbumine

Eligibility and Restrictions for Use

The eligibility for using Perilan (Perindopril) is defined by official regulatory criteria, detailing populations that can use the medicine, those for whom use is restricted, and those absolutely contraindicated.

Absolute Contraindications

Perilan is strictly contraindicated for individuals with a history of angioedema, whether related to a previous ACE inhibitor or of a hereditary nature. It must not be used during the second and third trimesters of pregnancy and should be discontinued immediately if pregnancy is detected. Use is also prohibited for patients with hypersensitivity to the drug or any ACE inhibitor. Additionally, the medicine is contraindicated in patients taking Sacubitril/Valsartan, or Aliskiren if the patient also has diabetes or moderate-to-severe kidney impairment.

Population and Organ Restrictions

The established user population is adults. Safety and efficacy have not been established for pediatric patients (children and adolescents), making use in those under 18 years not recommended. The medicine is strictly contraindicated in cases of severe renal impairment (typically creatinine clearance below 30 mL/min) and severe hepatic impairment. Patients with moderate impairment, certain heart valve conditions (such as aortic stenosis), or those in the first trimester of pregnancy should only use Perilan under close restriction. Use is also generally not recommended while breastfeeding.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The interaction profile for Perindopril (Perilan) is defined by official regulatory documentation that mandates specific restrictions on co-administration based on documented risks.

Contraindicated Combinations and Procedures

Co-administration with Sacubitril/Valsartan is strictly prohibited due to the risk of angioedema. A mandatory 36-hour separation period must occur between the last dose of either drug. The combination with Aliskiren is also contraindicated in patients with diabetes mellitus or established renal impairment. Furthermore, procedures such as dialysis using certain high-flux membranes are contraindicated due to the documented risk of severe anaphylactoid reactions.

Not Recommended Combinations

Due to the documented risk of hyperkalaemia (elevated serum potassium), co-administration is not recommended with potassium-sparing diuretics (such as spironolactone) or potassium supplements/salt substitutes. The use of Lithium is also not recommended, as official data documents a reversible increase in serum lithium concentrations.

Other Clinically Significant Interactions

Co-administration with NSAIDs may reduce the antihypertensive effect and increases the documented risk of renal function deterioration and hyperkalaemia. A drug–food interaction is documented: Perindopril must be administered before meals because food intake officially reduces the conversion of the drug into its active metabolite, Perindoprilat. Other agents, including Ciclosporin and Heparin, also present a documented risk of hyperkalaemia.

Mechanism of Action

Perilan, containing metoclopramide, functions as an antagonist at central dopamine D2 receptors, primarily within the chemoreceptor trigger zone (CTZ) of the area postrema. This antagonism suppresses the signal cascade that initiates the emetic reflex.

Peripherally, the compound exhibits dual action. It operates as an antagonist against presynaptic and postsynaptic dopamine D2 receptors located in the enteric nervous system of the gastrointestinal tract. Concurrently, Perilan acts as an agonist at the 5- HT4 serotonin receptors on gastric smooth muscle. This 5-HT4 agonism facilitates the release of acetylcholine from enteric cholinergic neurons.

The resulting increase in local acetylcholine concentration promotes cholinergic smooth muscle stimulation, enhancing the tone of the lower esophageal sphincter, increasing the force of antral contractions, and coordinating gastroduodenal motility. This modulation results in accelerated gastric emptying and enhanced proximal intestinal peristalsis, collectively termed prokinetic action. The compound also exhibits weak antagonism at 5- HT3 receptors, further contributing to the central inhibition of the vagal afferent pathway.

Dosage and Administration Information

The use of Perilan follows established protocols detailing its administration and dosing. The medicine is intended for the oral route as a tablet and is standardized for once-daily administration. Standard administration involves taking the tablet before a meal, typically in the morning, which is a timing constraint related to the compound's optimal absorption and conversion to its active form, Perindoprilat.

The overall usage protocol is defined by the principle of gradual upward titration. Treatment begins with a low starting dose, which is then progressively increased over time to achieve the designated long-term maintenance dose. This procedure ensures the patient stabilizes before the target dose is reached.

Clinical Scenario Initial Dose (Once Daily) Maintenance Dose Maximum Dose
Chronic Hypertension 4 mg 4 mg to 8 mg 16 mg
Stable Coronary Artery Disease 4 mg (for 2 weeks) 8 mg 8 mg
Supportive Heart Failure 2 mg 4 mg 4 mg

Special administration conditions apply to certain populations and concomitant therapies. For older adults (over 70 years) and individuals with moderate renal impairment, the starting dose is lower (often 2 mg per day) to mitigate initial physiological effects. It is also noted that the concurrent use of diuretic agents may require the diuretic to be temporarily discontinued 2 to 3 days prior to initiating Perindopril. This structured approach facilitates the stabilization of the patient throughout the course of treatment.

Recent Clinical Evidence

Perilan: Recent Clinical Evidence

Phase III Randomized Controlled Trials (RCTs)

One Phase III randomized controlled trial (RCT), the largest trial reviewed, focused on the findings of the study related to the predefined clinical endpoints. This study was a 52-week, double-blind, placebo-controlled investigation involving 850 participants.

  • Primary Outcome: The trial focused on a composite measure of disease severity.
    • Findings: Study findings indicated a measured difference in the composite measure across the groups observed at the 52-week point.
  • Secondary Outcome: Researchers evaluated how disease progression was measured over time in the treatment groups; the recorded findings varied among populations.
    • Observation: The trial design included measuring time to reported changes in symptoms.

Preclinical and Observational Research

Preclinical research has investigated potential biological mechanisms. Other preclinical research examined potential influences on molecular pathways.

  • Laboratory Research: Laboratory studies examined the compound's characteristics in different cell models.
    • Reported Finding: One finding reported that the study measured the effects of the treatment in relation to standard care.

Subgroup and Comparative Research

The effects of the study compound were compared to older treatment options in a number of studies. These studies were generally smaller Phase II investigations or open-label extension studies.

  • Liver Impairment: Studies have explored the compound’s characteristics in individuals with mild liver impairment.
    • Data Analysis: Data analysis reported similar frequencies of specific events in this subgroup compared to the overall study population.
  • Research Design: Studies reviewed reported events in various adult populations. Research was also conducted to observe outcomes across different levels of the study compound.
    • Combination Therapies: Early results from a Phase II trial evaluated whether the combination was associated with changes in patient-reported sleep quality.

Frequently Asked Questions (FAQ)

Common questions about Perilan (FAQ)

Q: How quickly can a person expect Perilan to start working?

Official product information indicates that the initial effect on blood pressure may begin within a few hours. However, the full blood pressure-lowering benefit is described as potentially taking up to one month to be reached. For heart-related conditions, the reported benefits in studies may take weeks or months.


Q: Is it possible for Perilan to cause weight changes?

Regulatory safety documents describe both weight gain and weight decrease as uncommon adverse events associated with the use of Perilan. Because they are not listed as common occurrences, these are not considered major reported side effects in the overall safety profile.


Q: How long does Perilan usually stay in your system?

Perilan is a prodrug that is converted by the body into its active form, perindoprilat. Official prescribing information indicates that the majority of this active form typically has an elimination half-life ranging between 3 and 10 hours.


Q: What happens if I forget to take a scheduled use of Perilan?

Official patient information indicates that if a dose is missed, the user should take it as soon as it is remembered. If it is very close to the time for the next scheduled use, the missed dose is skipped, and the regular schedule is continued. Official information states that a double dose must not be taken.


Q: Does Perilan have any known interactions with birth control pills?

Official documents indicate that the active ingredient, perindopril, does not directly interfere with the effectiveness of hormonal contraception. However, due to the underlying condition (high blood pressure), official documents indicate that a healthcare provider often reviews the overall use of hormonal birth control methods.


Q: Can Perilan affect the ability to drive or operate machinery?

Regulatory product monographs state that Perilan may have a minor to moderate effect on a person's ability to drive or operate machinery. This is attributed to potential side effects like dizziness, fatigue, and headache. Official guidance notes that caution may be necessary, particularly when beginning therapy.


Q: Can Perilan be taken with common supplements like multivitamins?

The official interaction profile specifically notes that potassium supplements are generally not recommended due to a documented risk of elevated potassium levels (hyperkalemia). While other general multivitamins are not restricted, official sources indicate that all supplements are typically reviewed by a healthcare provider for potential individual interactions.


Q: Is Perilan known to interact with alcohol consumption?

Regulatory information indicates that alcohol may have an additive effect when combined with Perilan, potentially resulting in a greater drop in blood pressure. This effect is described as increasing the reported risk of dizziness, lightheadedness, or fainting, particularly during the initial phase of treatment.


Q: Can Perilan cause issues with sleep patterns?

Official safety data from clinical trials reports that some users have experienced uncommon side effects related to sleep patterns. These reported effects are noted to include insomnia (difficulty sleeping) and abnormal dreams.


Q: What is the typical duration of use described for Perilan?

For the chronic conditions that Perilan is officially approved to address, such as high blood pressure, the treatment is described as typically long-term. Regulatory documents suggest that use may be required for the patient's remaining life as part of the established management protocol for the condition.


Q: Do the side effects of Perilan usually go away over time?

Official sources state that common side effects may lessen or resolve as the body adjusts to the medicine over time. However, serious adverse reactions, such as Angioedema (swelling), are noted in official guidance as requiring immediate discontinuation and urgent clinical assessment.


Q: Is Perilan known to interact with common cold or allergy medicines?

Regulatory labeling indicates that sympathomimetic agents, which are often ingredients in certain cold and allergy medicines, should be administered with caution. These agents can potentially cause adverse cardiovascular effects, especially in users who have existing heart or blood pressure conditions.


Q: Does Perilan require any special monitoring or lab tests?

Official prescribing information indicates that regular monitoring may be required during the use of Perilan. This typically involves blood tests to check kidney function, such as creatinine levels, and to monitor serum potassium levels due to the documented risk of hyperkalemia (high potassium).


Q: What is the difference between the brand name and generic versions of Perilan?

While brand and generic versions may use different salt forms of the active ingredient, official reviews have found no documented clinical benefit or difference in the safety profile between them. Any differences are generally related to cost or the stability characteristics of the tablet formulation.


Q: Is Perilan known to cause any mood changes or anxiety?

Regulatory safety documents indicate that Perilan has been associated with some uncommon psychiatric side effects in clinical trials. These reported mood-related changes include anxiety, depression, and other unspecified mood alterations.


Q: Is there a patient information leaflet available for Perilan online?

Yes. Official sources, such as regulatory and governmental drug databases, generally make a digital copy of the Patient Information Leaflet (PIL) or equivalent consumer information available online.

How should Perilan be stored and disposed of?

Official Storage and Disposal Instructions

Perilan (Perindopril) tablets require specific conditions to maintain stability. The medicine must be stored at room temperature, typically below 25 C or 30 C, and strictly protected from moisture and excess heat [MedlinePlus; SmPC]. Regulatory guidelines explicitly state that the medication must be kept from freezing and stored in its original container, which should be tightly closed [Mayo Clinic; MedlinePlus].

For safety, all labeling mandates keeping the medicine out of the sight and reach of children and advises locking safety caps [MedlinePlus].

Unused or expired Perilan should not be disposed of in household waste or flushed down the toilet, as instructed by environmental regulations [Rwanda FDA]. Disposal should follow official guidelines, utilizing drug take-back programs or a pharmacist's advice [FDA].

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

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