From the Guidelines
Perindopril should be taken before a meal, preferably in the morning, to ensure optimal absorption and effectiveness. This recommendation is based on the general principles of pharmacology and the properties of ACE inhibitors, such as perindopril, which are known to be affected by food intake 1. Taking perindopril about 30 minutes before breakfast allows the medication to be absorbed properly without significant interference from food.
Key Considerations
- Perindopril is an ACE inhibitor used to treat high blood pressure, heart failure, and other cardiovascular conditions.
- The timing of perindopril intake is crucial for maintaining steady blood levels of the medication, which provides better blood pressure control throughout the day.
- If you experience stomach upset, you can take it with a small amount of food, but a full meal may delay absorption and reduce effectiveness.
- Always follow your doctor's specific instructions regarding timing, as they may have personalized recommendations based on your health condition and other medications you may be taking.
Administration and Dosage
- The study by Rosendorff et al 1 discusses the treatment of hypertension in the prevention and management of ischemic heart disease, highlighting the importance of ACE inhibitors like perindopril.
- While the study does not specifically address the timing of perindopril intake in relation to meals, the general principle of taking medications like ACE inhibitors on an empty stomach for better absorption applies.
- Never double-dose if you miss a dose; instead, take it when you remember or skip it if it's almost time for your next dose, as advised by your healthcare provider.
From the FDA Drug Label
Oral administration of perindopril erbumine tablets with food does not significantly lower the rate or extent of perindopril absorption relative to the fasted state However, the extent of biotransformation of perindopril to the active metabolite, perindoprilat, is reduced approximately 43%, resulting in a reduction in the plasma ACE inhibition curve of approximately 20%, probably clinically insignificant.
The effectiveness of Perindopril is not significantly affected by taking it before or after a meal, as the rate and extent of perindopril absorption are not significantly lowered by food. However, the biotransformation to its active metabolite, perindoprilat, is reduced by about 43% when taken with food, resulting in a 20% reduction in plasma ACE inhibition, which is likely clinically insignificant 2, 2, 2.
From the Research
Administration of Perindopril
- The bioavailability of perindopril is not influenced by meals, as stated in the study 3.
- Perindopril can be taken regardless of meal times, as its absorption and efficacy are not affected by food intake.
Efficacy of Perindopril
- Perindopril has been shown to be effective in lowering blood pressure in patients with hypertension, with a significant and linear relationship between the dose and the activity of perindopril 3.
- The antihypertensive efficacy of perindopril is maintained for at least 24 hours, as evidenced by trough/peak ratios of >50% 4.
- Perindopril has been found to be at least as effective as other ACE inhibitors, such as captopril and enalapril, in the treatment of hypertension 5, 4.
Pharmacokinetics of Perindopril
- Perindopril is a prodrug that is hydrolyzed to the active metabolite perindoprilat, which reaches peak plasma concentrations 3 to 4 hours after administration 3.
- The maximal pharmacodynamic effects of perindopril are seen 4 to 6 hours after dosing, with substantial effects still present at 24 hours 6.
- Perindopril is cleared by the kidneys, with 70% of the active metabolite being excreted in the urine 6.