From the Guidelines
For a 48-year-old female, the recommended dose of Perindopril (Coversyl) is 4 mg once daily, preferably taken in the morning before breakfast, as suggested by the NICE guidelines for patients under 55 years old 1. The dose may be adjusted after several weeks based on blood pressure response, with a maximum recommended dose of 8 mg daily.
- It is essential to consider the patient's kidney function, liver problems, or interactions with other medications like diuretics, which may require a lower starting dose of 2 mg.
- The ASH/ISH guidelines suggest that the initial dose of a drug should be at least half of the maximum recommended dose, so that only one up-titration is required to reach the maximum recommended level 1.
- The JNC 8 guidelines provide three suggested dosing strategies, but emphasize that the final decision should be left to the clinician and patient 1.
- Regular monitoring of blood pressure and follow-up with a healthcare provider are crucial to ensure the medication is effective and well-tolerated.
- Common side effects of Perindopril may include dry cough, dizziness, and headache, and dosage adjustments should only be made under medical supervision.
- The guidelines recommend reviewing and modifying the dose and antihypertensive treatments every 2–4 weeks until an appropriate regimen is established 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Hypertension Use in Uncomplicated Hypertensive Patients: In patients with essential hypertension, the recommended initial dose is 4 mg once a day The dosage may be titrated upward until blood pressure, when measured just before the next dose, is controlled or to a maximum of 16 mg per day. The usual maintenance dose range is 4 to 8 mg administered as a single daily dose.
The recommended initial dose of Perindopril (Coversyl) for a 48-year-old female is 4 mg once a day. The dosage may be titrated upward until blood pressure is controlled, with a usual maintenance dose range of 4 to 8 mg administered as a single daily dose 2.
From the Research
Perindopril Dosage
The recommended dose of Perindopril (Coversyl) is not explicitly stated in the provided studies for a 48-year-old female. However, some general information about Perindopril can be found:
- Perindopril is a non-sulphydryl, pro-drug, ACE inhibitor 3.
- The antihypertensive efficacy of perindopril 4-8 mg once daily is comparable to that of other antihypertensive agents 3.
- Dose reduction is required in elderly subjects and those with renal impairment 3.
Factors Affecting Dosage
Some factors that may affect the dosage of Perindopril include:
- Age: Dose reduction is required in elderly subjects 3.
- Renal impairment: Dose reduction is required in patients with renal impairment 3.
- Concomitant use of other drugs: The use of diuretics may reduce the risk of hyperkalemia in patients taking ACE inhibitors 4.
Hyperkalemia Risk
The risk of hyperkalemia in patients taking Perindopril is a concern, especially in those with chronic kidney disease:
- The risk of hyperkalemia is higher in patients with lower glomerular filtration rates (GFR) 4.
- The use of ACE inhibitors, such as Perindopril, is associated with a higher risk of hyperkalemia compared to other antihypertensive agents 4.
- The concomitant use of diuretics may reduce the risk of hyperkalemia in patients taking ACE inhibitors 4.