If you notice any signs of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Your doctor may want to test your liver function regularly with blood tests while you are taking this medication. Occasionally, blood pressure drops too low after perindopril is taken. This usually happens after the first or second dose or when the dose is increased. It is more likely to occur for those who take aliskiren, water pills, have a salt-restricted diet, are on dialysis, are suffering from diarrhea or vomiting, or have been sweating excessively and not taking in enough fluids.

If low blood pressure causes you to faint or feel lightheaded, contact your doctor. ACE inhibitors such as perindopril may cause severe harm or death to a developing baby if taken by the mother during pregnancy. This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.

While these side effects when they occur are usually mild they can be serious. Dizziness becoming severe or fainting induced by low blood pressure Difficulty breathing or wheezing, tightening of the chest. This may occur at any time during treatment. If you develop such symptoms described below you should tell your doctor immediately or go to the Accident and Emergency department at your nearest hospital.

These side effects are extremely rare but can become serious. Swelling of your extremities limbs, hands or feet , lips, face, mouth, tongue or throat. Very rare Painful red areas, developing large blisters and peeling of layers of skin. Very rare Red, often itchy spots, similar to the rash of measles, which starts on the limbs and sometimes on the face and the rest of the body a condition known as Erythema Multiforme.

Very rare Stroke signs include weakness of arms or legs or problems speaking. Very rare Heart disorders such as a fast and irregular heart beat, heart attack, angina pectoris a feeling of tightness, pressure or heaviness in the chest. Very rare Inflammation of the pancreas Pancreatitis.

These side effects are extremely rare but can become serious. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines. Keep your tablets in the pack until it is time to take them. Heat and dampness can destroy some medicines. Keep them in a cool, dry place where the temperature stays below 30 degrees C.

Do not store medicines in a bathroom or near a sink. Do not leave them in a car or on a windowsill. The tablets are gluten free. It is distributed in Australia by: Intestinal angioedema should be included in the differential diagnosis of patients on ACE inhibitors presenting with abdominal pain. Concomitant use of mTOR inhibitors e.

Patients taking concomitant mTOR inhibitors e. Anaphylactoid reactions during desensitisation There have been isolated reports of patients experiencing sustained, life-threatening anaphylactoid reactions while receiving ACE inhibitors during desensitisation treatment with hymenoptera bees, wasps venom.

ACE inhibitors should be used with caution in allergic patients treated with desensitisation, and avoided in those undergoing venom immunotherapy. However these reactions could be prevented by temporary withdrawal of ACE inhibitor for at least 24 hours before treatment in patients who require both ACE inhibitors and desensitisation.

Anaphylactoid reactions during LDL apheresis Rarely, patients receiving ACE inhibitors during low density lipoprotein LDL -apheresis with dextran sulfate have experienced life-threatening anaphylactoid reactions.

These reactions were avoided by temporarily withholding ACE-inhibitor therapy prior to each apheresis. Haemodialysis patients Anaphylactoid reactions have been reported in patients dialysed with high-flux membranes e. In these patients consideration should be given to using a different type of dialysis membrane or a different class of antihypertensive agent.

Pregnancy ACE inhibitors should not be initiated during pregnancy. Unless continued ACE inhibitor therapy is considered essential, patients planning pregnancy should be changed to alternative anti-hypertensive treatments which have an established safety profile for use in pregnancy. When pregnancy is diagnosed, treatment with ACE inhibitors should be stopped immediately, and, if appropriate, alternative therapy should be started see sections 4.

Hepatic encephalopathy When liver function is impaired, thiazide diuretics and thiazide-related diuretics may cause hepatic encephalopathy.

Administration of the diuretic should be stopped immediately if this occurs. Photosensitivity Cases of photosensitivity reactions have been reported with thiazides and related thiazides diuretics see section 4. If photosensitivity reaction occurs during treatment, it is recommended to stop the treatment. If a re-administration of the diuretic is deemed necessary, it is recommended to protect exposed areas to the sun or to artificial UVA.

Precautions for use Common to perindopril and indapamide: In certain hypertensive patients without pre-existing apparent renal lesions and for whom renal blood tests show functional renal insufficiency, treatment should be stopped and possibly restarted either at a low dose or with one constituent only.

In these patients usual medical follow-up will include frequent monitoring of potassium and creatinine, after two weeks of treatment and then every two months during therapeutic stability period.

Renal failure has been reported mainly in patients with severe heart failure or underlying renal failure including renal artery stenosis. The drug is usually not recommended in case of bilateral renal artery stenosis or a single functioning kidney. Hypotension and water and electrolyte depletion There is a risk of sudden hypotension in the presence of pre-existing sodium depletion in particular in individuals with renal artery stenosis.

Therefore systematic testing should be carried out for clinical signs of water and electrolyte depletion, which may occur with an inter-current episode of diarrhoea or vomiting. Regular monitoring of plasma electrolytes should be carried out in such patients. Marked hypotension may require the implementation of an intravenous infusion of isotonic saline. Transient hypotension is not a contra-indication to continuation of treatment.

After re-establishment of a satisfactory blood volume and blood pressure, treatment can be started again either at a reduced dose or with only one of the constituents. Potassium levels The combination of perindopril and indapamide does not prevent the onset of hypokalaemia particularly in diabetic patients or in patients with renal failure. As with any antihypertensive agent containing a diuretic, regular monitoring of plasma potassium levels should be carried out.

Cough A dry cough has been reported with the use of angiotensin converting enzyme inhibitors. It is characterised by its persistence and by its disappearance when treatment is withdrawn.

An iatrogenic aetiology should be considered in the event of this symptom. If the prescription of an angiotensin converting enzyme inhibitor is still preferred, continuation of treatment may be considered.

Paediatric population The efficacy and tolerability of perindopril in children and adolescents, alone or in combination, have not been established. Marked stimulation of the renin-angiotensin-aldosterone system has been observed particularly during marked water and electrolyte depletions strict sodium-free diet or prolonged diuretic treatment , in patients whose blood pressure was initially low, in cases of renal artery stenosis, congestive heart failure or cirrhosis with oedema and ascites.

Occasionally this can be acute in onset, although rare, and with a variable time to onset. In such cases, the treatment should then be initiated at a lower dose and increased progressively. Elderly Renal function and potassium levels should be tested before the start of treatment. The initial dose is subsequently adjusted according to blood pressure response, especially in cases of water and electrolyte depletion, in order to avoid sudden onset of hypotension.

Atherosclerosis The risk of hypotension exists in all patients but particular care should be taken in patients with ischaemic heart disease or cerebral circulatory insufficiency, with treatment being started at a low dose.

Renovascular hypertension The treatment for renovascular hypertension is revascularisation.

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You tab require urgent medical attention, tab coversyl 5mg. Reporting of suspected adverse reactions: How to take Coversyl Arginine Always 5mg this medicine exactly as your doctor or pharmacist has told you. Uncommon may affect up to 1 in people side effects can include: The tablets are gluten free. All medicines can have side effects, tab coversyl 5mg. See also section 4. This could be a sign that you are developing glaucoma. These coversyl effects are extremely rare but can become serious. Uncommon may affect up to 1 in people:

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