Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Angioedema: Although not common, angioedema (a serious allergic reaction that causes the area around the throat and tongue to swell) may occur with ACE inhibitors, including perindopril. If you experience swelling of the face, tongue, or glottis, stop taking amlodipine - perindopril at once and seek immediate medical attention. People who have had angioedema caused by other substances may be at increased risk of angioedema while taking an ACE inhibitor such as perindopril.
Blood counts: This medication can decrease the number of neutrophils (a type of white blood cell that helps fight infection), red blood cells (which carry oxygen), and platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. If you notice more frequent signs of infection (e.g., fever, chills, or sore throat) or unusual bleeding or bruising, contact your doctor.
Cough: People taking perindopril may develop a dry, persistent cough that usually disappears only after stopping or lowering the perindopril dose. Be sure to tell your doctor of any cough that does not seem to be related to a usual cause.
Diabetes: Perindopril may affect blood sugar control. If you have diabetes, 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. You may need to test your blood sugar more often when you first start taking this medication.
Drowsiness/dizziness: Amlodipine - perindopril may cause drowsiness or dizziness, affecting the mental or physical abilities needed to drive or operate machinery. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how this medication affects you.
Fluid and electrolyte balance: Increases in levels of potassium in the blood may occur as a result of taking amlodipine - perindopril. This is more likely to occur if you are using certain other medications, have kidney problems or diabetes, or are taking potassium supplements or salt substitutes that contain potassium. Although this doesn’t usually cause problems, your doctor will probably want to monitor your potassium levels regularly with blood tests.
Grapefruit juice: Grapefruit juice may increase the effects of amlodipine. Avoid grapefruit juice while taking this medication.
Kidney function: Changes in kidney function have been seen in certain people who take this medication. The use of diuretics (water pills) or aliskiren may further increase the risk of kidney problems for those already at risk for this problem. If you have kidney disease or renal artery stenosis (narrowing of blood vessels in the kidneys), 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.
Liver function: Rarely, people taking this medication experience decreases in liver function, possibly leading to liver failure. Your doctor will do blood tests to monitor this. 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.
Amlodipine is removed from the body by the liver. Reduced liver function or liver disease may cause this medication to build up in the body, causing side effects. 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.
Low blood pressure: Occasionally, blood pressure drops too low after amlodipine - perindopril is taken. This usually happens after the first or second dose or when the dose is increased. It is more likely to occur if you 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.
Surgery: Certain anaesthetics (medications to put you to sleep) used during surgery cause decreased blood pressure. Perindopril blocks the body’s natural response to these sudden reductions in blood pressure, which may be dangerous during surgery. If you are scheduled to have surgery and are taking perindopril - amlodipine, talk to your doctors about stopping the medications for surgery.
Pregnancy: 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.
Breast-feeding: Medications in the ACEI family have been reported to pass into breast milk. If you are a breast-feeding mother and are taking amlodipine - perindopril, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.
Seniors: Amlodipine - perindopril has not been studied for use by seniors and should not be prescribed for seniors.