Coversec (Perindopril)

Indication : Coversec tablets contain the active ingredient perindopril, which is a type of medicine called an ACE inhibitor. (NB. Perindopril is also available without a brand name, i.e. as the generic medicine.)

ACE inhibitors work by blocking the action of a compound in the body called angiotensin converting enzyme (ACE). Normally ACE produces another compound called angiotensin II, as part of the body's natural control of blood pressure. Angiotensin II causes blood vessels to constrict and narrow, which increases the pressure within the blood vessels.

As perindopril blocks the action of ACE, it reduces the production of angiotensin II. This means that the blood vessels are allowed to relax and widen. The overall effect of this is a drop in blood pressure, hence perindopril can be used to lower high blood pressure.

The reduced pressure within the blood vessels means that the heart doesn't have to work as hard to pump the blood around the body. This means that ACE inhibitors can be used to improve the symptoms of heart failure, where the heart is not pumping as efficiently, and to improve survival following a heart attack.

It is recommended that Coversec tablets are taken in the morning before breakfast.

What is it used for?
* Heart failure.
* High blood pressure (hypertension).
* Reducing the risk of further heart attacks in people with stable coronary heart disease who have had a heart attack or heart bypass surgery.

Warning : Coversec tablets contain a different salt of perindopril to the old Coversec tablets (perindopril arginine instead of perindopril tert-butylamine). This new salt has an extended shelf-life and greater stability. Coversec is equivalent to the old Coversec in terms of safety and effectiveness, and the action of the medicine has not changed. However, the new tablets come in different packaging and in different strengths to the old Coversec tablets. Coversec 2.5mg tablets are equivalent to the old Coversec 2mg tablets. Coversec 5mg tablets are equivalent to the old Coversec 4mg tablets and Coversec 10mg tablets are equivalent to the old Coversec 8mg tablets. Generic perindopril tablets remain available; these contain the tert-butylamine salt. Coversec 2.5mg tablets are equivalent to generic perindopril 2mg tablets. Coversec 5mg tablets are equivalent to generic perindopril 4mg tablets and Coversec 10mg tablets are equivalent to generic perindopril 8mg tablets. If you have any questions or concerns about this change you should talk to your pharmacist.

Some people may experience dizziness caused by low blood pressure in the first few days of taking this medicine and in particular the first dose. For this reason, the first dose should preferably be taken at bedtime. Your doctor may want you to take the first dose of this medicine under medical supervision in hospital if you are aged over 70 years, have low blood pressure, low levels of fluids or salt in your blood (eg due to dehydration), severe or unstable heart failure, kidney problems, or are taking high doses of diuretic medicines, multiple diuretic medicines, or certain other medicines that dilate your blood vessels.

Alcohol may enhance the blood pressure lowering effect of this medicine, which can increase dizziness and may increase the risk of fainting.

ACE inhibitors can sometimes cause an allergic reaction called angioedema. Stop taking this medicine and consult your doctor immediately if you experience difficulty breathing or swallowing, or swelling of your face, lips, tongue, throat, hands, feet or ankles while taking this medicine. This type of allergic reaction has been reported more frequently in people of Afro-Caribbean origin.

Your blood pressure, kidney function and the amount of potassium in your blood should be regularly monitored while you are taking this medicine.

Use with caution in
* Elderly people.
* Decreased liver function.
* Decreased kidney function.
* Narrowing of the arteries that supply blood to the kidneys (renal artery stenosis).
* High blood pressure caused by compression or blockage of the arteries that carry blood to the kidneys (renovascular hypertension).
* People with low fluid volume or salt levels in the body, eg due to diuretic therapy, low-sodium diet, diarrhoea or vomiting.
* People taking other medicines for high blood pressure, particularly diuretics (see end of factsheet).
* People with hardening of the arteries (athersclerosis) in the heart (cardiovascular disease), brain (cerebrovascular disease) or legs (peripheral vascular disease).
* Narrowing of the main artery of the body (aortic stenosis).
* Heart valve disease (mitral valve stenosis).
* Heart disease characterised by thickening of the internal heart muscle and a blockage inside the heart (hypertrophic obstructive cardiomyopathy).
* Diseases affecting connective tissue, eg scleroderma, systemic lupus erythematosus or rheumatoid arthritis (collagen vascular diseases).
* Diabetes.
* People with kidney failure requiring a certain type of haemodialysis (high-flux membrane).
* People undergoing therapy to decrease allergy to bee or wasp stings (desensitisation).
* People receiving therapy to remove certain types of fat from the blood using a machine (LDL apheresis).



Not to be used in
* Allergy to other ACE inhibitor medicines.
* History of swelling of the lips, face or tongue (angioedema) with no known cause, or caused by previous use of an ACE inhibitor medicine.
* Hereditary angioedema (angioneurotic oedema).
* Pregnancy.
* Breastfeeding.
* Rare hereditary problems of galactose intolerance, glucose-galactose malabsorption, or the Lapp lactase deficiency (Coversec tablets contain lactose).
* The safety and efficacy of this medicine in children have not been studied. It is not recommended for children.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Side effects Common
* Headache.
* Pins and needles sensations.
* Low blood pressure (hypotension).
* Dizziness.
* Visual disturbances.
* Sensation of ringing or other noise in the ears (tinnitus).
* Dry cough.
* Shortness of breath.
* Disturbances of the gut such as diarrhoea, constipation, indigestion, nausea, vomiting or abdominal pain.
* Alteration in taste.
* Rash or itching.
* Muscle cramps.
* Feeling of weakness.

Presentation
Coversec Tablets               Blister of 10 Tablets