Compatibility «Perindopril» and «Valsacor»

• Interactions Perindopril with Valsacor

  • Dangerous interactions
    • ⓘ Concomitant use of ARA II with ACE inhibitors is contraindicated in patients with diabetic nephropathy and is not recommended in other patients.
    • ⓘ Double blockade of RAAS ARA II, ACE inhibitors or aliskiren is associated with an increased risk of hypotension, hyperkalemia and changes in renal function (including acute renal failure) compared to monotherapy.
    • ⓘ Some drugs or drugs of other pharmacological classes may increase the risk of hyperkalemia: aliskiren and aliskiren‑containing drugs, potassium salts, potassium-sparing diuretics, ACE inhibitors, angiotensin II receptor antagonists (ARA II), heparin, immunosuppressants such as cyclosporine or tacrolimus, trimethoprim, drugs containing co-trimoxazole (trimethoprim + sulfamethoxazole).
    • ⓘ In patients with established atherosclerotic disease, heart failure or diabetes mellitus with target organ damage, simultaneous therapy with ACE inhibitor and ARA II is associated with a higher incidence of arterial hypotension, syncope, hyperkalemia and deterioration of renal function (including acute renal failure) compared with the use of only one drug that affects the RAAS.
    • ⓘ ACE inhibitors (C09A) + angiotensin ii receptor antagonists => Are associated with an increased risk of arterial hypotension, syncope, hyperkalemia and impaired renal function (in pm acute renal failure) compared with monotherapy.
    • ⓘ Patients taking diuretics, especially those who have recently started treatment, may sometimes experience an excessive decrease in blood pressure after starting therapy with perindopril erbumin.
    • ⓘ The use of a diuretic may further increase the risk of lithium toxicity.
    • ⓘ In the elderly, patients with insufficient BCC (in pm receiving diuretic therapy) or with impaired renal function, the combined use of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including perindopril, may lead to deterioration of renal function, including possible acute renal failure.
    • ⓘ In patients receiving diuretics, especially with excessive excretion of fluid and / or electrolytes, at the beginning of perindopril therapy, an excessive decrease in blood pressure may be observed, the risk of which can be reduced by discontinuing the diuretic, replenishing fluid loss (intravenous infusion of 0.9% sodium chloride solution), as well as using perindopril in lower doses.
    • ⓘ When using diuretics in the case of CHF, an ACE inhibitor should be prescribed at a low dose, possibly after reducing the dose of a potassium-sparing diuretic used simultaneously.
    • ⓘ It should be used with caution with hypotensive drugs (their effect is potentiated, dose adjustment may be necessary), cardiac glycosides (hypokalemia and hypomagnesemia associated with the action of thiazide diuretics may increase the toxicity of digitalis), amiodarone (its use simultaneously with thiazide diuretics may lead to an increased risk of arrhythmias associated with hypokalemia), hypoglycemic oral medications (their effectiveness decreases, hyperglycemia may develop), corticosteroids, calcitonin (increase potassium excretion), NSAIDs (may weaken the diuretic and hypotensive effects of thiazides), non-depolarizing muscle relaxants (their effect may be enhanced), amantadine (clearance of amantadine may decrease with hydrochlorothiazide, which leads to an increase in plasma concentration of amantadine and possible toxicity), colestyramine (reduces absorption of hydrochlorothiazide), ethanol, barbiturates and narcotic analgesics, which enhance the effect of orthostatic hypotension.
  • Negative interactions
    • ⓘ With the simultaneous use of lithium preparations with ACE and ARA II inhibitors or thiazide diuretics, a reversible increase in the concentration of lithium in blood plasma and an associated increase in toxic manifestations were noted.
    • ⓘ Antihypertensive drugs.
    • ⓘ It is possible to enhance the antihypertensive effect when combined with other drugs that reduce blood pressure (ACE inhibitors, beta-blockers, BMCC, guanethidine, methyldopa, vasodilators, direct renin inhibitors, ARA II).
    • ⓘ Caution is required when combining ARA II, including valsartan, with other drugs that block RAAS, such as ACE inhibitors or aliskiren.
    • ⓘ When used concomitantly with ACE inhibitors and diuretics, cases of reversible increases in the plasma concentration of lithium and its toxic effects have been reported.
    • ⓘ Other antihypertensive drugs.
    • ⓘ The possibility of hypotensive effects can be minimized by reducing the dose or canceling the diuretic, or increasing salt intake before starting treatment with perindopril.
    • ⓘ Double blockade (for example, with simultaneous use of an ACE inhibitor with ARA II) should be limited to individual cases with careful monitoring of renal function, potassium content and blood pressure.
    • ⓘ Concomitant use of ACE inhibitors with angiotensin II receptor antagonists.
    • ⓘ Antihypertensive and vasodilating agents.
    • ⓘ It enhances the antihypertensive effect of ACE inhibitors, blood pressure monitoring is required and, if necessary, dose adjustment of antihypertensive drugs.
    • ⓘ However, the bioavailability of perindoprilate was reduced by diuretics, which was associated with a decrease in ACE inhibition in plasma.
    • ⓘ In patients receiving diuretics that remove fluid and / or salts, at the beginning of Perindopril therapy, there may be a marked decrease in blood pressure, the risk of which can be reduced by discontinuing diuretics, replenishing the loss of fluid or salts before starting Perindopril therapy, as well as using Perindopril at a low dose with a further gradual increase.
    • ⓘ In hypertension in patients receiving diuretics, especially those that remove fluid and/or salts, diuretics should either be discontinued before the use of an ACE inhibitor (while a potassium-sparing diuretic may be prescribed again later), or an ACE inhibitor should be prescribed at a low dose with a further gradual increase.
    • ⓘ The additional use of thiazide diuretics against the background of the combined use of lithium preparations and ACE inhibitors increases the already existing risk of lithium intoxication.
    • ⓘ It may be necessary to adjust the dose of simultaneously prescribed antihypertensive drugs.
  • No interactions
    • ⓘ Concomitant diuretics do not affect the rate and degree of absorption and excretion of perindopril.
  • Positive interactions
    • ⓘ Thiazide diuretics enhance the antihypertensive effect of other antihypertensive drugs (including guanethidine, methyldopa, beta-blockers, vasodilators, BMCC, ACE inhibitors, ARA II, renin inhibitors).
    • ⓘ The antihypertensive effect of perindopril may be enhanced when combined with other antihypertensive drugs, vasodilators, nitrates of short and prolonged action.
  • Unclear interactions
    • ⓘ Diuretics.
    • ⓘ Potassium-containing diuretics (eplerenone, spironolactone).
    • ⓘ Potassium-sparing diuretics.
    • ⓘ If this is not possible, then the initial dose of ACE inhibitors should be reduced.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 170,041,552 possible combinations of drugs and their components were found 412,577 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2026-06-18

Category - medicine