Perindopril side-effects?

[PowerFly]

Hi, I'm 69 and a skinny, fit & active cyclist and walker, now constrained by persistent AFib that kicked off in January (probably much earlier tbh). Cardioversion was an instant failure and an ablation is considered to have a low chance of success, so I've decided to just live with it. I've bought an e-bike and just pace myself when hill walking. I'm on Bisoprolol, Apixaban and Atorvastatin, but during my cardiology discharge conversation, the cardiologist recommended adding Perindopril to my pharmaceutical cocktail, which I was less than thrilled about due to the long list of side effects. It's "to help atrial remodelling and possibly help the trajectory of chronic AV annular stretch". Chief worry is the 'cough' and how long it will last.

I'd be interested in the views and experiences of others with this medication.

Thanks, Phil

[scentedgardener]

I think I'm getting issues with perindopril after being on it for 3 years with no problem.I had zero side effects, very unusual for me, and I was very happy about that, but since I've been given the ultra cheap generic ones I seem to be getting a few issues. Very disappointing.

[dg2024]

I take perindopril-indapamid. The indapemide is a diuretic so it is a combi drug. I don't have any side effects and am tolerating it well. Toresimed was too strong for me. I'm recovering from myocarditis and I might be able to even get off this drug. I wish you luck.

[ashhussain]

Hi. I've been taking perindopril tablets for over a decade now, with (luckily) no side effects. I also take Bisoprolol and Atorvastatin tablets. Perhaps side effects with your GP or the acrdiologist?

[Zephyr6]

The main side effect I had with perindopril was coughing especially through the night where it kept me awake. A friend of mine was coughing so badly on perindopril that it caused him a hernia.

I have since tried Losartan which also had side effects so now I’m on Amlodipine which thank goodness has no side effects for me.

[Seasid in reply to Zephyr6]

Which side effects did you experience with Losartan?

I always believed until now that when I develop coughing on my perindopril arginine ACE inhibitor medication that I can just simply switch to angiotensin receptor blocker (ARB) like Losartan?

I am on 5mg per day and I am fine. Maybe you could try to reduce the dose until your cough goes away. Usually I wish to make sure that the side effects are from the medication or from the combination of the medications used before stopping them.

I had some cough but that wasn't a dry cough what I would expect from an ACE inhibitor. But now two months later I don't have a cough. I was thinking that maybe I just had a seasonal allergy or maybe just accide reflux which could also cause coughing. The easiest is to troubleshoot what's going on is maybe just to stop eating 5 hours before bedtime.

If I would you I would either just consult your doctor or if nothing works try to get an expert opinion about your coughing. Yes, ace inhibitors can cause dry cough. Maybe you could ask your doctor to try proton pump inhibitors if he believes that this could help you with your cough. Thanks God my cough went away on its own.

[Seasid in reply to Seasid]

The other thing is sleep apnea which could cause the food to get into your lungs if you are not using a CPAP machine or if your CPAP machine pressure is not correct. The easiest solution is to stop eating 5 hours before going to bed and of course to be diagnosed with a proper over night sleep study I a hospital.

[Zephyr6 in reply to Seasid]

Hi, Losartan caused me to experience dizzy spells sporadically, some occasions when driving and I had to turn off and park up until I was ready to continue.

The final straw was when I was walking into town and the dizziness caused me to lose my balance and fall three times.

Since being on Amlodipine for approx. 18 months now I have had no side effects whatsoever as far as I can tell.

[Seasid in reply to Zephyr6]

Q. Why would you under losarta experience upper respiratory infection?

A. Losartan, primarily used to treat high blood pressure and protect kidney function in people with diabetes, is part of a class of medications called angiotensin II receptor blockers (ARBs). Some people taking losartan may experience upper respiratory symptoms, like cough or cold-like symptoms, as a side effect. Here’s why this might happen:

1. Immune System Impact: Losartan can mildly affect the immune system's function in certain individuals. This impact may make some people more susceptible to respiratory infections or cause symptoms resembling respiratory infections.

2. Histamine Release: Losartan has a mild effect on histamine release, which can lead to nasal congestion, runny nose, or a cough that may feel similar to cold symptoms.

3. Sensitivity in Respiratory Pathways: Some people are more sensitive to medications like losartan, leading to irritation or inflammation in their respiratory pathways. This can result in coughing or throat discomfort, even though it isn't due to an infection.

4. Individual Variation: The body’s response to medications varies from person to person. For some, losartan may cause mild inflammation or irritation in the respiratory tract, leading to symptoms similar to an upper respiratory infection.

If you’re experiencing persistent symptoms, it’s a good idea to let your healthcare provider know. They might suggest an alternative medication if losartan is uncomfortable or causes bothersome side effects.

ChatGPT said

[Seasid in reply to Zephyr6]

"Thank you for sharing your experience. Losartan can indeed cause dizziness in some people due to its effect on blood pressure. Dizziness may happen more often if blood pressure drops too low or if there’s a sudden change in position (like standing up too quickly). This side effect can be especially concerning when it affects activities like driving or walking.

Switching to a different blood pressure medication, like amlodipine, can sometimes alleviate these issues. Amlodipine is a calcium channel blocker, which works differently than losartan, and may lead to fewer side effects like dizziness in some individuals. It’s great to hear that amlodipine has been effective and side-effect-free for you so far. This is a helpful reminder that individual responses to medications can vary widely, and sometimes finding the right medication is a matter of trial and adjustment."

ChatGPT said

What was your dose of losartan? Was it high?

[Zephyr6 in reply to Seasid]

The Losartan was 25mg which I believe is quite a low dose

[Greenfarm]

I have permanent AF. I’m 82 and lead an active life. I take Apixaban, Bisoprolol and Atorvastatin.. Then added to the mix was Florisimide prescribed by my cardiac consultant to lessen the strain on my heart. I have three leaking heart valves! I think I’m doing pretty well although I do hate having to take pills . The only symptoms I seem to have are persistent runny nose and mild sleep problems. I feel lucky

[PowerFly]

Just go follow up : I’m 11 days in with Perindopril and I’m happy to say there has been no sign of a cough. As mentioned by Greenfarm, I also suffer from a runny nose but I think this is a typical side effect of the Bisoprolol ( as are looser stools!)