A fixed-dose combination (FDC) of an ACE inhibitor (Perindopril) and an ARB (Losartan) used for synergistic blood pressure control and cardiovascular protection. This combination is typically reserved for patients with severe or resistant hypertension not adequately controlled by monotherapy or other combinations, as per Indian guidelines. It provides dual blockade of the Renin-Angiotensin-Aldosterone System (RAAS) at different levels.
Adult: One tablet (Perindopril 4mg + Losartan 50mg) once daily. Initiation under medical supervision. Dose may be titrated based on response and tolerability, but the fixed-dose nature limits titration flexibility.
Note: Can be taken with or without food. Preferably taken at the same time each day, in the morning to avoid nocturnal diuresis. Swallow whole with a glass of water. Do not crush or chew.
Provides dual blockade of the Renin-Angiotensin-Aldosterone System (RAAS). Perindopril inhibits Angiotensin Converting Enzyme (ACE), reducing the conversion of Angiotensin I to the potent vasoconstrictor Angiotensin II and decreasing aldosterone secretion. Losartan competitively blocks the Angiotensin II type 1 (AT1) receptors, preventing the action of any Angiotensin II (including that generated via non-ACE pathways like chymase). This synergistic action leads to more complete RAAS suppression, vasodilation, reduced aldosterone, and decreased sodium and water retention.
Pregnancy: CONTRANDICATED in second and third trimesters (Pregnancy Category D). Drugs that act directly on the RAAS can cause fetal injury and death, including hypotension, neonatal skull hypoplasia, anuria, reversible or irreversible renal failure, and oligohydramnios. Discontinue as soon as pregnancy is detected.
Driving: May cause dizziness, lightheadedness, or fatigue, especially during initiation or dose escalation. Patients should be cautioned about operating machinery or driving until they know how the medication affects them.
| Potassium supplements / Salt substitutes (high K+) | Increased risk of severe hyperkalemia. | Major |
| Potassium-sparing diuretics (Spironolactone, Eplerenone, Amiloride) | Additive risk of hyperkalemia. | Major |
| NSAIDs (Ibuprofen, Diclofenac, Naproxen) | Reduced antihypertensive effect; increased risk of renal impairment and hyperkalemia. | Major |
| Diuretics (Thiazides, Loop diuretics) | Potentiated hypotensive effect, especially after first dose. | Moderate |
| Lithium | Increased serum lithium levels and toxicity. | Major |
| Aliskiren | Increased risk of hyperkalemia, hypotension, and renal impairment. | Major (contraindicated in DM/CKD) |
| Other Antihypertensives | Additive hypotensive effect. | Moderate |
| CYP2C9 Inhibitors (Fluconazole, Amiodarone) | May increase Losartan levels. | Moderate |
| CYP2C9 Inducers (Rifampicin) | May decrease Losartan efficacy. | Moderate |
Same composition (Perindopril erbumine (4mg) + Losartan (50mg)), different brands: