Perindopril arginine and amlodipine besylate for hypertension: a safety evaluation

source extracted confidence: high 2026-04-09
#amlodipine #antihypertensive-agents #blood-pressure #cough #dose-response-relationship-drug

Perindopril arginine and amlodipine besylate for hypertension: a safety evaluation

Elliott et al., 2018 | Expert Opin Drug Saf | Systematic Review

Citation

Elliott William J, Bistrika Evgeny A. Perindopril arginine and amlodipine besylate for hypertension: a safety evaluation. Expert Opin Drug Saf. 2018-Feb;17(2):207-216. doi:10.1080/14740338.2018.1397129

Abstract

Controlling blood pressure is a global health priority; single-pill antihypertensive combinations may improve adherence, persistence, and outcomes. Areas covered: A novel combination of perindopril arginine and amlodipine besylate was recently approved. A systematic review of the literature revealed its most common adverse effects as: peripheral edema (depending on the dose of amlodipine, but attenuated by perindopril), cough, dizziness and hypotension. Dose-dependent hyperkalemia, impairment of renal function (especially in renovascular hypertension), angioedema, and teratogenicity were derived from experience with other ACE-inhibitors. Expert opinion: Substantial clinical trial experience with amlodipine or perindopril suggests that these two agents effectively lower blood pressure, and can reduce the risk of major adverse cardiovascular events, as in the Anglo-Scandinavian Cardiac Outcomes Trial. The incidence of adverse effects reported in clinical trials is lower than expected, likely due to exclusion of subjects previously exposed to its components; the nature of open-label, uncontrolled observational studies; and difficulty in recognizing and measuring cough and pedal edema. This new formulation of perindopril arginine protects its ethyl ester, without requiring physical separation from amlodipine in a single tablet, and is less hygroscopic than perindopril erbumine. These and other attributes may make this combination an attractive addition to the antihypertensive armamentarium.

Key Findings

These and other attributes may make this combination an attractive addition to the antihypertensive armamentarium.

Outcomes Measured

  • blood pressure

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition hypertension

MeSH Terms

  • Amlodipine
  • Antihypertensive Agents
  • Blood Pressure
  • Cough
  • Dose-Response Relationship, Drug
  • Drug Combinations
  • Edema
  • Humans
  • Hypertension
  • Perindopril

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: arginine-cardiovascular

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09