Published

The PBAC has approved the change of perindopril salt from erbumine to arginine. The decision was based on bioequivalence of the two formulations of the angiotensin-converting enzyme (ACE) inhibitor. The new salt has improved stability in high humidity but there is no change to the effectiveness of the medicine.

The new formulation is available on the PBS from 1 August. The old erbumine-based formulation will not be removed from the PBS until 1 December meaning there is a 4-month period where both formulations are available.

While such formulation changes are often inconsequential to how the medicine is used, in this case there are some differences that may cause confusion:

  • Tablet strengths have changed slightly
  • The 4-mg tablet has changed colour
  • Packaging is now a small bottle rather than a blisterpack in a box.

The new product has retained its brand name — Coversyl — which may add to the potential for confusion by medicine users not expecting the appearance of the medicine to change.

The table shows the therapeutically equivalent doses of perindopril. Note there is no increase in dose in moving, for example, from perindopril erbumine 2 mg to perindopril arginine 2.5 mg.

Perindopril arginine (new) Perindopril erbumine (replaced)
2.5 mg (white, round) = 2.0 mg (white, round)
5.0 mg (light green, rod-shaped) = 4.0 mg (white, rod-shaped)
10.0 mg (dark green, round) = 8.0 mg (dark green, round)

Finally, be aware that the fixed-strength combination tablets of perindopril with the diuretic, indapamide, (Coversyl Plus) will continue to contain the erbumine salt into 2007.