What is in this leaflet
This leaflet answers some common questions about this medicine. It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you taking this medicine against the benefits they expect it will have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine. You may need to read it again.
What this medicine is used for
The name of your medicine is GenRx Perindopril/ Indapamide 4/1.25 tablets. It contains the active ingredients perindopril and indapamide, which are used to treat high blood pressure (also known as hypertension).
Everyone has blood pressure. This pressure helps to circulate blood all around the body. Your blood pressure may be different at different times of the day, depending on how busy or stressed you are.
You have high blood pressure (hypertension) when your blood pressure stays higher than is needed, even when you are calm and relaxed.
If high blood pressure is not treated, it can lead to serious health problems. You may feel fine and have no symptoms, but eventually it can cause stroke, heart disease and kidney failure.
Perindopril/indapamide helps to lower your blood pressure
Ask your doctor if you have any questions about why this medicine has been prescribed for you. Your doctor may have prescribed this medicine for another reason.
This medicine is available only with a doctor's prescription.
There is no evidence that this medicine is addictive.
Use in children
There is not enough information to recommend the use of this medicine in children.
Before you take this medicine
When you must not take it
Do not take this medicine if you have an allergy to:
- any medicine containing perindopril or indapamide
- sulphonamide (sulpha) antibiotics, thiazide diuretics (a type of "fluid" or "water" tablet)
- any other angiotensin converting enzyme (ACE) inhibitor
- any of the ingredients listed at the end of this leaflet.
Some of the symptoms of an allergic reaction may include:
- shortness of breath
- wheezing or difficulty breathing
- swelling of the face, lips, tongue or other parts of the body
- rash, itching or hives on the skin
Do not take this medicine if you have experienced serious swelling of the face, tongue, lips or throat either suddenly or in response to another medicine in the past (a rare allergic condition known as angioedema).
Do not take this medicine if you are intolerant or allergic to lactose. This medicine contains lactose.
Do not take this medicine if you have or have had any of the following medical conditions:
- severe heart failure which is not being treated
- low potassium levels (hypokalaemia)
- severe liver problems or hepatic encephalopathy
- trouble urinating (i.e. little or no urine)
- severe kidney problems or if you are on dialysis
- renal artery stenosis (a problem with the blood vessels to one or both kidneys)
- narrowing of the main blood vessel leading from the heart and/ or heart valve.
Do not take this medicine if you undergo treatments where your blood is treated outside of the body (also known as extracorporeal treatments) that may increase your risk of allergic reactions, such as:
- renal dialysis or haemofiltration using polyacrylonitrile membranes
- low-density lipoprotein (LDL) apheresis, a technique where LDL is 'filtered' out of a patient's blood, using dextran sulphate.
Do not take this medicine if you are taking other medicines which have the possible side effect of a heart problem called torsades de pointes, including:
- some medicines used to treat abnormal heart rhythms (e.g. disopyramide, amiodarone, sotalol or flecainide)
- some medicines used to treat mental illnesses (e.g. trifluoperazine, amisulpride, sulpiride, droperidol or haloperidol)
- other medicines such as diphemanil, erythromycin IV, pentamidine or moxifloxacin
- sacubitril/valsartan combinations, used to treat long-term heart failure
Do not take this medicine if you are treated with a blood pressure lowering medicine containing aliskiren and have diabetes or impaired kidney function.
Do not take this medicine if you are pregnant or trying to become pregnant. Perindopril/indapamide may affect your developing baby if you take it during pregnancy.
Do not take this medicine if you are breastfeeding or intend to breast-feed. Perindopril/indapamide may pass into human breast milk.
Do not take this medicine after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering. If it has expired or is damaged, return it to your pharmacist for disposal.
If you are not sure whether you should start taking this medicine, talk to your doctor.
Before you start to take it
Tell your doctor if you have allergies to any other medicines, foods, preservatives or dyes.
Tell your doctor if you have or have had any of the following medical conditions:
- kidney disease or you are on renal dialysis
- liver disease
- heart or blood vessel disease
- hyperparathyroidism (overactive parathyroid gland)
- photosensitivity reactions (increased sensitivity of the skin to sun)
- systemic lupus erythematosus (a disease affecting the skin, joints and kidneys)
- high or low levels of potassium, low levels of sodium or chlorine, or high levels of uric acid
- you are on a salt restricted diet or use salt substitutes which contain potassium
- you are undergoing, or you are intending to undergo, treatments where your blood is treated outside of the body (also known as extracorporeal treatments)
- you are undergoing a medical test that requires injection of an iodinated contrast agent (a substance that makes organs like kidney or stomach visible on an X-ray)
- you have recently suffered from diarrhoea or vomiting
- you are undergoing desensitisation treatment or have had an allergic reaction during previous desensitisation treatment (e.g. treatments using bee, wasp or ant venom)
- abnormally increased levels of a hormone called aldosterone in your blood (primary aldosteronism)
- muscle disorders including muscle pain, tenderness, weakness or cramps
- you experience a decrease in vision or eye pain – these could be symptoms of fluid accumulation in the vascular layer of the eye or an increase of pressure in your eye and can happen within hours to a week of taking perindopril/indapamide.This can lead to permanent vision loss, if not treated. If you earlier have had a penicillin or sulfonamide allergy, you can be at higher risk of developing this.
Tell your doctor if you are pregnant or plan to become pregnant or are breastfeeding. Do not take this medicine whilst pregnant or breastfeeding.
Taking other medicines
Tell your doctor or pharmacist if you are taking any other medicines, including any that you get without a prescription from your pharmacy, supermarket or health food shop.
Some medicines may interact with perindopril/indapamide. These include:
- some medicines used to treat high blood pressure (including angiotensin receptor blockers), aliskiren, diuretics (sometimes called "fluid" or "water" tablets) or medicines used to treat heart failure (e.g. sacubitril/valsartan or digoxin)
- some anti-inflammatory drugs (including high dose aspirin and ibuprofen) for pain relief
It is especially important to tell your doctor when taking blood pressure, water and/or heart tablets together with anti-inflammatory drugs.
- some drugs used to treat gout (e.g. allopurinol)
- some drugs used to treat cancer (e.g. vandetanib, oxaliplatin or anagrelide), or to suppress the immune system, such as after organ transplants (e.g. cyclosporin)
- baclofen, a muscle relaxant
- some antibiotics used to treat infections (e.g. trimethoprim, ciprofloxacin or moxifloxacin)
- some anti-fungal medications used to treat fungal infections (e.g. fluconazole or amphotericin B by injection)
- medicines such as lithium and tricyclic antidepressants (e.g. imipramine, citalopram or escitalopram) for treating depression and mood disorders
- medicines used for treating psychiatric disorders
- donepezil, used in Alzheimer’s disease
- medicines which increase blood potassium levels, such as potassium-sparing diuretics, potassium tablets, salt substitutes containing potassium, or other drugs which can increase potassium in your body (e.g. heparin, or trimethoprim/ sulfamethoxazole)
- medicines which decrease blood potassium levels such as steroids, tetracosactide and certain types of laxatives (e.g. senna)
- antiparasitic medicines used to treat certain types of malaria (e.g. chloroquine).
- pentamidine, used to treat certain types of pneumonia
- antihistamines used to treat allergic reactions, such as hay fever
- medicines used to treat nausea and vomiting (e.g. ondansetron or domperidone)
- medicines which have the possible side effect of a heart problem called torsades de pointes, including: some medicines used to treat abnormal heart rhythms (e.g. disopyramide, amiodarone, sotalol or flecainide); some medicines used to treat mental illnesses (e.g. trifluoperazine, amisulpride, sulpiride, droperidol, haloperidol); other medicines such as diphemanil, erythromycin IV, pentamidine, moxifloxacin
- metformin, insulin or gliptins (e.g. sitagliptin), medicines used to treat diabetes
- medicines used for the treatment of low blood pressure, shock or asthma (e.g. ephedrine, noradrenaline or adrenaline (epinephrine))
- gold injections used for treating arthritis
- calcium supplements
- injections containing iodine used to diagnose certain medical conditions
- alcohol or strong painkillers (e.g. methadone)
- medicines which make your heartbeat faster or increase your blood pressure, such as decongestants (in cold & flu remedies)
- medicines used during operations (e.g. anaesthetics)
- cilostazol (used to treat cramplike pain in the legs when you walk)
- medicines which may increase the risk of angioedema (a severe allergic reaction) such as mammalian target of rapamycin (mTOR) inhibitors, used to avoid rejection of transplanted organs (e.g. temsirolimus, sirolimus, everolimus)
These medicines may be affected by perindopril/indapamide or may affect how well it works.
If you are taking any of these, you may need a different dose, or you may need to take different medicines.
Other medicines not listed above may also interact with perindopril/ indapamide.
Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking this medicine.
How to take this medicine
Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained in this leaflet.
If you do not understand the directions, ask your doctor or pharmacist for help.
How much to take
Your doctor will tell you how much of this medicine you should take. This will depend on your condition and whether you are taking any other medicines.
How to take it
Swallow your tablet(s) with a glass of water.
Do not crush or chew the tablets.
When to take it
Take it at about the same time each day, preferably in the morning before breakfast.
Taking it at the same time each day will have the best effect and will also help you remember when to take it.
How long to take it for
Perindopril/indapamide can help to control your blood pressure or heart failure but cannot cure these conditions.
Perindopril/indapamide treatment is usually for life, so you should keep taking your medicine for as long as your doctor tells you.
Make sure you have enough to last over weekends and holidays.
If you forget to take it
If your next planned dose is less than 6 hours away, leave out the dose that you missed. Take the next dose at the usual time and continue as normal.
Otherwise, take it as soon as you remember, and then go back to taking your medicine as you would normally.
Do not take a double dose to make up for missed doses. This may increase the chance of you experiencing side effects.
If you have trouble remembering to take your medicine, ask your pharmacist for some hints to help you remember.
If you take too much (overdose)
If you think that you or anyone else may have taken too much of this medicine, immediately telephone your doctor or the Poisons Information Centre (Tel: 13 11 26 in Australia) for advice. Alternatively, go to the Accident and Emergency department at your nearest hospital.
Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.
If you take too much perindopril/ indapamide, your blood pressure may drop (hypotension) or you may be sick, feel confused, or have kidney problems or changes in the salt and water content of your body or muscle cramps.
While you are taking this medicine
Things you must do
If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking this medicine.
Tell any other doctors, dentists, and pharmacists who treat you that you are taking this medicine.
If you are going to have surgery, tell the surgeon or anaesthetist that you are taking this medicine. It may affect other medicines used during surgery.
If you become pregnant or start to breastfeed while taking this medicine, tell your doctor immediately.
If you are about to have any blood tests, tell your doctor that you are taking this medicine. It may interfere with the results of some tests.
Keep all your doctor's appointments so that your progress can be checked. Your doctor may do some tests from time to time to make sure the medicine is working and to prevent unwanted side effects.
Make sure you drink enough water during exercise and hot weather especially if you sweat a lot. This will help you avoid any dizziness or light-headedness caused by a sudden drop in blood pressure.
Tell your doctor immediately if you notice any serious side effects, especially severe nausea or vomiting or stomach pain.
Things you must not do
Do not take this medicine to treat any other complaints unless your doctor tells you to.
Do not give your medicine to anyone else, even if they have the same condition as you.
Do not stop taking your medicine or change the dosage without checking with your doctor.
Things to be careful of
Be careful when driving or operating machinery until you know how this medicine affects you. You may feel light-headed or dizzy when you begin to take this medicine. This is because your blood pressure is falling. If you have these symptoms when standing up or getting out of bed, then getting up more slowly can help. This allows your body to get used to the change in position and blood pressure.
If you have these symptoms and they do not get better in a short time, then talk to your doctor.
Perindopril/indapamide contains a drug substance which may give a positive result in doping tests.
Tell your doctor as soon as possible if you do not feel well while you are taking perindopril/indapamide or if you have any questions or concerns.
All medicines can have side effects. Sometimes they are serious but most of the time they are not.
Do not be alarmed by the following lists of side effects. You may not experience any of them.
Tell your doctor or pharmacist if you notice any of the following and they worry you:
- a dry cough
- headache, dizziness, drowsiness, giddiness, numbness, tingling or pins and needles
- tinnitus (pain or ringing in the ears)
- hypotension (low blood pressure), palpitations, poor circulation in your hands and feet
- dry mouth, strange taste sensations, loss of appetite, flushing, constipation, diarrhoea
- feeling tired or weak or as if you have less energy
- feeling uncomfortable after eating, indigestion, feeling or being sick
- rash, itching, pimples on the skin
- runny or blocked nose, or nosebleeds
- muscle cramps, tenderness, weakness or spasms, weak legs
- back or joint pain
- altered mood, problems when sleeping or getting to sleep, or strange dreams
Tell your doctor as soon as possible if you notice any of the following:
- feeling depressed, anxious, confused or hearing or seeing things that are not there
- sexual problems e.g. erectile dysfunction or libido disorder
- kidney problems (i.e. cystitis, cloudy urine or problems urinating or urinating too much)
- sunburn following only a small exposure to the sun
- fine, broken blood vessels below the skin, or skin reactions which makes the skin look scalded.
- infections such as chest or throat infections, fever, severe chills or mouth ulcers
- itching blood vessels
- blurred or changed vision, short sightedness (myopia).
- decrease in vision or pain in your eyes due to high pressure (possible signs of fluid accumulation in the vascular layer of the eye or acute angle-closure glaucoma)
- worsening of psoriasis
The above list includes serious side effects that may require medical attention. Serious side effects are rare.
If you experience any of the following, stop taking your medicine and contact your doctor immediately or go to the Accident and Emergency department at your nearest hospital.
These are very serious side effects and you may need urgent medical attention or hospitalisation:
- purple spots with occasional blisters on the front of your arms and legs and/or around your neck and ears (a rare condition known as Stevens-Johnson syndrome)
- severe blisters, widespread skin rash, itching, skin reaction which makes the skin look scalded (can also be accompanied by fever and chills)
- other skin reactions such as red, often itchy spots, similar to the rash of measles, which starts on the limbs and sometimes on the face and the rest of the body
- a fast, slow or irregular heartbeat
- angina or chest pain, loss of consciousness
- sudden weakness or numbness of the face, arms or legs, especially on one side, slurred speech
- liver problems, yellowing of skin or eyes, or not passing any urine (symptoms of jaundice)
- feeling breathless or having problems breathing, or chest infections such as bronchitis or pneumonia
- severe pains in the stomach or upper stomach
- feeling or being very sick, or have a fever or high temperature
- concentrated urine (dark in colour), feeling sick, have muscle cramps, confusion and fits which may be due to inappropriate antidiuretic hormone (ADH) secretion
- symptoms of an allergic reaction including cough, shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue, throat or other parts of the body; rash, itching or hives on the skin.
Other side effects not listed above may occur in some patients.
Some of these side effects e.g. changes in the level of sugar, salt, calcium, potassium, urea or creatinine in blood, can only be found when your doctor does tests from time to time to check your progress.
Tell your doctor if you notice anything that is making you feel unwell.
Storage and disposal
Keep your medicine in its original packaging until it is time to take it.
If you take your medicine out of its original packaging it may not keep well.
Keep your medicine in a cool dry place where the temperature will stay below 25°C.
Do not store your medicine, or any other medicine, in the bathroom or near a sink. Do not leave it on a windowsill or in the car. Heat and dampness can destroy some medicines.
Keep this medicine where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
If your doctor tells you to stop taking this medicine or it has passed its expiry date, your pharmacist can dispose of the remaining medicine safely.
What GenRx Perindopril/ Indapamide 4/1.25 tablets looks like
Perindopril/ Indapamide 4/1.25 tablets:
White, capsule-shaped, biconvex tablets engraved "4/1.25" on one side and "APO" on the other side.
AUST R 127119.
Available in blister packs of 30 tablets.
Each tablet contains 4 mg of Perindopril erbumine and 1.25 mg indapamide hemihydrate as the active ingredients.
It also contains the following inactive ingredients:
- magnesium stearate.
This medicine is free from gluten, sucrose, tartrazine and other azo dyes.
Apotex Pty Ltd
16 Giffnock Avenue
Macquarie Park NSW 2113
This leaflet was last updated in July 2020.
Published by MIMS September 2020