Peripil 4 Side effects

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What are the possible side effects of Peripil 4?

Get emergency medical help if you have any of these signs of an allergic reaction to Peripil 4: hives; severe stomach pain, difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

Common Peripil 4 side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side effects of Peripil 4 in details

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Because clinical trials are conducted under widely varying conditions, adverse event rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Clinical Trials Experience

The following adverse reactions are discussed elsewhere in labeling:

Hypertension

Peripil 4 has been evaluated for safety in approximately 3,400 patients with hypertension in U.S. and foreign clinical trials. The data presented here are based on results from the 1,417 Peripil 4-treated patients who participated in the U.S. clinical trials. Over 220 of these patients were treated with Peripil 4® (Peripil 4) for at least one year.

In placebo-controlled U.S. clinical trials, the incidence of premature discontinuation of therapy due to adverse events was 6.5% in patients treated with Peripil 4 and 6.7% in patients treated with placebo. The most common causes were cough, headache, asthenia and dizziness.

Among 1,012 patients in placebo-controlled U.S. trials, the overall frequency of reported adverse events was similar in patients treated with Peripil 4 and in those treated with placebo (approximately 75% in each group). The only adverse events whose incidence on Peripil 4 was at least 2% greater than on placebo were cough (12% vs. 4.5%) and back pain (5.8% vs. 3.1%).

Dizziness was not reported more frequently in the Peripil 4 group (8.2%) than in the placebo group (8.5%), but its likelihood increased with dose, suggesting a causal relationship with Peripil 4.

Stable Coronary Artery Disease

Peripil 4 has been evaluated for safety in EUROPA, a double-blind, placebo-controlled study in 12,218 patients with stable coronary artery disease. The overall rate of discontinuation was about 22% on drug and placebo. The most common medical reasons for discontinuation that were more frequent on Peripil 4 than placebo were cough, drug intolerance and hypotension.

Postmarketing Experience

Voluntary reports of adverse events in patients taking Peripil 4 that have been received since market introduction and are of unknown causal relationship to Peripil 4 include: cardiac arrest, eosinophilic pneumonitis, neutropenia/agranulocytosis, pancytopenia, anemia (including hemolytic and aplastic), thrombocytopenia, acute renal failure, nephritis, hepatic failure, jaundice (hepatocellular or cholestatic), symptomatic hyponatremia, bullous pemphigoid, pemphigus, acute pancreatitis, falls, psoriasis, exfoliative dermatitis and a syndrome which may include: arthralgia/arthritis, vasculitis, serositis, myalgia, fever, rash or other dermatologic manifestations, a positive antinuclear antibody (ANA), leukocytosis, eosinophilia or an elevated erythrocyte sedimentation rate (ESR).

Clinical Laboratory Test Findings

Hematology

Small decreases in hemoglobin and hematocrit occur frequently in hypertensive patients treated with Peripil 4, but are rarely of clinical importance. In controlled clinical trials, no patient was discontinued from therapy due to the development of anemia. Leukopenia (including neutropenia) was observed in 0.1% of patients in U.S. clinical trials.

Liver Function Tests

Elevations in ALT (1.6% Peripil 4 versus 0.9% placebo) and AST (0.5% Peripil 4 versus 0.4% placebo) have been observed in placebo-controlled clinical trials. The elevations were generally mild and transient and resolved after discontinuation of therapy.

What is the most important information I should know about Peripil 4?

Peripil 4 contraindications

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Hypersensitivity to Peripil 4 or to any of the excipients of Peripil 4 or to any other ACE inhibitor; history of angioedema associated with previous ACE inhibitor therapy; hereditary or idiopathic angioedema.

Due to the presence of lactose, patients with rare hereditary problems of galactose intolerance, glucose-galactose malabsorption, or the Lapp lactase deficiency should not take Peripil 4.

Use in pregnancy: Peripil 4 should not be used during the 1st trimester of pregnancy. When a pregnancy is planned or confirmed, the switch to an alternative treatment should be initiated as soon as possible. Controlled studies with ACE inhibitors have not been done in humans, but in a limited number of cases with 1st trimester exposure, there do not appear to have been any malformations consistent with human foetotoxicity as described as follows.

Peripil 4 is contraindicated during the 2nd and 3rd trimesters of pregnancy.

Prolonged ACE inhibitor exposure during the 2nd and 3rd trimesters is known to induce human foetotoxicity (decreased renal function, oligohydramnios, skull ossification retardation) and neonatal toxicity (renal failure, hypotension, hyperkalaemia).

Should exposure to Peripil 4 have occurred from the 2nd trimester of pregnancy, ultrasound check of renal function and skull is recommended.


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References

  1. European Chemicals Agency - ECHA. "1H-Indole-2-carboxylic acid, 1-[(2S)-2-[[(1S)-1-(ethoxycarbonyl)butyl]amino]-1-oxopropyl]octahydro-, (2S,3aS,7aS): The European Chemicals Agency (ECHA) is an agency of the European Union which is the driving force among regulatory authorities in implementing the EU's groundbreaking chemicals legislation for the benefit of human health and the environment as well as for innovation and competitiveness.". https://echa.europa.eu/ (accessed September 17, 2018).
  2. NCIt. "Perindopril: NCI Thesaurus (NCIt) provides reference terminology for many systems. It covers vocabulary for clinical care, translational and basic research, and public information and administrative activities.". https://ncit.nci.nih.gov/ncitbrowser... (accessed September 17, 2018).
  3. KEGG. "Target-based classification of drugs". http://www.genome.jp/kegg-bin/get_ht... (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Peripil 4 are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Peripil 4. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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