Coversyl Plus (Perindopril + Indapamide)
Compared with: Blackmores Conceive Well Gold 28 Tablets + 28 Capsules

Coversyl Plus combines perindopril 4 mg (ACE inhibitor) and indapamide 1.25 mg (thiazide‑like diuretic) in a once‑daily tablet. It lowers blood pressure by inhibiting angiotensin II formation and promoting natriuresis, achieving superior systolic/diastolic reductions versus monotherapy with good tolerability
Experts@Minnesota

Perindopril Arginine 4 mg (equivalent to perindopril 3.5 mg)

Indapamide Hemihydrate 1.25 mg

Perindopril + Indapamide SPC
Preterax® (alternate brand)
Noliprel®
ACE‑I + Diuretic Combination
Perindopril is a prodrug converted hepatically to perindoprilat, a long‑acting ACE inhibitor that reduces angiotensin II formation and aldosterone secretion, leading to vasodilation and decreased blood volume

Indapamide is a thiazide‑like diuretic that inhibits distal tubular Na⁺–Cl⁻ reabsorption, causing natriuresis, mild diuresis, and direct vasodilation via calcium‑activated K⁺ channels

Essential Hypertension: First‑line or add‑on therapy to achieve target blood pressures.

High‑Risk Hypertensive Patients: Benefits in reducing stroke and cardiovascular events when added to ACE‑I monotherapy
Open Access Journals

Population Initial Dose Maintenance
Adults 1 tablet (4 mg/1.25 mg) once daily, morning May increase to 2 tablets (8 mg/2.5 mg) daily if needed
UpToDate Online
Elderly (>65 years) ½ tablet (2 mg/0.625 mg) once daily Titrate to 1 tablet daily with close monitoring
MedsInfo
Renal Impairment CrCl 30–60 mL/min: start ½ tablet once daily
CrCl <30 mL/min: contraindicated —
Hepatic Impairment Moderate: no adjustment
Severe: contraindicated —

Administration: Take orally in the morning, before food, with a glass of water.

Missed Dose: If <12 h before next dose, take as soon as remembered; otherwise skip.

Formulation: Film‑coated tablet

Strength: 4 mg perindopril + 1.25 mg indapamide

Packaging: 28 tablets per blister pack

Legal Status: Prescription Only

Pregnancy & Lactation: Contraindicated in pregnancy and breastfeeding due to teratogenic risk and diuretic effects.

Pediatric Use: Not established; use only under specialist guidance.

Elderly: Start low and titrate; monitor renal function and electrolytes.

Monitoring: Check BP, renal function, serum electrolytes (K⁺, Na⁺) periodically.
Dizziness, headache
Experts@Minnesota

Cough (ACE‑I class effect)

Orthostatic hypotension

Hypokalemia, hyponatremia

Serious:

Angioedema (ACE‑I)

Severe hyponatremia (diuretic)

Renal impairment or acute kidney injury

Hyperuricemia/gout exacerbation

Angioedema: Discontinue immediately if swelling of face, lips, or airway occurs.

Electrolyte Imbalance: Monitor and correct hypokalemia/hyponatremia before and during therapy.

Volume Depletion: Ensure euvolemia prior to initiation; adjust diuretic therapy if needed.

Renovascular Hypertension: Use with caution; risk of acute renal failure.

Therapeutic Class: Antihypertensive Combination

Pharmacologic Class: ACE Inhibitor + Thiazide‑Like Diuretic

Legal Category: Prescription Only

Concomitant Agent Interaction Recommendation
Potassium‑Sparing Diuretics / Supplements ↑Risk of hyperkalemia (perindopril) Monitor K⁺; avoid high‑dose supplements
NSAIDs ↓Antihypertensive effect; ↑renal impairment Monitor BP and renal function
Lithium ↓Renal clearance → lithium toxicity Monitor serum lithium
Digoxin Hypokalemia ↑arrhythmia risk Monitor electrolytes and ECG
Other Antihypertensives Additive hypotension Adjust doses; monitor hemodynamics
Corticosteroids / Amphotericin B ↑Hypokalemia risk (diuretic) Monitor electrolytes

PREMIER Study: Perindopril + Indapamide SPC achieved target BP (<140/90 mm Hg) in 68 % vs 45 % with perindopril monotherapy at 12 weeks (P < 0.001)
PMC
HYVET Sub‑Study: Addition of low‑dose indapamide to perindopril reduced stroke risk by 39 % versus placebo in elderly hypertensives
Open Access Journals

FAQs – Coversyl Plus (Perindopril + Indapamide)
Q1. How quickly will I see BP reduction?
A: Significant reduction often within 2 weeks; maximal effect by 4–6 weeks
Experts@Minnesota
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Q2. Can I take Coversyl Plus at bedtime?
A: Morning dosing minimizes orthostatic hypotension; avoid late‑day dosing.

Q3. What if I miss a dose?
A: Take as soon as remembered if >12 h before next dose; otherwise skip—do not double.

Q4. Is Coversyl Plus safe long‑term?
A: Long‑term studies demonstrate sustained BP control and cardiovascular risk reduction; monitor periodically.

Q5. Does Coversyl Plus cause cough?
A: ACE‑I component may cause dry cough in up to 10 %; consider switching class if persistent.

Q6. Can I drink alcohol?
A: Alcohol may enhance hypotensive effect; consume in moderation and monitor BP.

Q7. Do I need blood tests?
A: Yes—check renal function and electrolytes at baseline, 2 weeks, and quarterly.

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