Pharmacokinetics of perindopril in high-risk populations.

The aim of this article is to review the pharmacokinetics of perindopril and its active metabolite perindoprilat in high-risk populations in comparison with their basic features in healthy volunteers. As it has been shown that the kinetics of perindoprilat are mainly affected by renal insufficiency, a dosage reduction is therefore recommended on initiation of treatment in elderly patients and in those with renal failure according to the degree of renal failure. In patients with chronic heart failure, the kinetics of both perindopril and perindoprilat were shown to have been altered, also indicating the need for an initial dosage reduction in such patients. Hepatic impairment had no significant effect on the kinetics of either the prodrug or the active metabolite.