Take the next dose at the usual time and continue as normal. Then take the next dose at the usual time and continue as normal. Do not try to make up for missed doses by taking more than one dose at a time. The most likely effect in case of overdose is low blood pressure which can make you feel dizzy or faint.
If this happens, lying down with the legs elevated can help. Other effects like sickness, cramps, sleepiness, confusion, kidney problems, salt and water disturbances are possible. You may require urgent medical attention. You may require urgent medical attention. Telephone your doctor or the Poisons Information Centre 13 11 26 in Australia; 03 in New Zealand , or go to the Accident and Emergency department at your nearest hospital.
Do this even if there are no signs of discomfort or poisoning. Otherwise you may not get the benefits from treatment. 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. 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. Low white blood cell levels may increase your risk for infection. If you notice any signs of infection e. People taking perindopril may develop a dry, persistent cough that usually disappears only after stopping this medication.
Occasionally, blood pressure drops too low after taking this medication, especially when getting up from a sitting or lying position. This may lead to fainting. It is more common after the first or second dose, when the dose is increased, or when a person is dehydrated.
To reduce the risk of dizziness, get up slowly from a lying down or sitting position. If low blood pressure causes you to faint or feel lightheaded, contact your doctor. Indapamide may make it more difficult for people with diabetes to control their blood sugar. Disorders of the blood, kidney, liver or pancreas and changes in laboratory parameters blood tests can occur. Your doctor may need to give you blood tests to monitor your condition. In cases of hepatic insufficiency liver problems , there is a possibility of onset of hepatic encephalopathy degenerative disease in the brain.
Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: By reporting side effects, you can help provide more information on the safety of this medicine.
How to store Coversyl Arginine Plus Keep out of the sight and reach of children. Do not use Coversyl Arginine Plus after the expiry date which is stated on the carton and container. The patient should be under close medical supervision until complete and sustained resolution of symptoms has occurred. Patients with a history of angioedema unrelated to ACE inhibitor therapy may be at increased risk of angioedema while receiving an ACE inhibitor see section 4.
Intestinal angioedema has been reported rarely in patients treated with ACE inhibitors. These patients presented with abdominal pain with or without nausea or vomiting ; in some cases there was no prior facial angioedema and C-1 esterase levels were normal.
The angioedema was diagnosed by procedures including abdominal CT scan, or ultrasound or at surgery and symptoms resolved after stopping the ACE inhibitor.
Intestinal angioedema should be included in the differential diagnosis of patients on ACE inhibitors presenting with abdominal pain. Rarely, patients receiving ACE inhibitors during low-density lipoprotein LDL apheresis with dextran sulphate have experienced life-threatening anaphylactoid reactions.
These reactions were avoided by temporarily withholding ACE inhibitor therapy prior to each apheresis. Anaphylactic reactions during desensitisation: Patients receiving ACE inhibitors during desensitisation treatment e.
In the same patients, these reactions have been avoided when the ACE inhibitors were temporarily withheld, but they reappeared upon inadvertent rechallenge. Rarely, ACE inhibitors have been associated with a syndrome that starts with cholestatic jaundice and progresses to fulminant hepatic necrosis and sometimes death.
The mechanism of this syndrome is not understood. Patients receiving ACE inhibitors who develop jaundice or marked elevations of hepatic enzymes should discontinue the ACE inhibitor and receive appropriate medical follow-up see section 4. In patients with normal renal function and no other complicating factors, neutropenia occurs rarely. Perindopril should be used with extreme caution in patients with collagen vascular disease, immunosuppressant therapy, treatment with allopurinol or procainamide, or a combination of these complicating factors, especially if there is pre-existing impaired renal function.
Some of these patients developed serious infections, which in a few instances did not respond to intensive antibiotic therapy. If perindopril is used in such patients, periodic monitoring of white blood cell counts is advised and patients should be instructed to report any sign of infection e. ACE inhibitors cause a higher rate of angioedema in black patients than in non-black patients. As with other ACE inhibitors, perindopril may be less effective in lowering blood pressure in black people than in non-blacks, possibly because of a higher prevalence of low-renin states in the black hypertensive population.
Cough has been reported with the use of ACE inhibitors. Characteristically, the cough is non-productive, persistent and resolves after discontinuation of therapy.
ACE inhibitor-induced cough should be considered as part of the differential diagnosis of cough. In patients undergoing major surgery or during anaesthesia with agents that produce hypotension, Coversyl arginine may block angiotensin II formation secondary to compensatory renin release.
Monitor blood pressure and adapt antihypertensive dosage if necessary. Your doctor will monitor you while you are taking this medication and may need to adjust your doses of antidiabetes medications. If you experience symptoms of fluid and electrolyte imbalance such as muscle pains or cramps; dry tablet numb hands, feet, or lips; or racing heartbeat, contact your doctor as soon as possible. If this happens, lying down with the legs elevated can help. When pregnancy is diagnosed, treatment with ACE inhibitors should be stopped immediately, and, if appropriate, alternative therapy should be started see sections 4. Pregnancy ACE inhibitors should not be initiated during pregnancy. As a result the ability to drive or operate machinery may be impaired. Characteristically, the cough is non-productive, persistent and resolves after discontinuation of therapy. Coversyl Arginine Plus is a combination of two active ingredients, perindopril and indapamide. Cough, often described as dry and irritating, coversyl plus 4/1.25mg 30 tablet, shortness of breath, discomfort on exertion Nosebleeds Headache, dizziness, vertigo, pins and needles Feeling coversyl or weak Tinnitus persistent noise in the earsvertigo, vision impairment Low blood pressure and related effectscoversyl plus 4/1.25mg 30 tablet, flushing, impaired peripheral circulation, vasculitis Nausea, vomiting, taste disturbances, indigestion, diarrhoea, constipation, stomach pain or discomfort Dry mouth. Plasma potassium and ECG should be monitored and, if necessary, treatment reviewed. Do not give it to anyone else under any circumstances. When pregnancy is diagnosed, treatment with ACE inhibitors should be 4/1.25mg immediately, and, if appropriate, alternative therapy should be started. It has been reported in the literature that in patients with established atherosclerotic disease, heart failure, or with diabetes with end organ damage, concomitant therapy with an ACE inhibitor and an angiotensin-receptor blocker is associated with a higher frequency of hypotension, syncope, hyperkalaemia, and worsening renal function including acute renal failure as compared to use of a single renin-angiotensin-aldosterone system agent. Do not breast-feed if you are taking this medication.
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