Drug interactions
Perindopril + Protein a column
Severity: Contraindicated
Perindopril and Protein a column: contraindicated interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Patients on ACE inhibitors who undergo apheresis with a protein A immunoadsorption column can develop anaphylactoid reactions such as flushing, hypotension and dyspnea. Bradykinin accumulates because ACE inhibition prevents its breakdown, and the column activates the kinin system.
What this interaction means in plain words
Perindopril and Protein a column are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
ACE inhibition blocks kininase II degradation of bradykinin, which is increased by column-mediated contact activation, causing anaphylactoid reactions.
What to do
Avoid the combination; stop the ACE inhibitor well before the procedure (about 72 hours per labeling) or use an alternative antihypertensive class. Consider a different apheresis membrane if the ACE inhibitor cannot be stopped.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Perindopril
- Aliskiren + Perindopril Contraindicated
- Perindopril + Sacubitril / valsartan Contraindicated
- Perindopril + Sacubitril-valsartan Contraindicated
- Amifostine + Perindopril Major
- Amiloride + Perindopril Major
- Amlodipine-hydrochlorothiazide-valsartan + Perindopril Major
Frequently asked questions
Can I take Perindopril with Protein a column?
MediHelp rates the interaction as contraindicated. Perindopril and Protein a column are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Patients on ACE inhibitors who undergo apheresis with a protein A immunoadsorption column can develop anaphylactoid reactions such as flushing, hypotension and dyspnea. Bradykinin accumulates because ACE inhibition prevents its breakdown, and the column activates the kinin system.
How serious is the interaction between Perindopril and Protein a column?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; stop the ACE inhibitor well before the procedure (about 72 hours per labeling) or use an alternative antihypertensive class. Consider a different apheresis membrane if the ACE inhibitor cannot be stopped.
What other medicines interact with Perindopril?
MediHelp also lists interactions of Perindopril with, for example, Aliskiren, Sacubitril / valsartan, Sacubitril-valsartan. The full list is on the Perindopril page.
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