Drug interactions
Perindopril + Tolbutamide
Severity: Moderate
Perindopril and Tolbutamide: moderate 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
ACE inhibitors can improve insulin sensitivity and may increase the glucose-lowering effect of sulfonylureas. Hypoglycemia can occur, mainly after starting the ACE inhibitor.
What this interaction means in plain words
Perindopril and Tolbutamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Perindopril belongs to Cardiovascular; Tolbutamide belongs to Endocrine.
Why it happens
Enhanced insulin sensitivity, possibly via increased bradykinin, adds to sulfonylurea-induced insulin secretion.
What to do
Monitor blood glucose closely in the first weeks of combined therapy. Lower the tolbutamide dose if hypoglycemia occurs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Perindopril
- Aliskiren + Perindopril Contraindicated
- Perindopril + Protein a column Contraindicated
- Perindopril + Sacubitril / valsartan Contraindicated
- Perindopril + Sacubitril-valsartan Contraindicated
- Amifostine + Perindopril Major
- Amiloride + Perindopril Major
Other interactions of Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Acetylsalicylic acid + Tolbutamide Moderate
- Albiglutide + Tolbutamide Moderate
Frequently asked questions
Can I take Perindopril with Tolbutamide?
MediHelp rates the interaction as moderate. Perindopril and Tolbutamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. ACE inhibitors can improve insulin sensitivity and may increase the glucose-lowering effect of sulfonylureas. Hypoglycemia can occur, mainly after starting the ACE inhibitor.
How serious is the interaction between Perindopril and Tolbutamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose closely in the first weeks of combined therapy. Lower the tolbutamide dose if hypoglycemia occurs.
What other medicines interact with Perindopril?
MediHelp also lists interactions of Perindopril with, for example, Aliskiren, Protein a column, Sacubitril / valsartan. The full list is on the Perindopril page.
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