Drug interactions
Perindopril + Torsemide
Severity: Moderate
Perindopril and Torsemide: 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
Adding an ACE inhibitor to a loop diuretic can cause a marked drop in blood pressure, particularly after the first dose in patients who are volume depleted. Renal function may also decline because of reduced glomerular filtration pressure.
What this interaction means in plain words
Perindopril and Torsemide 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; Torsemide belongs to Cardiovascular.
Why it happens
Additive hemodynamic effects: diuretic-induced volume and sodium depletion activates the renin-angiotensin system, and ACE inhibition removes efferent arteriolar compensation.
What to do
Start the ACE inhibitor at a low dose, consider temporarily lowering the diuretic dose, and monitor blood pressure, creatinine and potassium within the first weeks.
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 Torsemide
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
Frequently asked questions
Can I take Perindopril with Torsemide?
MediHelp rates the interaction as moderate. Perindopril and Torsemide 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. Adding an ACE inhibitor to a loop diuretic can cause a marked drop in blood pressure, particularly after the first dose in patients who are volume depleted. Renal function may also decline because of reduced glomerular filtration pressure.
How serious is the interaction between Perindopril and Torsemide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start the ACE inhibitor at a low dose, consider temporarily lowering the diuretic dose, and monitor blood pressure, creatinine and potassium within the first weeks.
What other medicines interact with Torsemide?
MediHelp also lists interactions of Torsemide with, for example, Amikacin, Amiodarone, Carbenoxolone. The full list is on the Torsemide page.
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