Perindopril for BP is now giving me foot and leg swelling

Posted by ros2u1111 @ros2u1111, Feb 22 11:51pm

I was put on Coversil 4 (perindopril) 10 years ago when my BP was going up to 180 - 190. That kept my BP at around 140 although The dosage needed to be increased periodically to keep achieving this BP.

When the dosage was eventually increased to 10 mg, I started getting constant foot and leg swelling and BP that tended to often be up to 190 by mid 2024.

A GP added a sulfa diuretic in mid 2023 but I had side effects as I am allergic to drugs with sulfa. A new GP again tried to add a sulfa diuretic early in 2025 and I ended up not taking it and my BP climbed to 170 - 190 and my feet and legs remained very swollen with pitting oedema . Then, in mid 2025, this same GP put me on a combined tablet (Coveram) of 10 mg of perindopril plus 5 mg of amlodipine. Subsequently my feet and legs remain very swollen and my BP now varies from the low to high 100s.

This GP now wants to prescribe the sulfa diuretic again.

I have three main questions:
1. How do I stop doctors ignoring my allergies (mainly NSAIDS) and sulfa) despite my notifying them of this?
2. Why do doctors keep wanting to add a diuretic and not just take me off medications with perindopril?
3. Why am I being made to continue to have high BP and oedema (and now this unusual variable BP)?

Fortunately my heart is fine. I have had a couple of echo scans and no problems were found.

Interested in more discussions like this? Go to the Heart & Blood Health Support Group.

See a Cardiologist that has a lot of experience. I reduced my blood pressure by not having any processed food at all. NO salt in my food at all (tasteless but healthy). I take walks 2 to 3 miles per day. I lost 20 pounds in 8 weeks and now my BP is 130/84. I hope this helps.

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@manuelpo

See a Cardiologist that has a lot of experience. I reduced my blood pressure by not having any processed food at all. NO salt in my food at all (tasteless but healthy). I take walks 2 to 3 miles per day. I lost 20 pounds in 8 weeks and now my BP is 130/84. I hope this helps.

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I did the same, went on a low carb diet, lost 22 pounds (I'm not a large man, under 5' 9", so that was a chunk o' weight for me), but I have been active on my feet for decades. I still walked or ran for between 10-22 km each day, or maybe five days each week. So, I can vouch for changing habits as a potential cure for heart problems.

However, it was really the undiagnosed sleep apnea that was most of the problem for me. Weight, yes, and the cardiologist I saw about my fibrillating heart put me on metoprolol for two reasons: incipient hypertension and to control my rapid atrial firing when my heart decided it was cranky enough to want to fibrillate. The problem, the trigger, for the cranky heart, though, was sleep apnea. In my case, the polysomnography results was a devastating 'severe obstructive sleep apnea.' And I couldn't be called 'overweight' back when this happened....the weight gain came subsequently when I felt I couldn't risk taxing my heart with aerobic running.

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@gloaming

I did the same, went on a low carb diet, lost 22 pounds (I'm not a large man, under 5' 9", so that was a chunk o' weight for me), but I have been active on my feet for decades. I still walked or ran for between 10-22 km each day, or maybe five days each week. So, I can vouch for changing habits as a potential cure for heart problems.

However, it was really the undiagnosed sleep apnea that was most of the problem for me. Weight, yes, and the cardiologist I saw about my fibrillating heart put me on metoprolol for two reasons: incipient hypertension and to control my rapid atrial firing when my heart decided it was cranky enough to want to fibrillate. The problem, the trigger, for the cranky heart, though, was sleep apnea. In my case, the polysomnography results was a devastating 'severe obstructive sleep apnea.' And I couldn't be called 'overweight' back when this happened....the weight gain came subsequently when I felt I couldn't risk taxing my heart with aerobic running.

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I have "very severe sleep apnea too" I used CPAP machine for 2 years but can't use it anymore so a dental device I sleep with in my mouth is helping me a lot!

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Thank you for you replies, everybody. But maybe I am in the wrong group. I do not have a heart problem. I couldn’t find a group for high blood pressure before. Is there one? Sorry

Also I need to edit my original post as I got some of the years wrong. I am new here.

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@ros2u1111

Thank you for you replies, everybody. But maybe I am in the wrong group. I do not have a heart problem. I couldn’t find a group for high blood pressure before. Is there one? Sorry

Also I need to edit my original post as I got some of the years wrong. I am new here.

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This group would be appropriate for you. I have taken many blood pressure lowering meds over the past 20 years. I had unfortunate side effects with some. Ankle swelling, cough, dizziness or hypotension. You need to get onto a good cardiologist. There is no excuse for giving you meds that cause you problems. There are so many drugs that worked. With the help of a cardiologist, I am taking 3 drugs. I split doses of 2 of them am and pm and take a beta blocker in the am only. Blood pressure is well controlled and no side effects.

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@con123

This group would be appropriate for you. I have taken many blood pressure lowering meds over the past 20 years. I had unfortunate side effects with some. Ankle swelling, cough, dizziness or hypotension. You need to get onto a good cardiologist. There is no excuse for giving you meds that cause you problems. There are so many drugs that worked. With the help of a cardiologist, I am taking 3 drugs. I split doses of 2 of them am and pm and take a beta blocker in the am only. Blood pressure is well controlled and no side effects.

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Thank you for your reply. I hope everything works out well for you.

Sorry for the delay in replying. I haven’t been feeling at all well and we have had a cyclone here in Australia to deal with.

The main reason I thought I might be in the wrong group was that I don’t have a heart problem. I had thought this group must be the one I should join but I’m now thinking I must have got that wrong as my concern is to do with medication for my high blood pressure. I still am not sure about what to do.

I have gone to see another GP and told him about my allergies to sulfa and nsaids and that I am not happy with my current BP medication, especially that I have had constant, pronounced oedema in both legs and feet for especially the last 2 years, firstly when I was put on 10mg of perindopril and continuing when this was changed to 10/5 mg of one tablet of perindopril and amlodopine . The change to the combined tablet also resulted in my BP coming down from a constant 170 - 190 to a BP that varied from 110 to 180 plus constant dizziness.

The GP I saw today wants me to go on Telmisartan instead. This is despite my sulfa allergy and his response to my reminding me about this was to say it didn’t have sulfa to be concerned about and it was hard to find the right BP medication for me. I am left concerned about side effects as, when an earlier GP had added Telmisartan to 10 mg of perindopril because my BP was very high and my legs and feet were swollen, I got very challenging side effects. I went off the telmisartan after 10 days of suffering I presumed was from it and still think so. The side effects stopped after I went off it.

I feel the new GP is pushing/ manipulating me into taking the telmisartan again. But I am dreading a repeat of the side effects. I could go back and try to talk to him about this. But I know he is happy with his decision and I found it hard to have a good conversation with it about him already, today. At one stage, when I was trying to talk sensibly about my concerns about taking a sulfa drug, he started playing what seemed to me like irrelevant and incomprehensible, diversionary word game with talk about the periodic table and sulfa, etc , when what I wanted was to resolve was the sulfa issue.

My BP when I visited him today was 167 and he said this was a good result for me. He also suggested I had a vascular (?) condition that led to the leg and foot swelling, but I am not aware that I have this.

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Could you start on a half-dose of what he intends you to be when you can take the entire dose? Just as it helps to get off many drugs by 'weaning' oneself off them over anywhere from a week to many weeks, maybe you can build a tolerance to the sulfa component by exposing yourself to low doses for a while, and then in increments over, say, a ten week period?

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