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    Can Perindopril for high BP cause anaemia?

Posted on Sat, 13 Dec 2014 in Medicines and Side Effects
I have been diagnosed with anaemia at the end of August 2014 after fluttering sensations in my chest, neck pain and shoulder pain and having passed out in a restaurant. Perindopril was reduced from 4mg to 2mg and the symptoms haven't happened again. However, since that time my GP has sought to find out the cause of anaemia. So far I have undergone an endoscopy, a rectal investigation both of which have not revealed any problems. I am not iron deficient and have no B12 problems. I am to undergo a tilt test which I am self funding and now a colonoscopy even though I have recently had a clear result from a postal test just recently. I wonder what the possibility is of this anaemia being due to perindopril as I have been told it's only happened in the last year and this concides with the length of time I've been taking perindopril. I feel empty most of the time so my eating has increased and my once good diet has changed into a less healthy one. There are intermittent instances of constipation and stools that are bulky but not difficult to pass and not diarrhoea. Instances of nausea but no sickness. I am worried that there is something wrong with my bone marrow which is also linked in rare cases with perindopril.
Answered by Dr. Noble Zachariah 30 minutes later
Brief Answer:
rarely from hemolysis or bone marrow suppression

Detailed Answer:
Welcome to HCM and thank you for your query.
I understand your concern.
Because you motion is not black or bloody and your iron level is normal, I don't think you have a gastrointestinal bleeding as a cause of anemia.
Angiotensin converting enzyme inhibitor (ACEI) like Perindopril can produce anemia rarely from hemolysis, aplastic anemia or myelosuppression.
A simple way to differentiate would be to do a reticulocyte count. If it is high, it is due to hemolysis. If it is very low, it can be aplastic anemia or myelosuppression.
In myelosuppression WBC count and platelet count also will be decreased.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Noble Zachariah 1 hour later
How would I go about your suggestions? Thank you.
Answered by Dr. Noble Zachariah 6 minutes later
Brief Answer:
Please get the blood tests

Detailed Answer:
Any good lab would be able to do a CBC and a reticulocyte count.
I shall interpret the results for you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Noble Zachariah

Internal Medicine Specialist

Practicing since :1974

Answered : 2276 Questions


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