Black Box Warning

Fetal toxicity: Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Potentially fatal neonatal hypotension, anuria, and renal failure have been reported. When pregnancy is detected, discontinue perindopril as soon as possible.