What kind of interaction is it?

Caution: an interaction that may reduce efficacy or raise side-effect risk and warrants monitoring.

Is this interaction backed by published research?

Yes. NutriStack lists 1 citation row for the Iron + Perindopril pair, each linking to PubMed by PMID where available. Full sourcing methodology at https://nutristackapp.com/methodology/interactions.

Supplement × Prescription·a caution·Emerging evidence

Iron + Perindopril

Q: Can I take Iron and Perindopril together?

Possibly, but with caution. Iron and Perindopril have a documented caution-tier interaction. ACE inhibitors are associated with a dry cough thought to involve bradykinin and substance P accumulation. Small studies suggest oral or intravenous iron may reduce ACE-inhibitor-induced cough, possibly via inhibition of nitric oxide synthase. While not harmful, this interaction is generally minor; the more practical concern is that iron salts and other supplements should be spaced from medications to avoid theoretical reductions in absorption.

Q: How does this affect a NutriStack Stack Score?

-5 to your Stack Score per scored caution row.

Caution Emerging evidence

ACE inhibitors are associated with a dry cough thought to involve bradykinin and substance P accumulation. Small studies suggest oral or intravenous iron may reduce ACE-inhibitor-induced cough, possibly via inhibition of nitric oxide synthase. While not harmful, this interaction is generally minor; the more practical concern is that iron salts and other supplements should be spaced from medications to avoid theoretical reductions in absorption.

Supplement × Prescription

Open the interaction checker → Read the methodology

From the database

What the row says.

Every entry follows the same shape: what is happening, the mechanism, and the recommendation.

Substances

Iron and Perindopril

Pair type

Caution

Evidence

Emerging

Source citations

Scope

Supplement × Prescription

Last verified

June 4, 2026

CautionEmerging evidence

What is happening. ACE inhibitors are associated with a dry cough thought to involve bradykinin and substance P accumulation. Small studies suggest oral or intravenous iron may reduce ACE-inhibitor-induced cough, possibly via inhibition of nitric oxide synthase. While not harmful, this interaction is generally minor; the more practical concern is that iron salts and other supplements should be spaced from medications to avoid theoretical reductions in absorption.

Mechanism. Iron may attenuate ACE-inhibitor-related cough by inhibiting nitric oxide synthase, reducing nitric oxide and bradykinin-mediated airway sensitivity; separately, polyvalent iron cations can chelate or bind co-ingested drugs and reduce their absorption.

Recommendation. No routine avoidance is needed. If taking iron for anemia, separate iron dosing from perindopril by about 2 hours as a general practice to minimize any absorption interference. Do not start iron specifically to treat ACE-inhibitor cough without clinician advice; persistent cough should be discussed with a prescriber, as switching agents is the standard approach.

Timing

Timing & separation.

Space the doses apart by at least this window to avoid the conflict.

Minimum separation

120

Stack Score

How it moves the number.

Effect on the composite score

If both Iron and Perindopril are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).

The full algorithm, the clamping rules, and four worked stacks are at /methodology/stack-score.

Sources

Sources, by evidence tier.

Every claim on this page is cited. PMIDs link straight to PubMed.

Reference material

1Lee SC, Park SW, Kim DK, Lee SH, Hong KP. Iron supplementation inhibits cough associated with ACE inhibitors. Hypertension. 2001.Needs sourceNo link

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One pair was the worked example.

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