Aceon (perindopril erbumine) is an angiotensin-converting enzyme (ACE) inhibitor specifically formulated for the management of hypertension and stable coronary artery disease. This prescription medication works by relaxing blood vessels, allowing blood to flow more smoothly and the heart to pump more efficiently. Clinical evidence supports its role in reducing cardiovascular mortality and morbidity in patients with demonstrated coronary artery disease. Its unique pharmacokinetic profile offers sustained 24-hour blood pressure control with a single daily dose, making it a cornerstone in modern antihypertensive therapy.

Features

• Active pharmaceutical ingredient: Perindopril erbumine
• Available in tablet strengths: 2 mg, 4 mg, and 8 mg
• Prodrug that is hydrolyzed to perindoprilat, the active metabolite
• Once-daily dosing regimen for improved adherence
• Long half-life of active metabolite (approximately 3-10 hours) with prolonged ACE inhibition
• Exhibits linear pharmacokinetics over the therapeutic dose range

Benefits

• Provides consistent 24-hour blood pressure control, reducing peak-trough variability
• Demonstrates proven reduction in cardiovascular events in patients with established coronary artery disease
• Improves endothelial function and vascular compliance beyond blood pressure lowering
• Shows beneficial effects on left ventricular hypertrophy regression
• Offers flexible dosing options to accommodate individual patient needs and response
• Generally well-tolerated profile with established safety data from extensive clinical use

Common use

Aceon is primarily indicated for the treatment of hypertension, either as monotherapy or in combination with other antihypertensive agents. It is also approved for use in patients with stable coronary artery disease to reduce the risk of cardiovascular mortality and nonfatal myocardial infarction. Additionally, it may be used as part of a comprehensive management strategy for heart failure patients, though this represents an off-label application. The medication is particularly valuable in elderly hypertensive patients and those with concomitant diabetes due to its protective effects on target organs.

Dosage and direction

The recommended initial dose for hypertension is 4 mg once daily, which may be increased to 8 mg once daily after at least two weeks of therapy based on blood pressure response. For elderly patients or those with renal impairment, starting with 2 mg once daily is advised. The dosage should be titrated gradually, with monitoring of blood pressure and renal function. Tablets should be taken orally, with or without food, at approximately the same time each day. For coronary artery disease, the maintenance dose is typically 8 mg once daily, though therapy should be initiated at 4 mg once daily for two weeks before increasing to 8 mg once daily.

Precautions

Patients should be monitored for hypotension, especially following the initial dose and during dose titration. Renal function and serum potassium should be assessed before initiation and periodically during therapy. Caution is advised in patients with renal artery stenosis, as ACE inhibitors may cause increased blood urea and serum creatinine. Patients should be advised against using potassium supplements or salt substitutes containing potassium without medical supervision. Angioedema may occur at any time during treatment and requires immediate discontinuation. Neutropenia/agranulocytosis has been reported with ACE inhibitors, particularly in patients with renal impairment or collagen vascular disease.

Contraindications

Aceon is contraindicated in patients with a history of angioedema related to previous ACE inhibitor therapy. It should not be used in patients with hereditary or idiopathic angioedema. Concomitant use with aliskiren-containing products is contraindicated in patients with diabetes. The medication is contraindicated in patients with hypersensitivity to perindopril or any other ACE inhibitor. It should not be used during pregnancy, particularly in the second and third trimesters, due to the risk of fetal injury and death.

Possible side effects

Common adverse reactions include cough (characteristically dry and persistent), dizziness, headache, and fatigue. Gastrointestinal effects such as nausea, vomiting, diarrhea, or abdominal pain may occur. Less frequently, patients may experience rash, taste disturbance, or orthostatic hypotension. Serious but rare side effects include angioedema, hyperkalemia, neutropenia/agranulocytosis, and hepatic failure. Renal impairment, including acute renal failure, may occur, particularly in volume-depleted patients or those with renal artery stenosis.

Drug interaction

Concomitant use with diuretics may potentiate hypotension. NSAIDs may reduce the antihypertensive effect and increase the risk of renal impairment. Potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium may lead to significant hyperkalemia. Lithium levels may increase when coadministered with ACE inhibitors. Dual blockade of the renin-angiotensin system with ARBs or aliskiren increases the risk of hypotension, hyperkalemia, and renal impairment. Antidiabetic medications may require dosage adjustment as ACE inhibitors may enhance their hypoglycemic effects.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. If it is nearly time for the next dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed dose. Consistent daily administration is important for maintaining stable blood pressure control, and patients should be educated about the importance of adherence to prescribed therapy.

Overdose

Symptoms of overdose may include severe hypotension, circulatory shock, electrolyte disturbances, and renal failure. Bradycardia may also occur. Management should include supportive measures with emphasis on correction of hypotension through volume expansion with normal saline. Perindopril may be removed from the body by hemodialysis. Patients should be monitored in an intensive care setting with continuous blood pressure and ECG monitoring. Vasopressors may be required in cases of profound hypotension.

Storage

Aceon tablets should be stored at controlled room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). The medication should be kept in its original container, tightly closed, and protected from light and moisture. Tablets should be kept out of reach of children and pets. Unused medication should be properly disposed of according to local regulations, and patients should not use tablets beyond the expiration date printed on the packaging.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Aceon is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual patient response may vary, and treatment decisions should be based on the healthcare provider’s assessment of the specific clinical situation. Patients should not initiate, discontinue, or change dosage without consulting their physician. The complete prescribing information should be consulted before initiating therapy.

Reviews

Clinical studies have demonstrated Aceon’s efficacy in reducing both systolic and diastolic blood pressure with once-daily dosing. The EUROPA study, involving over 12,000 patients, showed a 20% reduction in cardiovascular mortality and nonfatal myocardial infarction in patients with stable coronary artery disease. Real-world evidence supports good tolerability, though the characteristic ACE inhibitor cough remains a consideration in some patients. Many clinicians appreciate its metabolic neutrality and protective effects in diabetic patients. Long-term follow-up data confirm sustained antihypertensive efficacy and cardiovascular protection over extended treatment periods.