Aceon (perindopril erbumine) is an angiotensin-converting enzyme (ACE) inhibitor prescribed for the management of hypertension and stable coronary artery disease. As a prodrug, it is metabolized to its active form, perindoprilat, which effectively inhibits ACE, leading to reduced vasoconstriction and aldosterone secretion. This mechanism supports sustained blood pressure reduction and decreased cardiac afterload, making it a cornerstone in cardiovascular risk management. Clinical evidence supports its use in improving endothelial function and reducing cardiovascular events in appropriate patient populations.

Features

• Active ingredient: Perindopril erbumine
• Available in 2 mg, 4 mg, and 8 mg tablet strengths
• Once-daily dosing regimen for improved adherence
• Prodrug formulation with active metabolite perindoprilat
• Long half-life supporting 24-hour hemodynamic control
• Compatible with many antihypertensive combination therapies

Benefits

• Effectively lowers systolic and diastolic blood pressure through RAAS inhibition
• Reduces risk of myocardial infarction, stroke, and cardiovascular mortality in high-risk patients
• Improves endothelial function and vascular compliance
• Demonstrates cardioprotective effects in patients with stable coronary artery disease
• May slow progression of renal impairment in hypertensive patients with diabetes
• Provides sustained 24-hour blood pressure control with single daily dosing

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. The medication may be prescribed off-label for certain heart failure patients and for renal protection in diabetic nephropathy, though these uses require careful clinical consideration and monitoring.

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 based on blood pressure response. For elderly patients or those with renal impairment, starting with 2 mg once daily is advised. Tablets should be taken orally, with or without food, at approximately the same time each day. Dosage adjustments should be made gradually, with monitoring of blood pressure and renal function. For coronary artery disease, the maintenance dose is typically 8 mg once daily, though titration should be individualized based on patient tolerance and clinical response.

Precautions

Patients should be monitored for hypotension, especially during initiation and titration. Renal function and serum potassium should be assessed before and during treatment. Caution is advised in patients with renal artery stenosis, as ACE inhibitors may cause reversible increases in blood urea nitrogen and serum creatinine. Angioedema may occur at any time during treatment, requiring immediate discontinuation. Patients should be advised to avoid potassium supplements or salt substitutes containing potassium unless specifically recommended by their physician. Use with caution in patients with collagen vascular disease or those receiving immunosuppressive therapy.

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 in patients with diabetes is contraindicated. The medication is contraindicated during pregnancy, particularly in the second and third trimesters, due to risk of fetal injury. It should not be administered to patients with bilateral renal artery stenosis or stenosis to a solitary kidney.

Possible side effects

Common adverse reactions include cough (5-20%), dizziness (4-8%), headache (5-7%), and fatigue (2-5%). Less frequently, patients may experience orthostatic hypotension, hyperkalemia, rash, or gastrointestinal disturbances. Serious but rare side effects include angioedema, neutropenia/agranulocytosis, hepatic failure, and pancreatitis. Renal impairment may occur, particularly in volume-depleted patients or those with preexisting renal disease. Taste disturbance and photosensitivity have been reported in some patients.

Drug interaction

Concomitant use with diuretics may potentiate hypotension. NSAIDs may reduce the antihypertensive effect and increase risk of renal impairment. Potassium-sparing diuretics, potassium supplements, or salt substitutes may lead to hyperkalemia. Lithium levels may increase with concurrent ACE inhibitor use. Dual blockade of the RAAS with ARBs or aliskiren increases risk of hypotension, hyperkalemia, and renal impairment. Antidiabetic medications may require adjustment as ACE inhibitors can enhance hypoglycemic effects.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed one. Consistency in dosing is important for maintaining stable blood pressure control, but occasional missed doses are unlikely to cause significant clinical consequences given the medication’s long half-life.

Overdose

Symptoms of overdose may include severe hypotension, bradycardia, circulatory shock, electrolyte disturbances, and renal failure. Management involves supportive care with volume expansion with normal saline for hypotension. Hemodialysis may be effective in removing perindopril and perindoprilat. Bradycardia may require atropine administration. Patients should be monitored in an intensive care setting with continuous hemodynamic monitoring. Vasopressors may be necessary in cases of refractory hypotension.

Storage

Tablets should be stored at controlled room temperature (20-25°C or 68-77°F) in their original container, protected from light and moisture. Keep the medication out of reach of children and pets. Do not use tablets that appear discolored, damaged, or beyond the expiration date printed on the packaging. Proper disposal of unused medication should follow local regulations, typically through medication take-back programs rather than flushing or household trash.

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 response to medication may vary, and proper medical supervision is essential. Patients should not initiate, discontinue, or change dosage without consulting their physician. The complete prescribing information should be consulted before administration.

Reviews

Clinical studies demonstrate Aceon’s efficacy in blood pressure control, with 70-80% of patients achieving target blood pressure goals. Many physicians report good patient tolerance, though the characteristic ACE inhibitor cough remains a consideration. Long-term outcome studies show significant reduction in cardiovascular events in appropriate patient populations. Some patients note improved exercise tolerance and quality of life with stable blood pressure control. Adherence rates are generally favorable due to the once-daily dosing regimen.