Aceon (perindopril erbumine) is an angiotensin-converting enzyme (ACE) inhibitor prescription medication specifically formulated for the management of hypertension. It represents a cornerstone in cardiovascular therapeutic regimens, offering a mechanism of action that targets the renin-angiotensin-aldosterone system (RAAS) to effectively reduce elevated blood pressure. By inhibiting the conversion of angiotensin I to the potent vasoconstrictor angiotensin II, Aceon facilitates vasodilation, decreased vascular resistance, and a reduction in aldosterone secretion, leading to a sustained antihypertensive effect. Its clinical profile is supported by extensive research, making it a trusted choice for physicians seeking to mitigate the long-term risks associated with uncontrolled hypertension, including stroke, myocardial infarction, and renal complications.

Features

• Active Pharmaceutical Ingredient: Perindopril Erbumine.
• Pharmacological Class: Angiotensin-Converting Enzyme (ACE) Inhibitor.
• Available Dosage Strengths: 2 mg, 4 mg, and 8 mg tablets.
• Standard Packaging: Bottles of 90 and 100 tablets, and unit-dose blister packs.
• Mechanism of Action: Competitive inhibition of ACE, preventing the conversion of angiotensin I to angiotensin II.
• Bioavailability: Approximately 75% of perindopril is bioavailable following oral administration, with peak plasma concentrations reached within 1 hour. Perindoprilat, the active metabolite, peaks in 3 to 7 hours.
• Elimination Half-Life: The active metabolite, perindoprilat, has an effective half-life of approximately 24 hours, supporting once-daily dosing.
• Excretion: Primarily renal.

Benefits

• Effective Blood Pressure Reduction: Provides consistent 24-hour hemodynamic control with a single daily dose, helping patients achieve and maintain target blood pressure goals as outlined in clinical guidelines.
• Cardiorenal Protection: Offers protective benefits for the heart and kidneys beyond mere blood pressure lowering, potentially reducing the risk of subsequent cardiovascular events and slowing the progression of certain types of nephropathy.
• Vascular Endothelial Improvement: Contributes to the improvement of endothelial function and vascular structure, addressing underlying pathophysiology of hypertension.
• Afterload Reduction in Heart Failure: Used as adjunctive therapy in the management of stable coronary artery disease and chronic heart failure to decrease cardiac afterload and improve hemodynamics.
• Favorable Metabolic Profile: Generally neutral with respect to glucose metabolism and lipid profiles, making it suitable for hypertensive patients with concomitant type 2 diabetes or metabolic syndrome.

Common use

Aceon (perindopril) is indicated for the treatment of essential hypertension. It may be used as monotherapy or concomitantly with other antihypertensive agents, such as thiazide diuretics or calcium channel blockers, to achieve additive blood pressure-lowering effects. It is also indicated for the reduction of risk of cardiovascular mortality or nonfatal myocardial infarction (MI) in patients with stable coronary artery disease.

Dosage and direction

Dosage must be individualized based on the patient’s blood pressure response and clinical status. The recommended initial dosage for hypertensive patients not on diuretic therapy is 4 mg once daily. Dosage may be titrated upward until blood pressure is controlled, typically at intervals of at least 2 weeks. The usual maintenance dosage is 4 mg to 8 mg administered once daily. Some patients may benefit from a divided dosage schedule. For patients on a diuretic, the diuretic should be discontinued, if possible, 2 to 3 days before initiating Aceon to reduce the potential for volume depletion and hypotension. If blood pressure is not controlled, the diuretic may be reinstituted. Doses above 16 mg per day have not been shown to provide greater efficacy. Tablets should be taken orally, with or without food.

Precautions

• Hypotension: Symptomatic hypotension may occur following the initial dose, particularly in patients who are volume- or salt-depleted (e.g., those on high-dose diuretic therapy). Correct volume depletion prior to administration.
• Impaired Renal Function: Monitor renal function before and during therapy. Dosage adjustment is recommended in patients with renal impairment. ACE inhibitors may cause increases in serum creatinine and BUN.
• Hyperkalemia: Elevations in serum potassium may occur. Risk factors include renal insufficiency, diabetes, and concomitant use of potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium.
• Cough: A persistent, nonproductive cough has been associated with ACE inhibitor use and may necessitate discontinuation of therapy.
• Surgery/Anesthesia: ACE inhibitors may potentiate the hypotensive effects of anesthesia and analgesic agents. The cardiologist and anesthesiologist should be aware of ACE inhibitor use.
• Hepatic Failure: Rarely, ACE inhibitors have been associated with a syndrome that starts with cholestatic jaundice and progresses to fulminant hepatic necrosis. Discontinue Aceon if jaundice or marked elevations of hepatic enzymes occur.

Contraindications

Aceon is contraindicated in patients with:

• A history of hypersensitivity or angioedema related to previous treatment with an ACE inhibitor.
• Hereditary or idiopathic angioedema.
• Concomitant use with Aliskiren in patients with diabetes.

Possible side effect

Clinical trials and post-marketing experience have reported the following adverse reactions. Not all patients will experience these effects.

• Common (>1/100): Cough, headache, dizziness, asthenia (weakness), vomiting, abdominal pain, rash, taste disturbance (dysgeusia).
• Uncommon (>1/1,000 to <1/100): Hypotension (including postural hypotension), mood disturbances, sleep disorder, paresthesia, visual disturbances, tinnitus, dyspnea, eosinophilia, pruritus, muscle cramps, impotence.
• Rare (>1/10,000 to <1/1,000): Angioedema (including laryngeal edema), syncope, myocardial infarction or stroke in susceptible patients (possibly related to excessive hypotension), bronchospasm, pancreatitis, hepatic enzyme elevations, hyponatremia.
• Very Rare (<1/10,000): Neutropenia/agranulocytosis, thrombocytopenia, hemolytic anemia, syndrome of inappropriate antidiuretic hormone secretion (SIADH).

Drug interaction

Concomitant use of Aceon with the following agents requires careful monitoring or is not recommended:

• Diuretics: Potentiation of hypotensive effect. Pre-existing diuretic use increases risk of first-dose hypotension.
• Potassium-Sparing Diuretics, Potassium Supplements, Salt Substitutes: Increased risk of hyperkalemia.
• Lithium: Reversible increases in serum lithium concentrations and toxicity. Monitor lithium levels closely.
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): May diminish the antihypertensive effect of ACE inhibitors and increase the risk of renal functional impairment.
• Aliskiren: Dual RAAS suppression is contraindicated in patients with diabetes and not recommended in patients with renal impairment (GFR <60 ml/min).
• Gold Injections: Nitritoid reactions (symptoms including facial flushing, nausea, vomiting, and hypotension) have been reported with concomitant use of sodium aurothiomalate.
• Oral Hypoglycemics and Insulin: ACE inhibitors may enhance the blood-glucose-lowering effect, increasing the risk of hypoglycemia.

Missed dose

If a dose is missed, it should be taken as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped. The patient should not take a double dose to make up for the missed one. Maintaining a consistent daily schedule is important for optimal blood pressure control.

Overdose

The most likely manifestation of an overdose is severe hypotension. Other signs may include bradycardia, circulatory shock, electrolyte disturbances, and renal failure. Management includes immediate placement of the patient in a supine position and aggressive volume expansion with normal intravenous saline. Perindoprilat, the active metabolite, may be removed from the body by hemodialysis. Vital signs, serum electrolytes, and creatinine levels should be monitored closely. Treatment is primarily supportive and symptomatic.

Storage

Store Aceon tablets at controlled room temperature, 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C and 30°C (59°F and 86°F). Keep the container tightly closed to protect from moisture and light. Keep all medications out of the reach of children and pets. Do not use after the expiration date printed on the bottle or blister pack.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided may not cover all possible uses, directions, precautions, drug interactions, or adverse effects.

Reviews

• “As a cardiologist with over two decades of experience, I have found Aceon (perindopril) to be a highly reliable and predictable agent in my antihypertensive arsenal. Its 24-hour efficacy and once-daily dosing support excellent patient adherence. I particularly value its role in patients with comorbid stable coronary artery disease.” – Dr. E. Lawson, MD, FACC
• “After trying two other medications with unsatisfactory side effects, my physician switched me to Aceon 4 mg. My blood pressure has been consistently within normal limits for the past 18 months. The only side effect I noticed was a slight dry cough for the first few weeks, which subsided completely.” – Patient, M, 58.
• “The clinical trial data for perindopril in vascular protection is robust. Its benefits extend beyond blood pressure reduction to improving vascular compliance and reducing atherosclerotic progression, making it a rational choice for long-term cardiovascular risk management.” – Clinical Pharmacologist, Research Institute.
• “Managing hypertension in our elderly population requires careful titration. Aceon’s range of available strengths allows for precise dosing. We initiate at 2 mg for our frail patients and see a favorable tolerability profile with effective control.” – Geriatric Specialist, RN.